Every Wednesday in the Yukon River village of St. Mary’s, the 175 students and staff at the elementary school line up in the hallways for COVID-19 tests. The next day, the process repeats at the high school.
“We have markers where they are to stand, so we’re still practicing social distancing,” Superintendent Dee Dee Ivanoff, who helps with the testing, said in a phone interview. “Even when you get down to kindergarten age and preschool age, they know exactly what to do.”
The weekly process, relying on rapid antigen tests, takes just an hour. So far, St. Mary’s has not seen a single positive test among its 270 students and staff.
At least two other Alaska school districts, in Juneau and Kodiak, are instituting similar programs, known as screening testing, though they’re testing a smaller share of students and staff.
The Centers for Disease Control and Prevention says that such testing can get asymptomatic but contagious COVID-19 cases out of schools more quickly, and is particularly valuable in areas with high transmission — a label that currently applies to the entire state of Alaska. One scientific model found that mass testing of students could cut cases by more than half, in schools where masks are required, and vaccination and prior infection rates are low.
But in Alaska’s four largest road system school districts — in Anchorage, Fairbanks, the Mat-Su and the Kenai Peninsula — mass screening hasn’t been possible.
In Anchorage, district officials chose not to apply to a $5.5 million grant that could have helped pay for mass testing, saying implementing it would have created unrealistic expectations for administrators and staff. Officials from other districts also said they’re struggling to manage testing just for the far smaller number of students showing symptoms of the virus.
“There’s emotion behind that answer, and it’s an overwhelmed emotion,” said Wendy DeGraffenried, a Mat-Su school nurse who also works as a consultant on school testing for the state health department. “That’s what everyone is contending with: How do we do it? Even if we have the tools, even if we take the money, how do we do it?”
“Testing can make a difference”
With students returning to classrooms amid one of Alaska’s largest spikes in COVID-19, schools have become a focus in the fight against the coronavirus.
Officials say that the most important protection against transmission there is vaccination, followed by masking. But Anchorage, Fairbanks, the Kenai Peninsula and Mat-Su all rank in the bottom half of the state’s regions for their vaccination rates, and only in Anchorage schools are masks required.
“Particularly when you aren’t doing those things, testing can make a difference,” Dr. Anne Zink, Alaska’s chief medical officer, told reporters last week.
Zink cited the model by a CDC-funded lab that predicts sharp differences in classroom infection rates between schools that are and aren’t doing mass testing. If masks are required and vaccination and prior infection rates are low — protecting roughly 30% of students — then 49% of students are expected to get COVID-19 over the course of a semester.
Weekly testing of half of students reduces that number to 22%, said the study, which has not yet been peer-reviewed.
St. Mary’s may be the only Alaska school district testing something close to that share of its student body. It’s been running the program since last year, using free tests from both its regional tribal health care provider and the state, which has offered supplies to school districts around the state.
In Juneau, schools have been offering weekly voluntary testing for staff since the spring, and will continue doing so with the help of a $660,000 state grant, said Kristin Bartlett, the district’s chief of staff.
High school students participating in activities, like sports, have been required to take weekly tests, though vaccinated students can now opt out. That program is now being expanded to middle school athletes and coaches, Bartlett said.
The testing has only turned up a couple of COVID-19 cases, but it’s given officials peace of mind that their other protective measures, like masking, are effective, Bartlett added.
“I don’t think there’s any way we could have had a wrestling program last spring without being able to test students and have some kind of confidence that we weren’t putting them in an unsafe environment,” she said. “It’s absolutely been worth it. And that’s why we’re trying to expand it.”
In Kodiak, meanwhile, the school district is also using supplies from the state to launch optional weekly screening testing for students, with a focus on those who are unvaccinated. Teachers have been educating parents about the program at conferences at the start of the year, officials said.
“Do the math”
Larger districts outside Alaska have found ways to make screening testing work.
In Utah, schools are required to conduct mass testing to avoid moving to online learning when COVID cases rise above a certain threshold. And in Maine, many schools are doing pooled testing, where multiple samples are combined into one test, with individual follow-ups in the event of positives.
But one theme among the Alaska districts that have successfully launched screening tests is that they’re all relatively small, with enrollments of fewer than 5,000 students. The four road system school districts that aren’t currently screening all have substantially more — Kenai had more than 8,500 students last year, while Anchorage has 43,000, plus another 6,000 employees, compared to a staff of 100 nurses.
“Do the math: You’ve got every nurse doing some 490 surveillance tests of everybody in the district a week. You can’t do it,” Tom Roth, the Anchorage district’s chief operating officer, said. “It’s not just doing the testing. It is processing the samples, receiving the data, inputting it, making phone calls. It’s physically impossible to do that.”
Screening testing is a “great idea,” Roth said, but he added that an agency outside the district would have to lead the effort.
State officials point to the grant that Anchorage School District officials did not to apply for.
The money could have paid for staff, testing kits, or even contracted testing companies, according to a state health department presentation. Nearly two-dozen districts around the state applied for the grants, while four decided not to, according to state data.
Anchorage officials said they gave the grant “careful review” but found it would “bind Anchorage School District with expectations that it is unable to meet, including the administrative lift and staffing required to fulfill the grant.”
“ASD continues to explore options to implement screening testing programs as a way to promptly identify cases, clusters, and outbreaks,” spokeswoman Lisa Miller wrote in an email.
In the Mat-Su, the district surveyed parents during online registration about their openness to random screening testing, and it could explore such a program in the future. But officials’ current focus is on testing symptomatic students and staff, said spokeswoman Jillian Morrissey.
Officials in Fairbanks and the Kenai Peninsula also said those districts are already busy keeping up with demand for symptomatic testing.
“Demand has peaked so much that we are struggling a little bit,” said Kate LaPlaunt, an assistant superintendent in Fairbanks. “Our first commitment is to provide the testing we’ve already said that we want to offer.”
LaPlaunt said she can see “a lot of value” in considering mass screening testing. But she also noted that it can be a tricky topic to broach with parents.
“I think in this community, we wanted to be really respectful of parents’ right to choose things for their kids and not impose things,” she said. “Testing children is something that parents feel very strongly about.”
Alaska Public Media reporter Mayowa Aina contributed reporting.