UMMS Affiliation

Department of Medicine, Division of Infectious Diseases and Immunology

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Community Health and Preventive Medicine | Education | Infectious Disease | Pediatrics | Virus Diseases


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in K-12 schools was rare during in 2020-2021; few studies included Centers for Disease Control and Prevention (CDC)-recommended screening of asymptomatic individuals. We conduct a prospective observational study of SARS-CoV-2 screening in a mid-sized suburban public school district to evaluate the incidence of asymptomatic coronavirus disease 2019 (COVID-19), document frequency of in-school transmission, and characterize barriers and facilitators to asymptomatic screening in schools. Staff and students undergo weekly pooled testing using home-collected saliva samples. Identification of > 1 case in a school prompts investigation for in-school transmission and enhancement of safety strategies. With layered mitigation measures, in-school transmission even before student or staff vaccination is rare. Screening identifies a single cluster with in-school staff-to-staff transmission, informing decisions about in-person learning. The proportion of survey respondents self-reporting comfort with in-person learning before versus after implementation of screening increases. Costs exceed $260,000 for assays alone; staff and volunteers spend 135-145 h per week implementing screening.


COVID-19, K-12 schools, SARS-CoV-2, asymptomatic SARS-CoV-2 screening, in-school SARS-CoV-2 transmission, mitigation, prevention

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Copyright 2021 The Authors. This is an open access article under the CC BY-NC-ND license (

DOI of Published Version



Doron S, Ingalls RR, Beauchamp A, Boehm JS, Boucher HW, Chow LH, Corridan L, Goehringer K, Golenbock D, Larsen L, Lussier D, Testa M, Ciaranello A. Weekly SARS-CoV-2 screening of asymptomatic kindergarten to grade 12 students and staff helps inform strategies for safer in-person learning. Cell Rep Med. 2021 Nov 16;2(11):100452. doi: 10.1016/j.xcrm.2021.100452. Epub 2021 Oct 27. PMID: 34723225; PMCID: PMC8549440. Link to article on publisher's site

Journal/Book/Conference Title

Cell reports. Medicine

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Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.