Bello, Dr. Mendoza: No ‘test to stay’ COVID-19 option for Monroe County schools yet

Coronavirus

ROCHESTER, N.Y. (WROC) — Monroe County Executive Adam Bello and Public Health Commissioner Dr. Michael Mendoza held a a COVID-19 briefing Thursday afternoon to update residents on the county’s pandemic response efforts.

New numbers

Health department officials reported 224 new COVID-19 cases in Monroe County Thursday, bringing the county’s seven day average to 191 new cases per week. The county also reported a seven-day rolling average positivity rate of 4%, which has held near that rate since the delta surge began locally in early August.

The amount of new cases Thursday (224), as well as the seven day average for daily new cases (191), were both down from last week’s figures of 235 and 210, respectively.

“Our numbers continue to stay level, which is encouraging,” Bello said. “Our seven-day has dropped, which is great to see, but despite this, our focus remains on vaccinating everyone eligible. Last year at this time we saw a dramatic spike in numbers and there’s no better way to protect yourself, your family, and anyone else than getting vaccinated.”

Monroe County reports new COVID-19 deaths every week on Mondays. To date, 1,435 county residents have died from COVID.

According to the New York State Department of Pubic Health, 250 people in the Finger Lakes region are hospitalized with COVID, including 67 in the ICU. Recent regional hospitalization rates in the Finger Lakes have been at their highest levels since late February when the community was coming down from the holiday surge.

Change for schools?

New guidance from the New York State Department of Health gives local health departments more autonomy in regards to how COVID-19 protocols are implemented in schools.

The new guidance, issued in a memo published Wednesday, addresses Test to Stay (TTS), COVID-19 testing to permit return to school after symptoms, testing out of quarantine, and exemption to weekly unvaccinated staff or teacher testing for recently recovered persons.

As of Thursday morning, county officials said they were evaluating the guidance and have made no determination if they would adopt the policies afforded to them by the state.

“Many of you are aware of the memo, and I have asked my team to take a look at this,” Dr. Mendoza said. “First, nothing has changed, and the items in the memo [listed below] are not recommended at this time by the New York State Department of Public Health. I have questions that we have to consider, like if testing needs to be done before school, will that work for every school, and every student?”

The health commissioner said because these decisions impact the entire county, there will need to be some kind of consensus before any final decisions are made.

“This is something that school, families, parents, and districts will all need to weigh in on,” Dr. Mendoza said.

Test to stay

The guidance gives local health departments the option to use the test to stay strategy. Test to stay is a mitigation strategy that allows unvaccinated close contacts of people with COVID-19 to avoid school exclusion by testing negative with a rapid NAAT or antigen test on each school day for seven days after exposure.

“Test to stay is not what we are doing with our machines currently in Monroe County,” Dr. Mendoza said.

“At this time, the NYSDOH does not recommend TTS,” the memo said. “However, if LHDs (local health departments) choose to allow TTS to occur in schools within their jurisdiction, NYSDOH encourages them to ensure the following:

  1. The school/district must have a written protocol that: (A) Considers equity (i.e., families should not have to pay for testing, or if they do, then the inability to pay should not prevent a student from being eligible for TTS), (B) includes actions to follow-up on transmission (e.g., contact tracing) in the event that an individual tests positive, and (C) other factors deemed essential or important by the LHD or school.
  2. The daily test must be conducted and the results received before the school day begins, and positive individuals excluded/isolated per existing procedures.
  3. If the test is done in an unmonitored setting (e.g., home), a mechanism to ensure that the test is done correctly and on the correct person must exist.
  4. The exposed person who is allowed to remain in school through TTS must still be quarantined outside of school instruction/academic periods (on weekends/holidays when the seven-day TTS period is still active, but no school test is required; after school/evenings; no community activities or extracurricular participation including clubs, sports, arts/performance activities, etc.).
  5. If the exposed person who is allowed to remain in school through TTS develop”

To note: The test to stay strategy allows close contacts of infected people to avoid school exclusion, but not other parameters of quarantine.

Until now, test to stay hasn’t been an option for New York school districts, although it has been used in other states.

“We are not permitting test to stay at this time and the state does not recommend test to stay at this time,” Dr. Mendoza said. “We need more time to study the science behind this. It would require an all-county decision; the logistics are going to be daunting. We need consensus from the community. That is the main concern that we need to address going forward.”

Officials say the health department will not provide new test to stay technical assistance or resources for schools in jurisdictions who permit the strategy.

Test to return after symptoms

The new health department guidance also expands the accessibility of which COVID-19 tests count for people to return to schools.

Previously, a NAAT test was required to permit individuals to return to school after developing COVID-like symptoms, but those tests can be slow with results.

“Understanding that the turnaround time for some laboratory-based NAATs may result in multiple-day exclusions from school for people with mild symptoms, NYSDOH is amending its guidance to allow people who either (a) are fully vaccinated, or (b) have had a COVID-19 infection within the last 90 days to return to school following a negative antigen test result.”

“We currently do not test for kids who are in quarantine,” Dr. Mendoza said. “The machines we are using now are simply for kids who don’t have symptoms to get them back to school faster.”

According to the guidance, people who are not fully vaccinated, and who have not had COVID-19 within the past 90 days, still must receive a negative NAAT result before returning to school, unless specific otherwise criteria is met.

Test out of quarantine

Like test to stay, the state does not currently recommend a test out of quarantine policy, but will give local health departments the option to adopt this process.

This strategy allows people under quarantine to shorten their quarantine by receiving negative COVID-19 test results.

According to the health department, local health departments that choose to adopt this policy should align with CDC recommendations, which are as follwows:

“When diagnostic testing resources are sufficient and available, then quarantine can end after Day 7 if a diagnostic specimen tests negative and if no symptoms were reported during daily monitoring. The specimen may be collected and tested within 48 hours before the time of planned quarantine discontinuation (e.g., in anticipation of testing delays), but quarantine cannot be discontinued earlier than after Day 7.”

Like jurisdictions that adopt test to stay, officials say the state will not provide new assistance or resources for areas that adopt test out of quarantine.

Exemptions to weekly testing

The memo also includes new guidance pertaining to weekly COVID-19 testing for unvaccinated staff and teachers.

Department of Health officials say asymptomatic individuals exposed to COVID-19, who were previously diagnosed and confirmed to have COVID-19, and have since recovered, are not required to retest and quarantine within three months after the date of symptom onset from the initial infection, or date of first positive diagnostic test if they remain asymptomatic during the illness.

Health department officials say schools will have to keep track of when the three months is over, at which time the staff members would need to resume regular testing.

If these are adopted

State guidance says if these aforementioned strategies are adopted, certain requirements must be met, inclduing:

  • “Ensure that schools remain current on their reporting of all COVID-19 test results—including all results of home testing (if permitted)—to the New York State COVID-19 Report Card, in addition to their other reporting obligations under public health law;
  • Assess available local resources, especially related to testing availability and accessibility, prior to allowing the practice(s). NYSDOH will not make resources (e.g., antigen test kits), beyond that which is currently available, available to LHDs in order to facilitate “Test to Stay” and “Testing out of Quarantine” as described below. (Please note that testing related to the following practices is considered an allowable expense under ELC School Reopening Funding); AND
  • Ensure the opportunity to participate is available to every school in the county. Adoption of the following practices I-III must be a county-level, not school-level, decision in order to guarantee consistency in local administration of quarantine and isolation review responsibilities under Public Health Law Article 21 and its related regulations. For example, LHDs may not permit a school that has access to independent funding for test kits to adopt “Test to Stay” while prohibiting another school with inadequate resources from doing so.”

Watch the full briefing

Check back with News 8 WROC as we will continue to update this developing story.

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