COVID Testing In Our Schools: A Review of a Review
SARS-CoV-2 has ripped through our country, infecting nearly 9 million and claiming the lives of over 228-thousand people (Hopkins, 2020). This enduring test of medical and technological strength has strained nearly every corner of the earth, and while we wait for vaccine approval and distribution, studies have provided evidence that four populations have disproportionately suffered: women (Alon et al., 2020), minorities (Tai et al., 2020), seniors (Liu et al., 2020), and children (Moore et al., 2020). These studies provided evidence that women are hurting economically; ethnic minorities have a higher risk of morbidity and mortality than their white counterparts; seniors have an increased risk of death when infected; and children are missing out on play, a main staple for psychosocial, social, and physical health. Although women, minorities, and the elderly population are affected unjustly, children depend on their adult counterparts. In order to make the right choices, we as guardians of our youth should do everything we can with the technology we have to optimize our children’s growth and childhood experiences.
A commentary piece, by Michelle Mello, Stanford law professor and world-class expert in health law, and Yasmin Rafiei, Stanford medical student, Rhodes Scholar, and advisor to Canada’s COVID-19 Task Force, beseeches us all to proactively test and send our children back to school (2020). Rafiei and Mello (2020) begin with the bold COVID testing by Los Angeles Unified School District (LAUSD) — wherein, LAUSD has been testing nearly 40,000 students and faculty a day. This is in contrast with most school policies that track symptoms, a strategy that has been shown to be ineffective in preventing spread of the pandemic. Evidence suggests that about half of transmissions are by asymptomatic patients, and about two out of five patients are asymptomatic (Rafiei & Mello, 2020). Thus, symptom tracking is not a sufficient modality to protect our children.
Rafiei and Mello (2020) lay out three major challenges to school testing: cost, lag-time, and quarantine procedures…
Cost is a prohibitive factor, since many schools do not have the sufficient funds for testing, the price of the average test is from $50 to $200, and federal funds are restricted to diagnosing patients, not screening.
Rapid testing is limited across the country — a survey mentioned in the review (Rafiei & Mello, 2020) showed that only 26% of Americans receive their test result within one day. Considering that an individual can be exposed and infected within a matter of 2 days (Lauer et al., 2020), it is vital that tests come back within a day.
Quarantine procedures are complex and often rigid. Rafiei and Mello (2020) mention that a high school in Georgia had to quarantine 450 students after 25 students tested positive, one-fourth of their entire school. Measures like these are necessary but Draconian.
Long-term studies have not been conducted for online learning, but the mere lack of social connection and play between children and adolescents is at least a strain on the child and their parents, who have to carry out double-duties, and ensure that children are being sufficiently enriched. Rafiei and Mello (2020) call the federal government, who (our senate) recently rushed the replacement of supreme court justice Ruth Bader Ginsburg, a champion for gender equality, instead of passing a $2.2 trillion stimulus, of which $75 billion would be for increased national testing and contact tracing (H.R. 6800, 2020). One test mentioned by Rafiei and Mello (2020) is an open-source and cost effective test ($4) that uses saliva. Federal money could also be used for developing such tests, as threats of an endemic season or another pandemic could loom in the coming years and decades. With the collective expertise in the fields of Medicine and Science, our world can revolutionize how we handle communicable diseases for good, so that our children can play and grow up without the threat of spreading novel disease.
References
Alon, T. M., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M. (2020). The impact of COVID-19 on gender equality (No. w26947). National Bureau of Economic Research.
Johns Hopkins. CSSE Coronavirus COVID-19 Global Cases (dashboard). https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 (Links to an external site.)
The Heroes Act. H.R. 6800, 116th Cong. (2020) https://www.congress.gov/bill/116th-congress/house-bill/6800/text (Links to an external site.). Accessed October 30, 2020.
Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R., … & Lessler, J. (2020). The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Annals of internal medicine, 172(9), 577–582. https://doi.org/10.7326/M20-0504 (Links to an external site.)
Liu, K., Chen, Y., Lin, R., & Han, K. (2020). Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. Journal of Infection. https://doi.org/10.1016/j.jinf.2020.03.005 (Links to an external site.)
Moore, S. A., Faulkner, G., Rhodes, R. E., Brussoni, M., Chulak-Bozzer, T., Ferguson, L. J., … & Tremblay, M. S. (2020). Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 1–11. https://doi.org/10.1186/s12966-020-00987-8 (Links to an external site.)
Rafiei, Y., & Mello, M. M. (2020). The Missing Piece — SARS-CoV-2 Testing and School Reopening. New England Journal of Medicine. https://doi.org/10.1056/NEJMp2028209 (Links to an external site.)
Tai, D. B. G., Shah, A., Doubeni, C. A., Sia, I. G., & Wieland, M. L. (2020). The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciaa815
