biostudies-literatureKalu ICTrial Innovation NetworkNCATS NIH HHSNICHD NIH HHSNational Institutes of HealthNational Institute of Child Health and Human DevelopmentNIH HHS64-72https://www.ebi.ac.uk/biostudies/studies/S-EPMC9969331biostudies-literatureUnknown12(2)<h4>Background</h4>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is a recommended mitigation strategy for schools, although few descriptions of program implementation are available.<h4>Methods</h4>Kindergarten through 12th grade (K-12) students and staff practicing universal masking during the delta and omicron variant waves from five schools in Durham, North Carolina and eight schools in Kansas City, Missouri participated; Durham's program was structured as a public health initiative facilitated by school staff, and Kansas City's as a research study facilitated by a research team. Tests included school-based rapid antigen or polymerase chain reaction testing, at-home rapid antigen testing, and off-site nucleic acid amplification testing.<h4>Results</h4>We performed nearly 5700 screening tests on more than 1600 K-12 school students and staff members. The total cost for the Durham testing program in 5 public charter K-12 schools, each with 500-1000 students, was $246 587 and approximately 752 h per semester; cost per test was $70 and cost per positive result was $7076. The total cost for the Kansas City program in eight public K-12 schools was $292 591 and required approximately 537 h in personnel time for school-based testing; cost per test was $132 and cost per positive result was $4818. SARS-CoV-2 positivity rates were generally lower (0-16.16%) than rates in the community (2.7-36.47%) throughout all testing weeks.<h4>Conclusions and relevance</h4>Voluntary screening testing programs in K-12 schools are costly and rarely detect asymptomatic positive persons, particularly in universally masked settings.<h4>Clinical trial registration</h4>NCT04831866.Journal of the Pediatric Infectious Diseases SocietySARS-CoV-2 Screening Testing Programs for Safe In-person Learning in K-12 Schools.PMC9969331U24 TR001608U24TR001608HHSN275201000003CHD107559-01HD107555-01OT2 HD107555OT2 HD107559HHSN275201000003IT32 HD094671Moorthy GUthappa DMann TKKeener Mast DCampbell MMSelvarangan RGoldman JLEdwards LJBoutzoukas AEPotts JMBlakemore AMSchuster JEZimmerman KOKalu ICDeLaRosa JBenjamin DKfalseSARS-CoV-2 Screening Testing Programs for Safe In-person Learning in K-12 Schools.<h4>Background</h4>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening testing is a recommended mitigation strategy for schools, although few descriptions of program implementation are available.<h4>Methods</h4>Kindergarten through 12th grade (K-12) students and staff practicing universal masking during the delta and omicron variant waves from five schools in Durham, North Carolina and eight schools in Kansas City, Missouri participated; Durham's program was structured as a public health initiative facilitated by school staff, and Kansas City's as a research study facilitated by a research team. Tests included school-based rapid antigen or polymerase chain reaction testing, at-home rapid antigen testing, and off-site nucleic acid amplification testing.<h4>Results</h4>We performed nearly 5700 screening tests on more than 1600 K-12 school students and staff members. The total cost for the Durham testing program in 5 public charter K-12 schools, each with 500-1000 students, was $246 587 and approximately 752 h per semester; cost per test was $70 and cost per positive result was $7076. The total cost for the Kansas City program in eight public K-12 schools was $292 591 and required approximately 537 h in personnel time for school-based testing; cost per test was $132 and cost per positive result was $4818. SARS-CoV-2 positivity rates were generally lower (0-16.16%) than rates in the community (2.7-36.47%) throughout all testing weeks.<h4>Conclusions and relevance</h4>Voluntary screening testing programs in K-12 schools are costly and rarely detect asymptomatic positive persons, particularly in universally masked settings.<h4>Clinical trial registration</h4>NCT04831866.2023-01-01T00:00:00Z2023 Feb2026-05-28T21:34:48.089Z2025-04-04T07:44:24.873ZS-EPMC99693313641227810.1093/jpids/piac119