Duke University Pediatric Pulmonary Division and Fellowship Program, Department of Pediatrics, Duke University School of Medicine, Box 104013 DUMC, Durham, NC, 27710.
Doctor of Medicine Program, Duke University School of Medicine, Durham, NC, 27701.
J Sch Health. 2023 May;93(5):360-369. doi: 10.1111/josh.13283. Epub 2022 Nov 20.
Test-to-stay (TTS) is a strategy to limit school exclusion following an exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated the use of TTS within universally masked kindergarten through 12th grade (K-12) school settings following household SARS-CoV-2 exposure.
Three hundred twenty-two participants were enrolled. Serial rapid antigen testing was performed up to 15 days post-exposure. Analysis-eligible participants completed the 15-day testing protocol, tested positive any time during the testing window, or received a negative test on or after day 9. Primary outcomes included within-school tertiary attack rate (TAR) (test positivity among close contacts of positive TTS participants), and school days saved among TTS participants.
Seventy-three of 265 analysis-eligible participants tested positive for SARS-CoV-2 (secondary attack rate of 28% [95% CI: 16-63%]). Among 77 within-school close contacts, 2 were positive (TAR = 3% [95% CI: 1-5%]). Participant absences were limited to 338 days, resulting in 82% of 1849 school days saved.
IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: TTS facilitates continued in-person learning and can greatly reduce the number of missed school days.
Within universally masked K-12 schools, TTS is a safe alternative to school exclusion following household SARS-CoV-2 exposure.
Test-to-stay（TTS）是一种在接触严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）后限制学校隔离的策略。我们评估了在普遍戴口罩的幼儿园至 12 年级（K-12）学校环境中，在家庭接触 SARS-CoV-2 后使用 TTS 的情况。
共纳入 322 名参与者。在接触后最多进行 15 天的快速抗原检测。符合分析条件的参与者完成了 15 天的检测方案，在检测窗口期内任何时间检测呈阳性，或在第 9 天或之后检测呈阴性。主要结局包括校内三级攻击率（TAR）（TTS 参与者的密切接触者中检测呈阳性的比例）和 TTS 参与者节省的学校天数。
在 265 名符合分析条件的参与者中，73 名检测出 SARS-CoV-2 阳性（二级攻击率为 28%[95%CI：16-63%]）。在 77 名校内密切接触者中，有 2 人检测呈阳性（TAR 为 3%[95%CI：1-5%]）。参与者的缺勤仅限于 338 天，节省了 1849 个学校日中的 82%。
对学校卫生政策、实践和公平的影响：TTS 有利于继续进行面对面学习，并可以大大减少错过的学校天数。
在普遍戴口罩的 K-12 学校中，TTS 是家庭接触 SARS-CoV-2 后替代学校隔离的安全选择。
