Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA.
J Sch Health. 2023 Oct;93(10):877-882. doi: 10.1111/josh.13357. Epub 2023 Jun 4.
Per Centers for Disease Control and Prevention guidance, students with COVID-19 may end isolation after 5 days if symptoms are improving; some individuals may still be contagious. Rapid antigen testing identifies possibly infectious virus. We report on a test-to-return (TTR) program in a Massachusetts school district to inform policy decisions about return to school after COVID-19.
During the 2021-2022 Omicron BA.1 surge, students with COVID-19 could return on day 6-10 if they met symptom criteria and had a negative rapid test; students with positive rapid tests and those who declined TTR remained isolated until day 11. TTR positivity rates were compared by grade level, vaccination status, symptom status, and day of infection.
31.4% of students had a positive TTR rapid test; there were no differences by grade or vaccination status. Ever-symptomatic students were more likely to have a positive rapid test (75/174 [43.1%] vs 18/104 [17.3%]). For ever-symptomatic students, TTR positivity decreased by day of infection.
A substantial proportion of students may still be contagious 6 days after onset of COVID-19 infection. TTR programs may increase or reduce missed school days, depending on when return is otherwise allowed (day 6 or 11). The impact of TTR programs on school-associated transmission remains unknown.
根据疾病控制与预防中心的指导意见，如果 COVID-19 患者的症状有所改善，他们可以在 5 天后结束隔离；但部分患者仍可能具有传染性。快速抗原检测可识别出可能具有传染性的病毒。我们报告了马萨诸塞州一个学区的测试后返校（TTR）计划，该计划旨在为 COVID-19 后返校的政策决策提供信息。
在 2021-2022 年奥密克戎 BA.1 激增期间，如果 COVID-19 患者符合症状标准且快速检测结果为阴性，他们可以在第 6-10 天返校；如果快速检测结果呈阳性或拒绝 TTR 的学生，他们将继续隔离，直到第 11 天。按年级、疫苗接种状况、症状状况和感染日比较 TTR 阳性率。
31.4%的学生 TTR 快速检测呈阳性；年级或疫苗接种状况无差异。持续出现症状的学生更有可能快速检测呈阳性（174 名中有 75 名[43.1%]，而 104 名中有 18 名[17.3%]）。对于持续出现症状的学生，TTR 阳性率随感染日的推移而降低。
相当一部分 COVID-19 患者在感染后 6 天仍可能具有传染性。TTR 计划可能会增加或减少缺课天数，具体取决于返校的时间（第 6 天或第 11 天）。TTR 计划对学校相关传播的影响仍不清楚。
