ABSTRACT
BACKGROUND: Enhanced health and safety measures, such as symptom screening, physical distancing, cohorting, masking, and asymptomatic testing for children have been introduced into schools to prevent SARSCoV- 2 transmission. Although asymptomatic testing has been considered a measure to reduce in-school transmission, it has not been broadly implemented or evaluated. To address this, a pilot project with public health, school boards, and hospital-based testing partners was established to assess the feasibility of offering on-site and low barrier SARS-CoV-2 polymerase chain reaction (PCR) testing across schools in the Toronto region. OBJECTIVE(S): The primary objective of this study was to assess the feasibility of offering on-site and low barrier PCR asymptomatic testing across schools in the Toronto region. DESIGN/METHODS: A six-week testing pilot across the Greater Toronto Area took place. Schools were selected to participate in expanded testing to determine case prevalence in high-risk settings of school-based SARSCoV- 2. Students and staff were excluded if they had tested positive for COVID-19 in the last 3 months. Different testing opportunities were offered based on the testing partner and school preference including location and modality. Descriptive methods were used to assess the uptake of testing and case positivity by individuals recommended to be tested. RESULT(S): Eighteen schools participated in the pilot testing. All students and staff were invited to participate in asymptomatic testing. Testing was offered to 9282 students and 1000 staff, and testing uptake was 29% (2729 students) and 54% (544 staff), respectively. Forty-eight percent of tests (1645) were oral nasal tests, 18% (622) were NP swab tests and 33% (1120) were saliva tests. Of the saliva tests, 52% (590) were on-site saliva tests and 48% (530) were take-home saliva kits. The staff and student positivity rate for on-site testing was 1.9% and 4.9% for tests completed at the COVID-19 Assessment Center at SickKids. CONCLUSION(S): Results from this pilot project demonstrate that on-site PCR testing uptake remained low despite offering in-school testing, specialized support, and reduced barriers by using non-invasive testing with the use of saliva/ oral nasal/PCR testing kits. Results highlight the challenges of asymptomatic testing and the balance of resource utilization for low case counts. Future studies should examine alternate means of symptomatic testing.