OBJECTIVES: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related quarantines, which are required after close contact with infected individuals, have substantially disrupted kindergarten through 12th grade (K–12) in-person education. Recent recommendations allow for shortened durations of quarantine if negative SARS-CoV-2 testing is obtained at 5–7 days post-exposure, but access to testing remains limited. We hypothesized that providing access to in-school SARS-CoV-2 testing post-exposure would increase testing and reduce missed school days.

METHODS: This prospective cohort study was conducted in one large public K–12 school district in North Carolina and included two periods: pre-implementation (3/15/2021–4/21/2021) and post-implementation (4/22/2021–6/4/2021), defined around initiation of an in-school SARS-CoV-2 testing program that provided on-site access to testing. Number of quarantined students and staff, testing uptake, test results, and number of missed schooldays were analyzed and compared between the pre-implementation and post-implementation periods.

RESULTS: Twenty-four schools, including 12,251 in-person learners, participated in the study. During the pre-implementation period, 446 close contacts were quarantined for school-related exposures; 708 close contacts were quarantined after implementation. Testing uptake following school-related exposures increased from 6% to 40% (95% CI: 23% to 45%) after implementation, and 89% of tests were conducted in-school. After in-school testing implementation, close contacts missed (on average) 1.5 less days of school (95% CI: -2 to -1).

CONCLUSIONS: Providing access to in-school testing may be a worthwhile mechanism to increase testing uptake following in-school exposures and minimize missed days of in-person learning, thereby mitigating the pandemic’s ongoing impact on children.

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