Dive Brief:

• A who's who of diagnostic laboratories and manufacturers have helped create a proposal to use COVID-19 tests to reopen schools.

• The Rockefeller Foundation plan, which involves companies such as Abbott Laboratories, LabCorp, Quest Diagnostics and Roche, is focused on the use of antigen kits or pooled PCR testing to screen students and staff. Positive pooled results lead to further testing of individuals.

• With the Biden administration providing $10 billion for screening at schools, the foundation proposal gives administrators a roadmap for using the money — plus details of the companies that can help put the plan into practice.

Dive Insight:

The Rockefeller Foundation has emerged as a leading advocate for using COVID-19 screening tests to safely reopen schools in recent months, publishing details in February of a pilot study that showed weekly testing of student and teachers cut infections by up to 50% and then cheering the Biden administration's provision of $10 billion in funding released last week.

In its K-12 National Testing Action Program, the foundation has set out a more detailed vision for how schools can use screening tests to reopen. The Rockefeller Foundation worked with 21 labs, COVID-19 test manufacturers and other organizations to draw up the plan. Becton Dickinson, Quidel and Thermo Fisher Scientific were among the businesses to contribute.

The companies are competing for the school screening opportunity but all stand to benefit if there is widespread, ongoing use of COVID-19 tests to support the resumption and continuation of in-person education. With the need for testing of symptomatic individuals likely to fall as vaccination rates rise, screening at schools and other institutions could become a key piece of the COVID-19 testing market.

Working with the foundation, the companies have proposed a three-step program for schools. The first step, which the report calls optional, is to test everyone before screening begins. Schools should then test students once a week and staff twice a week. 

To reduce the burden of that second step, the Rockefeller Foundation is recommending pooled PCR testing "as the preferred option for routine screening testing." Pooled testing entails having all of the students and teachers in a classroom self swab and place them in one tube. A lab runs one test on a tube.  

If a tube tests positive, the students and teachers who provided samples undergo individual antigen or PCR tests to determine who in the group is infected with the coronavirus. Those follow-up tests are the third step in the three-step program. 

The Rockefeller Foundation proposed pooling after seeing the results of initiatives such as a Ginkgo Bioworks' pilot project, which has collected grouped samples from 130 schools in 11 states. It is taking less than 15 minutes to collect swabs for a classroom, in line with the NTAP goal of minimizing disruption. The pilot has tested more than 10,000 people and identified 32 positive individuals. The report also cites the use of pooled testing in Baltimore, New York City and Massachusetts.

Rolling such programs out nationwide could generate significant revenues for a diagnostic industry that is searching for testing alternatives as vaccination numbers climb and demand for symptomatic testing diminishes.

The report estimates the pooled PCR or antigen tests used in the asymptomatic screening step will cost $10 to $15 per person.

More than 50 million students are enrolled in kindergarten through 12th grade, suggesting the potential for asymptomatic screening to be worth hundreds of millions of dollars a week. And follow-up testing will provide further revenues.