Districts are planning to ramp up COVID-19 testing when classes resume in January, anticipating steep challenges in reopening schools amid an omicron-driven surge of infections. However, leaders are still scrambling to iron out the details, leaving major concerns about safety and logistics.

The new testing strategies are being implemented as COVID-19 infections and pediatric hospitalizations have increased in a number of states, particularly in the northeast.

With a record number of cases, even among fully vaccinated people, school leaders are concerned not only about the health of staff and students, but also about the ability to keep buildings open if too many employees become ill or are quarantined. With vaccination rates lagging, aggressive rapid testing can aid in the rapid detection and isolation of cases, preventing outbreaks that could result in school closures and a return to remote instruction, which does not meet the needs of many students.

Different approaches are being taken by different districts. Washington, D.C. and Baltimore are extending winter break by two days in order to put staff and students through their paces before reopening buildings on January 5. Before their children return to school, Chicago recommends that parents administer rapid tests to them.

And, as city officials announced this week, New York City is developing a rapid test strategy to stem the tide of cases while keeping as many children in school as possible. Meanwhile, state governments are distributing a slew of rapid tests to schools and families at a time when drugstore shelves are frequently depleted.

Millions of rapid antigen tests are being distributed to schools and families in New York and California. Vermont’s governor announced Tuesday that the state will make 80,000 free rapid tests available to parents to administer to their children at home. Connecticut’s governor announced that in January, 1 million tests will be distributed to the general public and 2 million will be distributed to schools.

Even in the midst of the omicron surge, doctors, health experts, politicians, and educators have emphasized the importance of returning to in-person learning.

However, teachers’ unions in Chicago and New York indicated this week that they would push for a delay in reopening if conditions aren’t safe or if plans for more widespread testing aren’t solidified.

New York City, the largest school district in the United States, has announced that it will add a rapid-testing regime to the surveillance PCR testing it conducted last year.

According to health officials, the number of children in New York City hospitalized with COVID-19 quadrupled in December.

Last semester, New York City used PCR tests to test a small sample of consenting, unvaccinated students in schools each week. PCR testing will now be expanded to include consenting vaccinated students. Mayor Bill de Blasio stated this week that the number of children tested each week should increase to around 80,000, up from 40,000.

In addition, positive students and staff in New York City schools are still subject to a 10-day quarantine, despite the fact that the CDC recently reduced isolation guidelines to five days.

Some New York City teachers believe that the new testing strategy will weaken school safety measures. Arthur Goldstein, a teacher at Francis Lewis High School in Queens, stated that his school has 4,500 students, about 800 are not vaccinated and around 37 opted into testing.

New York City’s strategy is based on a strategy known as “test to stay,” which was recently endorsed by the Centers for Disease Control and Prevention. The strategy aims to reduce the number of healthy children who are sent home to isolate themselves and miss school after being exposed to a positive case.

Utah was one of the first states to adopt the “test to stay” policy. The state issued guidelines for districts to follow in order to carry out the strategy with the assistance of local health departments. Schools with a 2% positivity rate or 30 infected students must hold a test-to-stay event, depending on their size. Mobile units are frequently used to aid in rapid testing.