RSF School approves new rapid COVID-19 testing of staff

The Rancho Santa Fe School board
The Rancho Santa Fe School board approved the use of antigen testing as another mitigation strategy.
(Karen Billing)

The Rancho Santa Fe School District will add rapid antigen testing as another tool in its COVID-19 prevention toolbox.

On Feb. 18, the board approved the use of free BinaxNow Antigen Tests for weekly asymptomatic testing of staff, response testing in the event that students and staff are exposed to a positive case, and symptomatic testing for staff and students.

BinaxNow, provided free by the California Department of Public Health, has also been piloted in the Coronado Unified School District. The testing adds another layer of safety to the district’s mitigation strategies that include facial coverings, distancing, stable cohorts and ventilation improvements.

“Adult to adult transmission is the greatest concern in spreading the virus and the antigen tests will be useful in increasing the frequency of staff testing,” Superintendent Donna Tripi said.

With parental consent, the district can also begin testing students who leave school with symptoms, enabling them to more quickly quarantine a class or cohort if the student is positive.

The district will also continue its monthly staff PCR testing through its partnership with UC San Diego Health—students also have access to the UCSD testing if they are symptomatic and for response testing.

The BinaxNow antigen tests, which detect specific proteins from the virus, are nasal swabs in which staff and students can swab themselves. The results are available within 15 minutes. PCR tests, molecular tests that detect the virus’s genetic material, have a turn-around time of 24 hours to up to 2-3 days depending on where the test was conducted.

“We’re only talking about doing what we already are doing right now, it’s just that we get to learn the results faster,” said board member John Tree.

“It is a really precious blessing that we have been able to be in school this full calendar year,” Tree continued. “I have so many friends across the county that aren’t in school, families are going through so much stress and depression and mental health issues that it just makes me more thankful that we have our school open.”

The board unanimously approved the symptomatic testing but President Kali Kim and board member Annette Ross voted against the use of the antigen tests for response testing. Kim also voted against asymptomatic testing for staff.

Since Rancho Santa Fe opened for five-day a week instruction in August, to date the district has had six students and five staff COVID-19 cases. All occurred during the December and January surge and no cases were contracted at school, nor was there any in-school transmission. Several classes have had to quarantine and move to online instruction.

Antigen tests have a lower sensitivity rate than PCR tests so more frequent testing is recommended. Originally designed to test symptomatic individuals, antigen tests are more likely to have a false negative than a PCR test but positive results are highly likely to be true positives and pick up those who are most infectious, Tripi said.

For the testing on site at R. Roger Rowe, eight RSF staff members have been trained. The school would need to receive a waiver to become a Clinical Lab Improvement Amendment (CLIA) site and individuals involved in the testing would need to wear gloves and masks as a minimum, with N95 masks, gloves, gowns and face shields recommended. The district has already provided N95 masks to staff but would need to purchase gowns, Tripi said.

As far as the time it would take to do the weekly testing, in the Coronado pilot, they are able to test 120 individuals per hour with six people.

“We think this is an opportunity that the school should take advantage of,” said Stacy Charat, speaking on behalf of the three physicians on the district’s Health and Hygiene committee. “It gives us potential in the future to use this in a variety of ways that may eventually be required or may be an increasingly recommended resource for schools that remain open, in addition to what the school has already done in such a successful way.”

According to the latest California Department of Public Health guidelines on reopening schools, student testing is not required and the science regarding the extent to which asymptomatic testing achieves the goal of safely re-opening schools is “still under development.”

As the testing contract was listed on the Feb. 18 agenda as “student testing,” during public comment several parents spoke out against the asymptomatic testing of students. Parents opposed to the testing said it was a waste of time and not effective; many noted that their pediatricians won’t even test their children without symptoms. Others had concerns about the impact that frequent testing could have on students.

“Our children have been through enough this past year without the added stressors of COVID-19 testing at school,” said parent Katie Crecian.

In her votes against antigen testing, Kim said she doubted the usefulness of asymptomatic testing and said while the tests may be free, there is a cost of staff time and resources, including the tracking and reporting of the tests administered.

“I feel like it’s overreacting because we have operated safely for half the school year,” Kim said. “It’s almost like putting on two masks. If one’s good, why not put on two? If two’s good why not put on three? Where do you draw the line?”

Kim said she has not seen the evidence for the virus spreading at schools and she believes that the district’s plan covers all of the essential elements of safe K-12 in-person instruction, in some cases going above and beyond the health guidelines.

“Testing can be useful for different environments but I don’t think Rancho Santa Fe falls into that environment,” Kim said. “The possibility of false negatives is just as dangerous as false positives and I think when you’re using antigen tests in response to an exposure I really do think it’s providing a false sense of security.”

Ross, too, struggled with the decision to approve testing, concerned that it would be like opening Pandora’s box—she said while it sounded like a good thing she feared it would lead to a place she does not want the district to go. She said what bothered her the most was the word “lab.”

“I don’t want the school to feel like it’s a testing site,” Ross said.

Board Vice President Jee Manghani said he understood the concern about opening Pandora’s box but he stated he is not in favor of surveillance testing and is also a strong advocate for parents making their own choices. He said he was in favor of the BinaxNow contract because it is for symptomatic testing they are doing already with PCR tests and asymptomatic testing for adults only.

“I think that speed and having another capability is worth this,” Tree said. “If (Superintendent Tripi) came here asking for a full approval to test everybody all the time whenever she felt like it, I think of course all five of us would vote that down right away.”

As an additional safety measure, the district offers families who are traveling or have exposure over break times the opportunity to quarantine their students and move to distance learning when they return from a break. A total of 90 students opted for that option after winter break and when students returned from Family Week on Feb. 18, 95 students opted to remain in distance learning.

“People are being very responsible and we are very grateful,” Tripi said.

The gratitude went both ways—when parents spoke out against testing, many prefaced their comments by sharing their appreciation that Rancho Santa Fe has been open when so many schools remain closed.

“I’m so grateful each day to pick up and drop my child at school,” said parent Michelle Crowley. “We have seen that the protocols are working. Our families are taking it seriously and they are doing their part.”