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Test to Stay

By Gillum, Stephanie on October 21, 2021

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Quarantine Option 4:

Test to Stay 

Quarantine outside of school setting is recommended. Stay in school and

participate in extracurricular activities. --Students, teachers, and staff identified as close contacts can continue to attend school and participate in extracurricular activities, if the following test to stay criteria are met:

•The close contact does not include household exposures (i.e., exposures among persons who live in the same household). There may be other similar higher-risk exposures where test to stay would not be recommended. The final decision regarding the inclusion in Test to Stay is at the discretion of the LPHA based on findings of the case investigation.

•Does not develop symptoms of COVID-19 throughout the full duration of the quarantine period (10 days past the last date of exposure to the case).

•Wears a mask consistently and correctly in school at all times during their quarantine period (10 days past the last date of exposure to the case), other than when eating or drinking. When these individuals cannot be masked (i.e., when eating or drinking) they should maintain 6 feet of distance from other individuals to the extent feasible.

•Receive a minimum of three rapid antigen tests (e.g., BinaxNOW) during the first seven days of the quarantine period per the following:

oTest One: Upon identification as a close contact (unless already participating in a screening testing program);AND

oTests Two and Three: A minimum of two additional rapid antigen tests,  preferably on two non-consecutive school days within the first seven days of the quarantine period. For example: contact identified as a close contact on day 2 of quarantine would be tested on day 2 (Wednesday); day 4 (Friday) and day 7 (Monday); AND

oThe testing is conducted upon entry to school and negative results received prior to returning to the K-12 setting.

oFor participation in extracurricular activities, daily testing is recommended, though at a minimum, an additional rapid antigen test is to be taken on the day of participation throughout the duration of the 10 day quarantine period. The testing should be completed and a negative result received prior to participation in the event. This includes testing on days when the event occurs during weekends, holidays, or other days when schools are not in session (see additional guidance below regarding testing and participation in extracurricular activities).

•Receive negative test results from COVID-19 testing conducted throughout the duration of the 10-day quarantine period.

•Active monitoring of persons participating in Test to Stay for symptoms is conducted by the school throughout the duration of the 10-day quarantine period, and persons should self-isolate at home if symptoms develop. 

A person with COVID-19 can spread the SARS-CoV-2 virus to others starting from two days before they have any symptoms (or, for asymptomatic patients, two days before the positive specimen collection date), until they meet the criteria for ending isolation. Therefore, persons can be infected with SARS-CoV-2 and spread the virus to others without having symptoms or knowing they are infected. Test to Stay is a strategy where persons who are identified as a close contact to a case of COVID-19 are allowed to continue some activities during the quarantine period through participation in routine testing for the SARS-CoV-2 virus following an exposure. The frequent repeat testing would enable the prompt identification and isolation of close contacts who become infected to prevent further transmission of the virus. A routine Test to Stay quarantine response protocol, with daily testing in an environment where masks are consistently used, has been shown to be generally equivalent to quarantine for school-based contacts, and a safe alternative to at-home isolation. DHSS and DESE have developed Option 4:Test to Stay for use in the K-12 setting in Missouri.

Note: Persons participating in the Test to Stay option who develop symptoms of COVID-19 or test positive during the test to stay period or the 10 days following the last date of exposure, should follow the proper isolation protocols, including self-isolating at home and NOT attending school or participating in extracurricular activities. In addition, quarantine outside of the school setting and outside of extracurricular activities, as outlined,  is still strongly recommended for individuals participating in Test to Stay. Participation in extracurricular activities such as sports or other activities that involve singing, shouting, playing instruments, and exercising that could lead to increased exhalation can increase the risk of spread of SARS-CoV-2 among persons in the K-12 setting. The prompt identification and isolation of persons with COVID-19 from participation in these activities is very important to avoid further transmission to others.Individuals following the Test to Stay protocol may be eligible to participate in school sports and extracurricular activities provided that they comply with all criteria included in the protocol. Daily testing is recommended, though at a minimum, an additional rapid antigen test is to be taken on the day of participation throughout the duration of the 10-day quarantine period. The testing should be completed and a negative result received prior to participation  in the event.

Note: It is recognized that many extracurricular events occur on weekends, holidays, or when the school is otherwise not in session. If a school cannot arrange for someone to administer the test, the close contact needs to stay in quarantine and NOT participate in the event. Alternatively, the individual may participate if tested negative (diagnostic test such as PCR or antigen test) by a healthcare provider, pharmacy, etc. (not to include at-home tests) on the day of the event. A negative test result or a note from a healthcare provider or pharmacy indicating the completion of the test and a negative result should be provided prior to participation in the event.