Types of Tests
Testing Program: What to Expect?
Safety & Privacy
Is testing free?
Yes! Testing is free. There are no out-of-pocket costs or co-pays for schools or families. The Washington State Department of Health (DOH) covers costs for school-based diagnostic and screening tests with funds received from the American Relief Package and the Centers for Disease Control and Prevention (CDC). Free, school-based testing for COVID-19 is available to all participating schools through July 2023.
If testing is free, why is insurance billed?
COVID-19 testing is free to your school community, but that doesn’t mean the lab is processing it for free. Some labs can bill insurance, which means we can stretch our public funds to serve more people. But if a patient doesn’t have insurance, or refuses to give it, they can still get tested at no cost.
Do rapid antigen tests detect COVID-19 variants?
Yes. Research has shown that SARS-CoV-2 variants can still be detected with commercially available rapid antigen tests.
Additionally, the FDA tracks whether tests can still pick up on those variants. To date, the FDA has not found any commercially available tests that fail to detect SARS-CoV-2 variants. You can trust your test to be able to pick up COVID-19 even with different variants.
If you have COVID-19 symptoms and get a negative result on your COVID-19 rapid antigen test, DOH and test manufacturers recommend repeating the test to lower the chances of a false negative test result since the test may not always detect the virus in the early stages. See DOH’s COVID-19 Self-Testing Guidance for more details.
Why is our school participating in this COVID-19 testing program?
COVID-19 testing for K-12 schools is one of our best defenses against outbreaks and school closures. School-based testing helps quickly identify cases and prevents further spread of the disease within the school community. We believe that safe, full-time, in-person learning is a top priority for our communities – it’s better for students, it’s better for teachers, and it helps parents and caregivers get back to work.
Is my child required to get tested?
No. Participation in Learn to Return is completely voluntary. Students opt-in (with parental consent) to participate in school-based testing if their school is offering it. While COVID-19 testing is voluntary, in some circumstances, like coming back to school after isolation, testing is required if a mask is not worn. See DOH’s K-12 School Requirements 2022-2023 for more information.
If a student is vaccinated, should they still take a COVID-19 test?
Yes. Although vaccines are very effective at preventing severe sickness and hospitalization, fully vaccinated and boosted individuals can still catch COVID-19 and spread the disease to others. When in doubt, individuals should get a test to confirm their status.
Types of Tests?
What types of tests are offered through Learn to Return?
There are four types of tests available: individual PCR, rapid antigen point-of-care (POC), rapid antigen at-home tests, and pooled PCR (see more details in right column). We have multiple testing technologies available for each type of test (except for rapid antigen at-home tests). All of our testing vendors are vetted by the Washington State Department of Health (DOH) and represent the best of COVID-19 testing technologies.
What is the difference between diagnostic testing and screening testing?
Diagnostic testing is voluntary, onsite testing of symptomatic individuals.
Students or staff who are experiencing symptoms or have been exposed to someone with COVID-19 can take a test before leaving school grounds. While entirely voluntary, this approach shortens the length of time between testing and results while reducing the burden on families to arrange for a test.
Screening testing is voluntary, onsite testing of asymptomatic individuals. Students and staff voluntarily opt-in to periodic testing to identify infected individuals so that measures can be taken to prevent those individuals from infecting others. For a screening strategy to be effective, tests need to be conducted frequently (at least once per week) and require high participation.
Screening may be particularly helpful in situations in which other strategies like masking and distancing are difficult to implement (i.e. some special education classes and athletics), in locations where asymptomatic spread is higher (such as in elementary schools), and in areas with larger proportions of unvaccinated people.
The Washington State Department of Health provides guidance on screening programs for athletics and high-aerosol generating activities, such as performing arts. For up-to-date guidance on testing, see the Washington State Department of Health K-12 COVID-19 Requirements. This document is updated when new state guidance is released and provides summaries of recent changes at the top of the report.
What is INDIVIDUAL PCR testing?
An INDIVIDUAL PCR TEST is used for onsite diagnostic testing when a student, staff, or volunteer has COVID-like symptoms. A swab is used to collect a shallow nasal sample or saliva is collected in a test tube. The sample is then shipped to the testing lab and analyzed using the most reliable laboratory technology available: polymerase chain reaction or “PCR.” Results can be expected between 24-72 hours.
What is RAPID ANTIGEN POINT-OF-CARE (POC) testing?
RAPID ANTIGEN POINT-OF-CARE (POC) testing is used for onsite diagnostic or screening purposes. These are the rapid antigen testing kits we are all familiar with, like BinaxNOW. Most students can administer these tests themselves with the supervision of a trained observer. They deliver results in 15 minutes and are a good option for diagnostic testing or routine screening of various groups (e.g. athletics, performing arts, etc.).
What is RAPID ANTIGEN AT-HOME (OTC) testing?
RAPID ANTIGEN POINT-OF-CARE (POC) tests can be taken home by students and staff for their personal use. These can be sent home with symptomatic students or staff so they have access to tests while isolating at home. These may also be handed out to students before holidays or school breaks so that families have a diagnostic solution at home before returning to school.
What is POOLED PCR testing?
POOLED PCR is used to test or “screen” multiple individuals at once. Samples are collected with a shallow nasal swab from all individuals in a specific group or “cohort.” This could be a classroom, sports team, or performing arts group, for example. The samples are sent to the lab and analyzed using PCR the most reliable laboratory technology available: polymerase chain reaction or “PCR.” If a cohort has a positive result, the individuals in that cohort may need to be tested individually to determine who has been infected. This type of testing is often used for athletics and performing arts to make sure that participation in these activities is not putting anyone at risk for infection. Results can be expected in 12-36 hours.
Testing Program: What to Expect?
Where and when will the testing take place?
COVID-19 testing locations will vary by school district. Some districts put a test site at every school, while other districts use a centralized site that serves several schools. Test sites may operate continually or for a set time, such as for four hours every morning, over lunch hours, or Monday through Thursday.
How does a diagnostic testing program work?
Teachers, staff, students, and possibly members of their households, who show any symptoms or have been exposed to COVID-19 will be referred to a testing site (potentially on school grounds).
Samples are usually collected via a shallow nasal swab for tests available through Learn to Return, though saliva testing is also available. Shallow nasal swabs are not the “brain tickler” type, or nasopharyngeal swab. The swab only enters half-an-inch into each nostril, makes some rotations, and is placed, swab-side down, in the collection tube.
Who performs the COVID-19 test?
In most cases, samples can be self-collected under the supervision of a test observer. Per a Public Readiness and Emergency Preparedness (PREP) Act Authorization, test observers do not need to be healthcare professionals and do not require formal certification. Testing vendors provide training materials for staff or other volunteers who will serve in this capacity. Trained testing observers oversee the sample collection process and, in the case of rapid antigen tests, resulting.
For rapid antigen tests that return results onsite, these test observers are also trained to read and report the results in the appropriate online system. This role may be filled by a nurse or trained staff and volunteers.
What is sample collection like?
All tests available through Learn to Return use a shallow nasal swab to collect samples*. This is not the dreaded “brain tickler” or nasopharyngeal swab. The shallow nasal swab enters to gentle resistance, about half-an-inch into each nostril, makes several rotations, and is placed, swab-side down, in the collection tube.
*We also have saliva tests available for individual PCR testing. Participants spit into a test tube to provide a sample that is then transported to a lab and analyzed. Saliva tests may be more accessible for students with special needs, sensory issues, sinus or nasal injuries, or other aversions to an anterior nasal swab.
Refer to our Testing Menu to learn more about each vendor and requirements for sample collection and observation.
What is the guidance on isolation for STUDENTS who test positive for COVID-19?
Students and staff who test positive for COVID-19 should follow the DOH What to do if you test positive for COVID-19 guidance.
According to this guidance:
- Students and staff who test positive for COVID-19 should stay home for at least 5 days and isolate from others in the home in order to avoid spreading COVID-19 to others.
- Individuals can leave isolation after 5 full days if:
- Symptoms are improving 5 days after the start of isolation, AND
- The individual has not had a fever for 24 hours without use of fever reducing-medication
- Students and staff should wear a well-fitting and high-quality mask for an additional 5 days (days 6 through 10) if they return to school or child care after the end of their 5 day isolation period.
- If an individual is unable to wear a well-fitting and high-quality mask, they should continue to isolate for a full 10 days, or follow the test-based strategy listed at the bottom of page 3 to determine when to leave isolation and remove their mask.
Key document: What to do if you test positive for COVID-19
What is a test observer and what do they do?
The test observer’s primary function is to make sure an accurate sample is collected so there is no need to retest. When using a lab-based test, for example, observers also confirm that the label on the sample is properly scanned and logged into the vendor’s results tracking system. Test observers do not need to be healthcare professionals and can be trained using online tutorials provided by the testing vendor. There is no formal certification, but some districts may have test observers sign a document acknowledging that they viewed the training videos.
Safety & Privacy
Can I use expired tests?
Yes. You can use expired COVID-19 rapid antigen tests, including triplex tests (COVID-19 & flu A+B), but not molecular tests. See the Expired COVID-19 Tests FAQ for more information (available in additional languages).
The Washington State Department of Health (DOH) released an official approval for the use of expired rapid antigen tests so long as the test passes quality control.
In addition, many test manufacturers have received shelf-life extensions from the FDA. While manufacturers are not able to recommend use beyond the extension they received from the FDA, DOH still allows use of expired tests if they pass their built-in quality control check.
The test instructions sheet included with your test tells you how to do the quality control check. If the test passes quality control, you can use it. If it does not, you should discard it.
Are nasal swabs safe?
Nasal swabs are sterilized by ethylene oxide, which is commonly used in the medical industry. Ethylene oxide is considered a safe and effective method that ensures the sanitation of medical devices and is used to sterilize more than half of the medical supplies in the United States. It has been used for decades and is considered by the FDA to be the only effective sterilizing method that doesn’t damage the object being sterilized. It is also used in a variety of industrial applications and everyday consumer products such as laundry detergent and shampoos.
The sterilizing process leaves no residual trace of ethylene oxide on the nasal swab. Ethylene oxide-sterilized nasal swabs are safe and will not cause long-term health problems such as cancer.
Get all your nasal swab and ethylene oxide questions answered with this helpful DOH fact sheet.
Will a nasal swab hurt my child?
The nasal swab will not hurt your child. The swab only enters to gentle resistance, about half-an-inch into each nostril, makes several rotations and is placed, swab-side down, in the collection tube. The swab is quick and painless and can be self-administered by children ages 4 and up for most L2R testing vendors. (For more information on sample collection processes for each vendor, see our Testing Menu).
Watch this second grader demonstrate a shallow nasal swab for sample collection.
What data will schools and health departments be collecting? How is privacy protected?
Throughout the process, all health information is kept private and confidential under the Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA). The school district must have a signed HIPAA Authorization Form for minors on file to implement the testing program. This step is required because the school will receive personal health information (PHI) about minors (students) from the laboratory.
- A testing vendor may collect data such as demographics, parental/guardian consent, and insurance information. The vendor may provide summary reports to your school district, showing the total number of tests required, the percentage of tests completed, the positivity rate, and the total number of positives.
- A few administrators and staff at your school district (such as COVID coordinators) will be alerted if there is a positive test result. COVID-19 staff members within the district will then look up individual test results and initiate outbreak procedures.