Early Insights and Recommendations for Implementing a COVID-19 Antigen Testing Program in K-12 Schools: Lessons Learned from Six Pilot Sites

The COVID-19 pandemic has forced many students across the United States to begin the 2020 school year online. Experts estimate the impact on students’ learning to be significant, with long-term learning losses that potentially shape children’s educations for years to come. Therefore, it is critical to identify strategies to keep schools open in a safe way that minimizes the risk of outbreaks. With this goal in mind, the Rockefeller Foundation partnered with Duke-Margolis Center for Health Policy, Johns Hopkins University, and schools in six sites to pilot the implementation of COVID-19 testing in schools based on the foundation’s Risk Assessment and Testing Protocols for Reducing SARS-CoV-2 Transmission in Selected K-12 Schools. The foundation engaged Mathematica as a learning partner for this effort to better understand and generate evidence about the acceptability, feasibility, and effectiveness of adding a testing program to schools’ existing COVID-19-related plans. All pilot sites began designing and planning their testing programs in October 2020 and began to mobilize and set up the resources necessary to implement them shortly thereafter. Already, pilot sites have generated key insights to inform schools and districts across the country on how to implement point-of-care antigen testing in K–12 school settings.

This report discusses early learnings and recommendations generated by pilot sites in their first four months of planning and implementing testing programs based on a review of sites’ documentation; key informant interviews; and agent-based modeling, a statistical modeling approach used to examine the effectiveness of testing programs on in-school infections and in-person learning. The early insights and recommendations in this report reflect the experience of several pilot sites captured at a relatively early stage in testing implementation. A future report will update the findings as pilot sites continue to refine their testing plans and conduct testing in their schools and as they are able to supply the data required for additional agent-based modeling work.