Expert Advisory Panel 4 discusses advantages and disadvantages of weekly testing



Expert Advisory Panel 4: Public Health, Safety and Logistics convened virtually via Zoom on Jan. 21 at 3 p.m. to review new COVID-19 data and discuss potential new safety procedures.

Expert Advisory Panel 4: Public Health, Safety and Logistics convened virtually via Zoom on Jan. 21 at 3 p.m. to review new COVID-19 data and discuss updating panel advice on safety procedures for the Public Schools of Brookline (PSB).

According to John Kleschinsky, Public Health policy analyst, over 350 Brookline residents were tested this week via the town-sponsored testing clinics.

The testing sites and vaccination clinics are open to all employees and residents in the town for free PCR testing and vaccines with no appointment necessary.

The panel said that their primary goal is to keep as many students as possible in school.

Much of the meeting was spent discussing an optional COVID-19 random testing program for asymptomatic students that the Massachusetts Department of Elementary and Secondary Education (DESE) is offering. The plan would provide one test a week for anyone who opts in and students would take those tests every Tuesday.

Medical Director at MassHealth and pulmonary and critical care physician at the Cambridge Health Alliance Lakshman Swamy said he is concerned about the effectiveness of random testing.

“I don’t think any of us think that asymptomatic screening is going to demonstratively reduce in-school transmission,” Swamy said. “If the data continues going the way it is, then I’m feeling increasingly confident that everything we’re doing in the school is really working and, in that case, keeping a couple of extra asymptomatic kids out is probably doing more harm to education overall than it is actually increasing anyone’s risk.”

Coordinator of Student Health Services Tricia Laham said that although random testing is not extremely effective, it still could serve a purpose in finding mildly symptomatic cases.

“The one thing I think we might catch is those people who are very mildly symptomatic, who don’t even think of it as a symptom necessarily,” Laham said.

Swamy said despite his concern over unnecessarily keeping students out of school, he does not believe we should intentionally allow COVID-19 positive students to be in school, even if they are completely asymptomatic.

“I’m nowhere near saying it’s okay for asymptomatic kids to come to school, but some asymptomatic kids can be in school and it’s not going to be enough to overcome all the barriers we have in place,” Swamy said.

Associate Professor of Infectious Diseases and Medicine at the Boston University School of Medicine Ben Linas said the risk of transmission in school, even with positive students, does not warrant enough concern for asymptomatic screening to matter.

“We know what the risk profile of a positive person walking in the door is mathematically, including during Omicron, and at this point it’s quite low,” Linas said. “We’ve got pretty convincing data coming both before and during Omicron that we can have a lot of people in school who are positive, and not have a lot of transmission. All by way of saying, we’re not sure we should sweat the incremental increase in finding cases.”

The panel also discussed the possibility of recommending or mandating a “test-to-return” policy where people who tested positive would need to test negative.

Swamy said he is concerned over the impact of even recommending test-to-return due to the number of students who would be held out of school while not posing the danger of transmission.

“How many kids are we talking about? Is this 30 percent of our population that’s going to be asymptomatic antigen positive? And how good is that test at telling us that those kids are going to be increasing the risk of in-school transmission?” Swamy said. “Because there’s a cost to them not coming back.”

Linas said he was uncomfortable with a mandate because of the lack of easy accessibility to tests.

“I just don’t see how we can mandate that given where we are with the tests. There’s such a huge equity issue there,” Linas said.

The panel also discussed confusion surrounding the Centers for Disease Control and Prevention (CDC) and DESE policy that would allow COVID-19 positive people to return to school with “improving symptoms.”

Swamy said the measure is vaguely defined, but is specifically meant for people with long term “recovery symptoms,” not for more extreme symptoms like a fever or muscle aches.

“The case in which it’s very obvious that people should not let symptoms affect them is a common post viral cough that can last weeks, and that cough doesn’t mean that they’re still infectious by any means,” Swamy said.

According to Swamy, he is creating a list of recommendations for the face masks that are most protective, economical, comfortable and easy to speak in.

Linas said although it is important to remain vigilant about case numbers and in-school transmission, the data throughout the COVID-19 pandemic has indicated that attending school does not pose a serious risk.

“With mitigation in place, it seems like school is not the main source of transmission,” Linas said. “We should always be open and always be looking [for improvements], but at some point we have to accept this fact.”