In this report, we share insights from a national scan and more than 80 interviews with early adopters of COVID-19 testing in K-12 schools as of December 2020. We describe the characteristics of early adopter schools and districts and their varied approaches to testing. We provide concrete examples of key facilitators of feasible, acceptable, and effective COVID-19 testing. Through ten detailed profiles of schools, districts, and states that have implemented COVID-19 testing in the K-12 setting, we illustrate how these facilitators enabled schools to establish their testing programs.

The experiences of early adopters of COVID-19 testing during the fall 2020 semester show that, despite the absence of a comprehensive national K-12 testing strategy, testing can be effectively integrated into schools' COVID-19 response plans and can help families and staff feel comfortable participating in in-person instruction. However, even for well-resourced districts and schools, launching a COVID-19 screening testing program was a major undertaking that required access to rapid-turnaround tests, additional staffing or strong partners for logistical support, technical assistance for the design and execution of testing programs, and a strategy for successfully engaging the school community to participate in testing.

Based on these findings, we conclude with several recommendations for school and district leaders and for policymakers to support the implementation of school-based COVID-19 testing programs that can achieve their intended goals.

  1. To support feasible COVID-19 testing in schools, policymakers can expand federal and state funding and resources for testing in schools — facilitating schools' access to tests, as well as staffing and logistical support to administer tests; continue to streamline requirements (e.g., CLIA certification waivers) to reduce barriers for schools to implement testing; and convene learning networks to share promising practices.
  2. To support schools to make COVID-19 testing acceptable to their communities, policymakers can convey clear, consistent, and science-based messages around the risk of COVID-19 transmission in schools and how testing can help to mitigate that risk; provide incentives for teachers (e.g., paid sick leave) and families to be tested and to isolate if infected; and build on existing guidance to help school and district leaders design a testing approach that best meets their needs.
  3. To support schools to implement COVID-19 testing programs that achieve their intended goals, policymakers can enact policies to expand laboratory capacity and access to tests that return results rapidly; establish state and regional technical assistance networks for schools and districts; promote the use of standardized metrics and of robust data and reporting platforms to support decisionmaking; and provide resources to strengthen state and local public health departments, ensuring they are equipped to help schools and districts respond appropriately to positive tests.

This research was supported by The Rockefeller Foundation.

The research described in this report was supported by The Rockefeller Foundation and conducted by RAND Health Care and RAND Education and Labor.

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