About COVID-19 School Testing
- Who is paying for tests in schools?
Washington State Department of Health (DOH) covers the costs for schools to conduct diagnostic and screening testing through funds received from the American Relief Package and the Centers for Disease Control and Prevention (CDC). These resources are available to all participating schools.
- Is my child required to get tested?
No. Participation is completely voluntary. Students’ opt-in (with parent/guardian consent) to participate in school-based testing if their school is offering it.
- If schools plan to provide on-site testing, how do they get tests?
Schools can reach out to Educational Service District (ESD) Coordinator with questions and next steps regarding testing supply. Supply ordering questions can also be sent to COVIDtestingsupport@doh.wa.gov for assistance. Schools will have access to free testing supplies that can be requested on the DOH ordering portal.
- What data will schools and health departments be collecting? How is privacy protected?
Throughout the process, all health information is kept private and confidential under the Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA). The school district must have a signed HIPAA Authorization Form for minors on file to implement the testing program. This step is required because the school will receive personal health information (PHI) about minors (students) from the laboratory.
A testing vendor may collect data such as demographics and parental/guardian consent. The vendor may provide summary reports to your school district, showing the total number of tests required, the percentage of tests completed, the positivity rate, and the total number of positives.
A few administrators and staff at your school district will be alerted if there is a positive test result. Staff members within the district will then look up individual test results and initiate outbreak procedures.
About the Tests
- What types of COVID-19 tests are available for schools to order?
Rapid antigen tests which are conducted onsite. OTC At-Home Antigen tests can be used at home or onsite. Schools can create their own policies around OTC test use and consult their local health jurisdiction (see DOH COVID-19 Self-testing Guidance for K-12 Schools for details).
- Are nasal swabs safe? Even with repeat testing?
Yes. Nasal swabs are completely safe, even when used often, such as with weekly testing. Learn more about the safety of nasal swabs, including common questions and answers.
- How should antigen testing supplies be disposed of at school? Are they considered hazardous waste?
No, used antigen testing supplies are not considered hazardous waste. Antigen test kits can be disposed of as regular garbage with the following caveat: make sure they are placed in a plastic-lined garbage can and that the plastic liner is tied shut prior to disposal. The garbage can should be placed where it can’t be inadvertently accessed by others.
Rapid antigen test electronic analyzers, such as the BD Veritor Test Analyzer, may be disposed of in general waste according to manufacturer instructions and any applicable municipal and/or local requirements for waste disposal.
Setting Up Your COVID-19 Testing Site
- How does a diagnostic testing program work?
Teachers, staff, and students, and possibly members of their households, who show any symptoms or have been exposed to COVID-19 will be referred to a testing site (potentially on school grounds).
Samples are usually collected via a shallow nasal swab for tests. Shallow nasal swabs are not the “brain tickler” type, or nasopharyngeal swab. The swab only enters half-an-inch into each nostril, makes some rotations, and is placed, swab-side down, in the collection tube. The FDA maintains a list of EUA-approved antigen tests, which includes links to the appropriate instructions for use (abbreviated “IFU”).
- What is a CLIA waiver/Medical Test Site (MTS) license? Do I need one?
If your school is providing rapid antigen testing onsite, a CLIA waiver/MTS license is required. See the Laboratory Quality Assurance page and The COVID-19 Self-Testing Guidance for Establishments for more information.
- Should we offer asymptomatic (a.k.a. screening) testing? Why or why not?
Asymptomatic testing is a screening testing strategy where people are tested regularly to catch infections in people who are not showing symptoms. To be effective, this strategy needs to be carried out frequently (up to twice a week, depending on the level of disease in the surrounding community) and have very high participation.
CDC no longer recommends routine screening testing in K-12 schools. There may be certain instances when screening testing may still be beneficial, such as during an outbreak or returning from school breaks. See DOH COVID-19 Guidance for K-12 Schools for more information on screening testing. Consult your LHJ for additional recommendations for screening testing and see DOH COVID-19 Guidance for K-12 Schools for more information.
Antigen tests, including over-the-counter tests, or pooled testing are generally best for screening because they are easily delivered at scale. Antigen tests can provide results in about 20 minutes.
- Where and when will the testing take place?
COVID-19 testing locations will vary by school district. Some districts put a test site at every school, while other districts use a centralized site that serves several schools. Test sites may operate continually or for a set time, such as for four hours every morning, over lunch hours, or Monday through Thursday. It is important to put the test sites at a location that has a separate entrance or is otherwise separated from the regular flows of students and staff. Your Educational Service District Coordinator can help you evaluate the best locations for your test sites. Some schools may offer over-the counter tests to students and staff to conduct testing off-site.
Staffing Your COVID-19 Testing Site
- Who can perform the COVID-19 test?
On May 11, 2023, after the federal public health emergency ended, the standing order that authorized the administration of point-of-care (POC) tests by non-medical staff expired. Moving forward, only registered nurses (RNs), RN-delegated staff, or RN-directed licensed practical nurses (LPNs) can perform POC tests onsite.
For schools without an RN, your best option may be to offer take-home OTC tests exclusively. Any staff member can hand out take-home OTC tests to students and staff for individual or self-administered use.
- What personal protective equipment (such as masks and gloves) do test administrators need to wear?
When you’re collecting a sample from a student, follow the DOH guidance by wearing an N95 mask or equivalent or higher-level respirator, eye protection, gloves, and a gown. Please also review the L&I guidance as schools are also required to follow their guidance as employers.
- What personal protective equipment (such as masks and gloves) do test observers need to wear?
When you’re supervising students as they self-administer sample collection, follow the CDC guidance. Use a clean set of gloves when you’re handing the swab to the student, staff, or family member to self-swab. Keep at least 6 feet of distance, because it is common for students to cough or sneeze during testing. Wear a well-fitting face mask. An N95 mask and eye protection are not necessary.
- Where can I get personal protective equipment (PPE)?
Washington Office of Superintendent of Public Instruction (OSPI), ESDs, and school districts are eligible to order PPE through the state in extraordinary emergent circumstances, such as when supplies are unavailable through regular supply chains, when shipping delays cause an insufficient level of PPE, and when urgent needs arise that cannot be addressed through other means.
How to get PPE:
- Requests for PPE from ESDs and school districts should be placed through the organization’s local emergency management agency.
- State agencies (such as OSPI) and federally recognized tribes may order directly through the Washington State Emergency Operations Center (SEOC).
- What results do I need to report? Who do I report them to?
Positive results from rapid antigen tests conducted at school must be reported to public health per Washington State law (WAC 246-101-101). Schools should use SimpleReport to report these test results. For more information on reporting test results, see COVID-19 Point-of-Care Test Reporting for K-12 Schools.
The WA DOH does not require schools to report positive cases that are identified through at-home tests. Schools are required to cooperate with their local health jurisdiction in their investigations of cases, outbreaks, and suspected outbreaks that may be associated with the school (WAC 246-101-420), which may include reporting positive cases.
All outbreaks, and suspected outbreaks in the school community must be reported to your local health jurisdiction in accordance with Washington State law (WAC 246-101-420). For additional information and the full COVID-19 outbreak definition for K-12 schools, see the Guidance to Prevent and Respond to COIVD-19 in K-12 Schools and Child Cares. Schools are encouraged to work with their local health jurisdiction to support COVID-19 mitigation strategies.
- What are the symptoms of COVID-19?
The CDC list of symptoms includes fever (over 100.4° F), cough, shortness of breath or difficulty breathing, new loss of taste or smell, fatigue, headache, muscle or body aches, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea (2 or more loose stools in 24 hours.)
- What if a student or staff member shows up to school with symptoms?
To mitigate potential risk of spreading the virus to others at school, a student or staff member who comes to school with COVID-19 symptoms should be asked to isolate at home and are recommended to test for COVID-19. Schools can use the COVID-19 Decision Tree for the General Public and Non-healthcare Settings to guide next steps, including how to handle exposure situations. Please also review the L&I guidance as schools are also required to follow their guidance as employers.
- What happens when a member of the school community tests positive? What about a negative test result?
Every outbreak or suspected outbreaks will be reported to your local health jurisdiction, and case investigation and contact tracing may be initiated to protect the community and prevent further transmission. Every positive test result from tests performed at school must be reported to the local health jurisdiction. There may be circumstances where contact tracing is required, such as during an outbreak. Talk to your local health jurisdiction for more details, and refer to the Guidance to Prevent and Respond to COVID-19 in K-12 Schools and Child Cares for information on COVID-19 mitigation strategies and outbreak response.
Your school district and local health jurisdiction may be able to refer you to resources that can help with paid sick leave, temporary unemployment insurance, grocery delivery, mental health support, and other services during isolation and quarantine. Check Care Connect Washington for more information.
Note: Take-home tests are also known as over-the-counter tests or OTC tests.
- How should take-home tests be used in schools?
Schools and child care providers may use and/or provide COVID-19 self-tests in a variety of ways, depending on whether the facility has a Medical Test Site/CLIA license. Take home tests can be used in the following ways:
- Diagnostic testing
- For those who have been exposed
- Testing onsite or sent home with families for true at-home testing, which can be useful for returning to school after break, for example.
For more information visit the DOH COVID-19 Self-testing Guidance for K-12 Schools.See this instructional video for using iHealth, an OTC test.
- Do schools need to report results for take-home tests?
OTC tests administered by schools, under a Medical Test Site/CLIA license, are considered point-of-care (POC) tests and must be reported as such through SimpleReport. Schools should not use SimpleReport to report OTC test results from students or staff who independently self-test at home. They should have the student, parent, or guardian follow the DOH COVID-19 Self-testing Guidance, which includes next steps after testing positive and options to report the result.
The COVID-19 Self-Testing Guidance for Establishments and the DOH POC Test Reporting page have more information. Any questions from test sites, or schools that are submitting data, should be directed to the Surveillance Outreach Unit at firstname.lastname@example.org.
- How should take-home tests be stored? Is there a temperature requirement?
Tests should be stored indoors in normal temperatures around 59-86°F. If a test is delivered in either hot or freezing temperatures, allow for the test kits to reach storage temperature by leaving it unopened at room temperature for two or more hours before use. Visit FDA’s At-home COVID-19 Diagnostic Tests: FAQ for more information.
- Can schools use expired rapid antigen tests?
The printed expiration date on your rapid antigen test may no longer be accurate. Tests may continue to receive new, extended expiration date extensions as additional performance data is made available to the FDA. The FDA maintains a list of authorized over-the-counter tests which has up-to-date details and shelf life of each test kit, by Lot Number (printed on the packaging).
On May 11, 2023, the Centers for Medicare and Medicaid Services issued a memorandum that ended the permission for laboratories to use expired COVID-19 tests. If your tests have expired, DOH recommends disposal of these tests once you have replenished your inventory with new non-expired tests. To order new tests, please reach out to your ESD coordinator or COVIDtestingsupport@doh.wa.gov for further assistance on next steps.