Health care access is a major concern in the Claremont section of the Bronx, where coronavirus positivity rates have outpaced citywide numbers.
Nearly three-quarters of the neighborhood’s elementary school, P.S. 55, have opted to learn from home full-time, with just 150 students attending in-person. Many parents believed they would be safer at home than at school in a neighborhood that was one of the hardest hit by the pandemic, said Luis Torres, the school’s principal. Three school closures since September due to positive cases among people in the building have stressed out families and educators.
But Torres is hoping a new rapid coronavirus testing option at his school will quell some anxiety and offer an extra layer of protection for students, families, and staff. His school is one of more than 90 elementary, middle, and high schools in the Bronx that will receive rapid COVID-19 diagnostic testing kits through a partnership with Montefiore Medical Center, on top of in-school testing already required weekly by the city. Though New York City’s middle and high schools remain closed, those campuses will be equipped with the new testing so that they’re ready when those buildings reopen.
Having this type of rapid, on-site testing is crucial since some families may otherwise avoid a clinic or a hospital, fearful it will expose them to others with the coronavirus, Torres said. (Hospitals and health clinics providing tests are taking precautions, such as mandating socially distanced lines and masks in waiting rooms.)
“It feels safer doing it within the school” where there are no long lines or waiting rooms, Torres said. “It would give us a greater sense of security knowing where the cases are, if there are cases in the building or not. It would make people feel a little bit more safer.”
These tests differ from the weekly testing conducted at all of the city’s reopened campuses, which target a random sample of students and staff displaying no symptoms and take up to three days to process. The rapid tests at Montefiore’s 31 partner campuses will be given to children who are attending in person and feel sick during the school day. Medical professionals from the school-based health clinic — which typically provide a range of medical services to students, such as dental and visual screenings, free-of-cost for children regardless of insurance — will administer the tests. Results are expected within 40 minutes, according to Montefiore officials.
Removing barriers to health access
Torres said that such on-site testing also removes barriers, such as travel and time constraints, that can be a burden for many P.S. 55 students, nearly all of whom are from low-income families. The neighborhood and the Bronx as a whole, which have been particularly affected by the pandemic, have long suffered from health access problems. Compared to the citywide average, the area had twice the number of children visiting emergency rooms for asthma, twice as many mothers who had late or no prenatal care, and where 15% of adults who go without needed medical care, compared to 12% Bronxwide and 10% citywide, according to health department data from 2018.
Montefiore officials already use these specific testing kits in their hospitals, said Dr. Michele St. Louis, director of the medical division for Montefiore’s School Health Program. Originally, program officials had planned to use similar testing to conduct rapid flu tests at the schools. But the testing company, Cepheid, created a new test that received emergency federal approval in September that tests for the flu and Respiratory Syncytial Virus (RSV), as well as for the coronavirus, all in one swab.
The rollout will take some time, as the hospital is in the process of setting the machines up at their school-based health clinics, St. Louis said. As of Monday, roughly half of its campuses were ready, and St. Louis expects all designated schools to be equipped by March.
St. Louis said she’s not expecting a lot of testing to happen since it’s only for children who may have symptoms while they’re in school. (Students who feel sick before arriving to the building are asked to stay home.) But for those who do get tested, families will have a much clearer idea of what their next steps should be, St. Louis said.
Since Montefiore began rolling out the new tests in mid-December, five students who felt sick at school have been tested, all with negative results.
Importantly, Montefiore officials said, this meant those families did not have to find a testing site or begin quarantining out of precaution until they were tested somewhere else. That also cuts the waiting game for school officials who have to contact the city’s Situation Room, which is the response team charged with investigating coronavirus cases at schools and determining building closures. Many schools have complained about long response times and unclear communications from the Situation Room. (Two unlinked positive cases can close down a school building.)
‘Exciting’ added layer of protection
Dr. Amanda Castel, professor of epidemiology at the Milken Institute of Public Health at George Washington University, said this sort of testing inside schools is “exciting” because it’s another layer of protection for students and staff.
“Being able to get results back in 40 minutes, versus two days or however long it would take, is certainly going to facilitate our ability to stop the spread of the virus,” Castel said, noting that the PCR testing they’re using is more accurate than rapid antigen testing. (The specific tests that Montefiore will use had a 98% accuracy rate for the coronavirus, the company reported, based on their analysis of 240 nasal swab samples.)
Castel also emphasized that schools are relatively safe when they take proper coronavirus precautions. Recent studies show that schools may be less likely to spread the coronavirus if the rates in the surrounding community are low.
“They’ve been shown to be safe when they reopen when they have certain prevention measures in place such as masks, social distancing, cohorting of students, increased ventilation,” Castel said.
The quick turnaround on the tests is especially important for his community, Torres said.
Of the five boroughs, the Bronx has the highest coronavirus positivity rate, and it was rising at a higher rate than the city. As of Friday, the borough had a 10.14% positivity average over the past week, compared to the city’s 7.63%, according to city testing data. Rates have slowly begun to drop this month.
At first there was “a lot of frustration,” with classroom and school closures, Torres said.
“But now it’s almost expected because it’s such a normal thing now, because it’s constant school closures in the community I serve,” Torres said, adding that some of their parents’ employers have become more flexible given the number of disruptions to in-person school.
Torres recalls at least four times where a child felt sick at school and had to be isolated before a relative had to pick them up. Having this testing in school “skips a step, so we don’t have to wait for results to know what’s going on.”
Education department officials said sponsors of school-based health clinics must apply to the state to perform tests in schools. Along with Montefiore, others including NYU/Langone, Northwell/LIJ, and Sinai High School Program have also received state approval to be testing providers.
Nathaniel Styer, a spokesperson for the department, said they “encourage” sponsors like Montefiore to apply to provide testing “because every test performed helps keep our schools and communities healthy.”
St. Louis said that she expects the tests to remain in schools for the foreseeable future. There will be many families who don’t choose to get vaccinated, she said, and because of that it will be important to have some sort of testing capacity in place. Public health experts have said that until large swaths of the population are vaccinated and community virus rates go down significantly, schools will still need to require mask wearing and social distancing.
“It’s important to get more tests out there,” St. Louis said. “The more we have out there, the more we can learn, the more we can prevent outbreaks.”