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What Missouri Schools Learned The Hard Way About Rapid Covid Testing

Updated: Feb 7, 2023

Original article written by Rachana Pradhan for NBC News.

Early in the tumultuous 2020-21 school year, Missouri officials made a big gamble: They set aside about 1 million rapid Covid tests for the state’s K-12 schools in hope of quickly identifying sick students or staff members.

What began as an ambitious plan landed with a thud. Missouri’s effort is a window into the complexities of Covid testing in K-12 schools, even before the highly transmissible delta variant of the coronavirus surged through.

The spread of the delta variant has mired communities in emotional fights about how to safely send children — most of whom are unvaccinated — back to classrooms, particularly in states like Missouri, which has been bedeviled by a high aversion to mask mandates and low vaccination rates. As classes begin, once again schools must weigh testing and other strategies to limit Covid-19’s spread — potentially without a deep supply of test kits available.

Missouri educators described the testing, which began in October, as a blessing for having rooted out infected people and given teachers peace of mind. But its logistical challenges quickly became clear, according to interviews and documents obtained by KHN.

Dozens of schools or districts that applied for rapid tests listed just one health care professional to administer them. The rapid tests initially were set to expire after six months, so officials were reluctant to order too many. And some worried that the tests would deliver inaccurate results or that on-site testing of people with Covid symptoms might spread infection.

“We were nervous” about sick kids’ being on campus, said Kelly Garrett, executive director of KIPP St. Louis, a charter school with 2,800 students and 300 staffers. Elementary school students returned in November. It reserved its 120 tests for “emergency” situations.

Molly Ticknor, executive director of the Show-Me School-Based Health Alliance of Missouri, which focuses on access to health services at school, said, “Many of our school districts don’t have capacity to store the tests, to manage the testing.”

Missouri is establishing a program for K-12 schools to regularly test people without symptoms, relying on a contract with the biotech company Ginkgo Bioworks, which provides testing materials, training and staffing. As of mid-August, only 19 institutions had expressed interest, said Lisa Cox, spokesperson for the state Department of Health and Senior Services.

Unlike Covid tests that use a polymerase chain reaction technique, which can take days to deliver results, rapid antigen tests return results within minutes. The trade-off: Studies have shown they are less accurate.

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