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Consider This: Why screen for COVID-19 in the schools?

This week, Harvard became one of the first public school districts in the nation to institute free, voluntary, weekly COVID-19 screening for all in-person faculty, staff, and students. While this program is freely available to everyone in those categories regardless of their financial situation, it is not without significant cost. Meanwhile, our schools have remained open since September without a single documented cluster of COVID-19 cases. Why, you might ask, should we bother screening?

Screening is the only way we can find and quarantine people without symptoms. 

According to Medscape, an online resource for clinicians, people with COVID-19 can be infectious for two to three days before they show symptoms. In addition, up to 50% of children and 20% of adults infected with COVID-19 never show any symptoms at all. The CDC estimates that more than 50% of transmission comes from people who aren’t showing symptoms. We can’t find these people unless we screen for them.

The prevalence of COVID-19 in schools reflects its prevalence in the community. 

According to the state’s weekly health report on COVID-19, over the course of the week ending Sept. 23, 2020, central Massachusetts saw 30 new cases per 100,000 people. During the week ending Dec. 20, that same region saw 498 new cases. Harvard’s successful autumn doesn’t guarantee a successful winter and spring.

Screening in the schools is a way to prevent the spread of disease in the whole town.

Any COVID-19 cases we are able to find and isolate are cases that can be prevented from spreading further in the community.

Screening data could help the schools maximize in-person learning. 

If we are testing the majority of people in the schools each week, the administration and School Committee may be able to rethink the current broad-based policy for responding to COVID-19 cases. For example, we may be able to move to a policy under which discovery of a small cluster of cases in one grade causes only that grade and associated siblings to move to remote learning, rather than the entire school.

Screening gives peace of mind to our teachers and other school staff. 

These people have been tirelessly working for our children under extraordinarily challenging conditions. They have been potentially putting themselves and their families in harm’s way four days a week for months. Providing them with periodic reassurance that they have not contracted the coronavirus—and that their students have recently tested negative—is one way we can thank them.


For more information about the COVID-Safe Schools program and to donate to the project, go to covidsafeschools.org. All donations are being collected by the Harvard Schools Trust and are tax-deductible.

Screening is not a magic bullet. A negative COVID-19 test in school on Monday doesn’t prevent exposure in school on Tuesday. That’s why all the other elements of prevention—in particular masking, distancing, ventilation, and hand hygiene—will remain critical until we’ve all been vaccinated.

Virologist Ian Mackay of the University of Queensland, Brisbane, Australia, has created probably the best analogy: the “Swiss Cheese Respiratory Pandemic Defense.” In his model, each individual anti-COVID-19 measure is equivalent to a single slice of Swiss cheese. It has holes. But stack up those slices in a pile, and the solid areas in one slice cover the holes in another. Together, they form a solid barrier.

Screening is a critical slice of the Swiss cheese pile for our schools, and it’s been missing for far too long. Now, as COVID-19 cases are rising around us, we are thrilled and relieved that we’re finally able to put this program in motion. We are hopeful that it will help to make everyone in town safer as we face this pandemic winter together.

Liz Ruark and Toby Bazarnick are co-chairs of the COVID-Safe Schools program. Ruark is the founder of covidsafeschools.org.

COVID-Safe Schools FAQ

Will screening for COVID-19 remove the need to wear masks and social distance at school?

No. Maintaining social distancing and wearing personal protective equipment both within and outside of school are central to keeping everyone safe.

How will patient privacy be maintained?

The lab will receive no personal information at all. All samples will be labeled with a bar code. The school nurse or their designee would be the only one with access to the database linking the bar codes with specific individuals.

Will COVID-19 screening be mandatory?

No, but the vast majority of faculty, staff, and families have indicated that they will participate. According to epidemiologists, any amount of testing is hugely helpful.

How often will screening happen?

Screening will happen once a week as long as funding continues to be available.

How much will screening cost?

The cost of testing is $10.50 per person, with COVID-Safe Schools organizing the effort, and the school system paying for the tests with local grants and donations. (Most testing runs between $30 and $150 per person and requires long wait times both to be swabbed and to receive results.) The total cost for the rest of the school year will be $250 per person.

How will screening be paid for?

This program is being funded by donations from businesses, foundations, and by matching donations from individuals’ employers.

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