Why Coronavirus Testing Is Falling Short in Many Schools Across the U.S.

Storms in California over the winter break decimated a million coronavirus testing kits that were intended to help schools screen returning students. Children in Seattle waited hours for virus testing. Some even in the rain. Broward County, Florida’s attempt to supply virus testing kits to teachers this month failed to deliver expired kits.

Chicago students were also kept out of school for a week due to a labor dispute. This dispute was partly over testing.

As millions of American students head back to their desks — Los Angeles, the nation’s second-largest school district, started classes on Tuesday — the coronavirus testing that was supposed to help keep classrooms open safely is itself being tested. In many parts of the country, things have not gone well.

Many districts have had difficulty establishing effective testing programs or ramping up the Omicron variant. This was due to political pressure, unclear federal guidance, and a shortage of rapid-test kit nationals. Schools have had to close in many areas in recent weeks due to infected teachers and children returning to school as a result of flawed screenings.

Most schools have maintained in-person instruction and, in many areas, transmission to classrooms has been lower than in other parts of the community. But parents’ anxieties and confrontations with teachers’ unions are jeopardizing the Biden administration’s efforts to prevent a return to remote instruction. Even districts with working testing programs are facing high costs that raise questions about their sustainability.

Burbio, a company that audits schools during the pandemic has shown that more than 5,400 schools switched to virtual learning. The issue, epidemiologists say, is not that testing does not work — particularly in combination with vaccination, face masks and other precautions. They claim that many districts are failing to properly test or bungling the execution.

“A lot of schools are just testing parts of their population once a week, or not using the tests strategically, or confusing surveillance with testing to suppress outbreaks,” said Dr. Michael J. Mina, a former Harvard University epidemiologist and a leading expert on rapid testing who is now the chief science officer for eMed, which authenticates at-home test results.

He described the result as an army going into battle without understanding its objectives or knowing how to use their weapons.

“You can throw all the guns and military personnel you want into a war zone, but if you don’t go in with strategy you’re never going to win,” Dr. Mina said.

Throughout the pandemic, testing — subsidized with billions of dollars in federal funding — has been viewed as a key way to keep children in classrooms and ease the toll of remote learning on emotional health and academic progress. But public health experts say few districts are testing enough, or strategically enough — particularly in the wake of Omicron.

Screenings that are meant to detect and isolate outbreaks need broad participation. However, many districts have refused to require students to take part in screenings, fearing backlash from the political right. P.C.R. is also used in many schools. These tests are useful in diagnosing the cases, but can expose schools to outbreaks while they wait for lab results.

Newer test-to-stay programs — which let exposed students remain in class as long as they test negative and do not have symptoms — also require intensive testing, but they rely on rapid antigen tests, which are in short supply nationally as soaring Omicron infections have spiked demand.

The lack of clear federal guidance on rapid tests has also been an issue, forcing “every school system to recreate the wheel,” Dr. Mina said.

Experts in health say that the result at many schools has been a mix of half-measures.

“Asking if school testing works is like asking if a dishwasher works — yes, it works, but only if you load the dishes,” said Meagan Fitzpatrick, an assistant professor at the University of Maryland School of Medicine who specializes in infectious disease modeling.

Seattle schools cancelled classes last week and held pop-up testing events for students and staff. This was done in an effort to prevent remote learning and to stop infectious people from entering schools. But only about 14,000 of the district’s 50,000 students and 7,800 employees showed up — with about one in 25 testing positive.

Monday saw two schools close due to staff shortages or infections. The district was also considering returning remote classes. David Giugliani is a parent of two and said he was thankful for the district’s efforts to protect schools. However, he was also anxious about the in-person learning process and the uncertainty. He also mentioned the four-hour wait to be tested. This was mostly indoors.

“I’d like greater confidence in what’s going to come next, but who has that?” he said.

Brenda Martinek (chief of student support services) said that only 27 percent of students in Portland, Ore., where Covid-related staff shortages led to the closure of two high schools. The school-based testing of vaccined teachers was not available until last week when district office staff, from secretaries to I.T. personnel, offered them school-based tests. P.C.R. tests were administered to employees at the department. Employees will be given the tests.

“I was in there, too, with my face shield and my mask and gloves, like, ‘OK, swab five times in one nostril, now swab five times in the other,’” she said. “I never thought I was a health care provider, but apparently I am.”

Some Republican-led states have decreased the importance of school testing or lagging in the distribution of stockpiles. Governor. Ron DeSantis said last week that unless their parents wanted it, children “do not need to be doing any crazy mitigation” such as wearing masks or testing. Broward County school employees who took advantage of a school district giveaway of 75,000 test found that some of them had passed their expiration dates.

Even in large urban areas, in heavily Democratic parts, effective testing has been limited. New York’s schools announced last week that they were doubling participation in their regular surveillance testing. But union officials noted that even at the expanded level, the optional screenings covered 20 percent of the district’s students at most.

Chicago schools received less than a third of the 150,000 re-entry home test kits that were mailed over winter break. Many of those that were returned were invalid. The district, which serves more than 300,000 students, shut down last week as teachers’ unions demanded more aggressive testing.

In California, the weather interrupted a Gov. Gavin Newsom to supply the state’s 1,000-plus districts with enough rapid tests to screen all six million-plus K-12 students for re-entry. According to state health authorities, one million of the 10 million rapid tests sent out to districts were destroyed by the rain.

Some districts are still leaning in.

Washington, D.C., where there are approximately 50,000 students, requires that every student returning to campus receive negative coronavirus test results. On Monday, district officials said they would also provide weekly rapid tests to students too young to be vaccinated and add unspecified “test-to-stay” provisions. District schools were present in large numbers this week.

And in Los Angeles, which since 2020 has had one of the nation’s most ambitious testing programs, masked parents with masked children in tow lined up for blocks at school sites for much of last week to undergo another free test, this one required for every student and teacher returning to campus.

“I do the swabs by myself now — it just feels like something is tickling my nose with a feather,” said Matthew Prado, 9, standing in line with his mother and little brother outside a school testing clinic in the working-class community of Wilmington near the Port of Los Angeles. “It’s just normal.”

The Los Angeles program demonstrates the importance of effective testing. Los Angeles Unified School District was the first to implement widespread school-based testing. The initiative — which encompasses more than 600,000 students and staffers — relies on P.C.R. SummerBio, a Bay Area start up, offered tests at a cost of $12 per test. SummerBio, a Bay Area startup, has created an automated system to reduce costs and speed up processing. The company is contractually bound to provide overnight results.

The district required all students and staff returning to school to take a baseline test before they could be allowed to attend in-person instruction. This strategy was effective in catching thousands of potential outbreaks, and it also alleviated labor safety concerns.

But even at its relatively low cost — the district’s cost per test is about half what the state negotiated for its tests with another vendor — Los Angeles Unified is spending about $5 million per week on coronavirus testing, said Nick Melvoin, the vice president of the school board.

“We were getting ready in November to pull back on testing because of the cost — then Omicron hit,” Mr. Melvoin said, noting that the arrival of vaccines had significantly reduced the number of cases and the risk of severe illness.

There were more than 400,000 tests taken in Los Angeles schools on Monday. The Omicron challenge was evident, at least for the short-term. Nearly 15% of the tests were positive.

Mike BakerContributed reporting