What is Test-To-Stay and is NC considering it?

CDC has included Test-To-Stay (TTS) in updated K-12 school guidance

In a media statement issued Dec. 17, the Centers for Disease Control (CDC) acknowledged adding Test-To-Stay (TTS) protocols to K-12 school guidance.

TTS allows a student who has had close contact with staff or a student who has tested positive for COVID-19 to remain in school during the typical quarantine period through the use of contact tracing and serial testing. The CDC defines serial testing as testing that is repeated at least twice during a seven-day period post-exposure.

“Initial investigations in K-12 schools implementing TTS with layered prevention strategies demonstrated low SARS-CoV-2 transmission in the school setting,” the CDC says in its Dec. 17 Science Brief.

The discussion of TTS on the CDC’s updated “What you should know” guidance page for K-12 schools states, “Because fully vaccinated close contacts are not required to quarantine following exposure, they would not be included in Test to Stay.”

Excluding the vaccinated in TTS creates an obvious problem with concept integrity and data validity given the increasing number of breakthrough cases in vaccinated persons and, in some cases, even those having received booster shots.

At a Dec. 20 COVID briefing held by N.C. Governor Roy Cooper, N.C. Department of Health and Human Services’ (NCDHHS) outgoing Secretary Mandy Cohen said to expect a “record number” of cases in the coming weeks, that 10,000 cases a week was possible from Omicron.

Cohen did add that Omicron cases appear to be “mild” or even asymptomatic with rare hospitalization.

Incoming interim NCDHHS Secretary Cody Kinsley contradicted Cohen, stating that they are “preparing for mass hospitalizations” and are upping vaccination sites, home testing kit availability, and are encouraging everyone eligible to get boosters.

Cohen acknowledged they were “looking at” TTS as a possible option to be added to the StrongSchoolsNC Toolkit.

The toolkit’s quarantining of healthy children during the current 2021-22 school year has been a bone of contention between NCDHHS and parents, but also school district administrators and school boards.

Cohen threatened Union County Public Schools with legal action after the district had questioned dropping the contact tracing and quarantine measures. In challenging the process, the district had exposed both issues with lack of authority and resource related to the toolkit’s quarantine rules.

Union County school board members and county commissioners would pass a resolution calling on the state to end quarantine and contract tracing on Dec. 7. That same day, Cohen would be scrutinized by lawmakers over the Union County threat and quarantining during a hearing on COVID response and funding.

Cohen said that “If kids are vaccinated, they don’t need to quarantine. If they are wearing masks, they don’t need to quarantine.” She added that schools “need to be using quarantine as a last resort.”

The outgoing NCDHHS secretary was asked by at least three legislators, one of which represented Union County, if the toolkit was a “recommendation, a law, or simply a suggestion.” Each time, Cohen evaded answering but at least once described the toolkit as a “guideline.” The document describes itself as “Interim Guidance.”

When asked what was “the offramp” for ending the use of the toolkit, Cohen’s answer wandered a bit across process and procedure, but ultimately was a refusal to commit to shuttering the toolkit in the future. Cohen’s interim successor has not yet been asked the same question.

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