IMPLEMENTATION & SAFETY
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 covers costs for school-based diagnostic and screening tests.
Have insurance? Great. Your provider will be billed directly with no cost to you.
No insurance? No problem. Just provide a valid government-issued ID and you’re good to go.
If you do not provide insurance or a government I.D., you can still get tested at no charge! The Washington Department of Health will cover the cost.
For tests performed by Curative, you will be asked to provide insurance information if you have it, and your insurance will be billed directly. You will not receive a bill for your test. Some individuals tested may receive an Explanation of Benefits statement from their insurer indicating a remaining balance, but they will never receive a bill from Curative for the testing.
If you do not have health insurance, you may provide a photo of your government-issued I.D. This information will allow Curative to bill the federal Health Resources and Services Administration (HRSA), which is covering testing not covered by insurance. However, if you do have health insurance, we ask that you use it.
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.
Who’s paying for this? Where does the money come from?
The Washington State Department of Health covers costs for diagnostic and screening tests with federal funds. This funding will continue through July 2022.
Governor Inslee announces expansion of Learn to Return funding to support screening tests for Washington schools.
Why is our school community participating in this COVID-19 testing program?
School-based testing and other safety measures are effective tools for allowing schools to open and stay open safely for full-time, in-person learning.
By participating in Learn to Return, school communities are empowered to get back to school full-time with confidence. Testing programs are critical for identifying cases of COVID-19 in our schools, preventing the spread of the disease, and keeping students, teachers, and other staff in school. 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.
If the vaccines are so effective, why does our school need a COVID-19 testing program?
Vaccines and boosters provide protection against severe disease caused by COVID-19, but breakthrough infections can occur, especially with highly contagious variants like omicron. The pediatric vaccine and booster were approved in late 2021 and early 2022 respectively. It is unlikely that a large portion of school-aged children will be fully vaccinated and boosted before the end of the 2021-2022 school year and into the following year. The unprecedented rates of infections caused by omicron has made it very clear that testing and other mitigating safety strategies are essential to maintaining a safe school environment and preventing outbreaks.
If a student is vaccinated, do they still need to take a COVID-19 test?
Yes. Even fully vaccinated and boosted individuals can be infected with COVID-19, particularly the highly contagious omicron variant. State guidance is often updated to address evolving science and trends.
For the most recent guidance, review 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. Read our summary of new guidance as of March 12, 2022 to learn more about updates to testing protocols for sports, Test-to-Stay and return to school after infection.
When in doubt, individuals should get a test to confirm their status. Learn to Return programs offer free, opt-in diagnostic and screening testing for school communities.
Will a COVID-19 vaccine be mandatory for students in Washington?
States cannot mandate vaccinations until fully authorized by the FDA. The vaccines currently available have been authorized under Emergency Use Authorization (EUA) and are simultaneously on track to satisfy requirements for full authorization. Such authorization and subsequent mandates at the state-level will greatly increase vaccination rates for school-aged kids.
Implementation & Safety
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 using a shallow nasal swab 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, asymptomatic 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.
For schools just beginning to incorporate a COVID-19 testing program, Learn to Return recommends starting by ensuring same-day diagnostic testing for anyone who has symptoms or may have been exposed.
The Washington State Department of Health provides guidance on screening programs for athletics and high-aerosol generating activities, such as performing arts. Although voluntary, failure to participate in screening programs may preclude participation in these types of activities. 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.
Who performs the COVID-19 test?
In most cases, samples can be self-collected by the individual being tested under the supervision of a test observer. 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.
For the Everlywell shallow nasal swab, only students aged 16 or older can self-administer the test. A healthcare professional is required for those 15 or younger.
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.
Refer to our Menu of Tests page to learn more about each vendor and requirements for sample collection and observation.
What does a test observer do?
The test observer’s primary function is to make sure an accurate sample is collected so there is not a need to retest. When using a Curative test, for example, observers also confirm that the label on the sample is properly scanned (using a barcode scanner provided by Curative) and logged into Curative’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.
What happens when a member of the school community tests positive? What are the requirements around isolation?
The Washington State Department of Health (DOH) periodically updates recommended isolation and quarantine protocols for people who have tested positive for COVID-19 or have been exposed to someone with a confirmed case.
On March 12, 2022, the Washington State Department of Health K-12 COVID-19 Requirements went into effect and include updates on isolation and testing protocols. See our summary of this new guidance on masking, testing, and isolation guidance and requirements.
Below are the key takeaways regarding isolation requirements:
Isolation at school:
- It is required that anyone at school with COVID-like symptoms be isolated immediately in a designated isolation room, referred to diagnostic testing*, and sent home regardless of vaccination status.
- Symptomatic individuals are required to wear a well-fitting face mask, if tolerated and age appropriate, while in the designated isolation area and on their way out of the school building.
- Anyone providing care or evaluation to the isolated individual is required to wear appropriate PPE.
Isolation at home:
- Any student or staff member who tests positive for COVID-19 is required to isolate at home for at least 5 days, regardless of vaccination status
- Individuals can return to school after five days if:
- Their symptoms have improved or they are asymptomatic, AND
- They are without a fever for the past 24 hours without use of fever-reducing medications.
- Students and staff returning to school after the 5-day isolation period are required to wear a well-fitting mask at school for the next 5 consecutive school days (days 6-10). If these 5 days post-isolation include weekends or school-holidays, individuals are strongly recommended to mask when in public indoor settings.
- Alternatively, students and staff are not required to wear a mask when returning from a 5-day isolation IF they test negative for COVID-19 after day five, before returning to school. This can be done with a lab-based or rapid antigen at-home test.
Are nasal swabs safe?
Yes, nasal swabs are 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 in 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 three 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 Menu of Tests page).
Watch this second grader demonstrate a shallow nasal swab for testing using his own words.
How does a diagnostic testing program work?
Teachers, staff, students and 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). This site will serve your school or school district specifically, and you’ll be able to access free testing on the day you are referred.
Samples are collected via a shallow nasal swab for all tests available through Learn to Return. Shallow nasal swabs are not the dreaded “brain tickler” or nasopharyngeal swab.
The swab enters to gentle resistance, about half-an-inch into each nostril, makes three rotations, and is placed, swab-side down, in the collection tube.
You can learn more about the types of tests and testing methods on L2R’s Menu of Tests. And you can watch a demonstration of a shallow nasal swab here.
What is pooled testing?
Pooled testing (also called batch testing) is a type of screening test that allows multiple samples to be processed at once.
This is a streamlined screening strategy for both students and staff that reduces labor, registration, and appointment responsibilities for the school district. Reflex testing (either with a PCR or rapid antigen test) is required for pools with a positive screen.
- PCR testing – the gold standard for accuracy – is used to analyze samples from up to 20 participants per cohort or “pool.”
- Students self-administer a shallow nasal swab and deposit them into a single collection tube for each cohort.
- Sample collection for a cohort takes about 5 minutes and results are returned between 12-48 hours.
- Pooled testing participants are de-identified in the testing application. Personal information is not shared with the lab, but rather is based on student and staff school ID.
- No CLIA waiver is required.
What is Test to Stay and what are the updated requirements for participation?
Many schools in Washingon implemented Test to Stay protocols as an alternative to at-home quarantine in an effort to keep kids in school who had been exposed to COVID-19 but had yet to test positive or develop symptoms.
As of March 12, 2022, Test to Stay protocols are no longer required for students or staff who have been exposed to COVID-19.
- According to the DOH guidance, “Exposed students and staff may continue to take part in all in-person instruction and activities, including sports, performing arts, and other extracurricular activities, as long as they are not symptomatic.”
- As stated in the updated requirements for isloation, symptomatic individuals must be isolated immediately, referred to a testing site or provided with a diagnostic test, and sent home.
Schools may consider using or continuing a Test to Stay protocol for high-risk activities such as high-contact sports and high-aerosol generating performing arts when participants have been exposed to COVID-19.
Read more about these recommendations under “Test to Stay” in the updated DOH guidance.
What data will schools and health departments be collecting? How is my privacy protected?
All health information is kept private and is protected by federal HIPAA rules.
School administrative staff collect data for daily symptom screening and exposure checks using either a paper form or an automated option (such as a smartphone app or online platform).
When referring someone for testing, school staff will provide a link to the testing vendor’s registration portal. Curative, for instance, captures demographic data, parental/guardian consent, and insurance information with their online registration system. Curative provides summary reports to your school district. These reports show the aggregate number of testing referrals, the percentage of tests completed, the positivity rate, and the total number of positives.
A few trusted administrators and staff at your school district (likely the superintendent) will be alerted if there is a positive test result. One or two staff members within the district will then look up individual test results and initiate outbreak mitigation. They will help with contract tracing to prevent further transmission and protect the other teachers, staff, students, and families within the school community. All health information is kept private and is protected by federal HIPAA rules.
The school district must have a signed HIPAA Authorization Form for Minors on file to implement the testing program. This step is required since the school will receive personal health information (PHI) about minors (students) from the laboratory.
What is a CLIA waiver, and does our school require one for conducting these tests?
CLIA (Clinical Laboratory Improvement Amendment) waivers are required when a diagnosis is performed and interpreted onsite. Schools providing rapid antigen tests need a CLIA waiver since results are provided onsite within 15-20 minutes of sample collection.
When collecting samples to send to a central lab for processing — as with the Curative and Everlywell tests — the school or testing site does not need a CLIA waiver.