Missouri exploring 'test to stay' school quarantine option

With thousands of students quarantined in the first weeks of the new school year, Missouri's health director said the state is exploring a new strategy that aims to keep students in class through regular testing.

Donald Kauerauf, the new director of the Department of Health and Senior Services, said his agency discussed a new modified quarantine protocol known as "test to stay" with schools Tuesday.

The concept generally allows students to stay in school and forgo quarantining if they continue to test negative for COVID-19 and don't exhibit symptoms after being identified as a close contact.

In an interview with The Independent on Wednesday, Kauerauf said specifics are still being worked out for what a "test to stay" model may look like in Missouri.

"That's a new procedure that several states have implemented successfully that allows kids to stay in school," Kauerauf said. "And one of the things we were clear in our message was our desire that we need to match up public health with the fact that we need to keep kids in school."

A growing number of schools nationwide have implemented the modified quarantine policy that relies on regular testing. However, it's not endorsed by the Centers for Disease Control and Prevention, which notes on its website that when it comes to allowing close contacts to stay in school it "does not have enough evidence at this time to support this approach."

An example of how "test to stay" may be used in Missouri includes when a person is exposed to a classmate when masks were not worn consistently and correctly, according to a presentation by DHSS and the Department of Elementary and Secondary Education that outlined the new strategy.

Kauerauf stressed it would be an option for schools to use but not a requirement.

"This is a novel outbreak. This disease is changing," he said. "And we have to change as a state to meet the demands of what that virus is placing on our citizens."

The state is assessing if it would provide test kits to districts along with other details. A timeline has not yet been set for when specifics on the modified quarantine option will be finalized, Kauerauf said, noting it's an "evolving process."

The possibility of a new modified quarantine option follows the state's relaxation of the CDC's 14-day quarantine guidelines last year. In November, the state announced that students and staff who were in close contact would not have to quarantine if both individuals were wearing masks "appropriately" at the time of the exposure.

Currently, students, teachers and staff identified as close contacts are also not required to quarantine if they are fully vaccinated and don't develop symptoms or have had COVID-19 within the previous three months and have recovered, state guidance notes.

It's unclear how widely a modified quarantine policy that relies on regular testing will be adopted. While large districts throughout the state have implemented regular testing of students and staff, many have forgone mitigation measures like testing or have made mask wearing optional.

A screening testing program backed by $185 million in federal funds that is already underway has struggled to attract many schools across the state.

The program, which is operated by Ginkgo Bioworks Inc., a Boston-based biotechnology company, has 15 districts participating, according to the state's dashboard. They are primarily in the Kansas City and St. Louis metros. Overall, there are 53 schools that have opted-in to the program, which provides testing supplies, staff and resources.

Some districts that have not opted-in previously told The Independent they were concerned about the extra burden a testing program would put on already overwhelmed school nurses. Others said they likely would not be interested even with funding made available as "we don't want to turn our school into a medical facility," as one superintendent said.

Mask lawsuits

Meanwhile, as the state health department aims to provide schools with more options, the attorney general's office is fighting through the courts to take away one.

Next week, a Boone County judge will be asked to decide if Attorney General Eric Schmitt can sue every district with mask mandates in a single case. Schmitt's office is seeking a preliminary injunction blocking the mask rules, while Columbia Public Schools is requesting the case be dismissed.

Kauerauf has been outspoken that wearing masks helps stop the spread of COVID-19.

But when asked Wednesday about Schmitt's argument that mask mandates are unnecessary in schools and that there "isn't any indication by any studies or widespread studies that masking is really effective," Kauerauf declined to comment.

Kauerauf said he has not spoken with Schmitt's office about their lawsuits challenging mask mandates and that it is not a priority of his.

"I'm not a politician. I'm never going to be a politician," Kauerauf said. "My job is to implement the rules, statutes as they exist, allow them to work out those things. My focus right now is on the outbreak right now."

A new law that limits local public health officials' authority to issue restrictions to curb the spread of contagious diseases is the basis of Schmitt's lawsuits - and one has already resulted in a temporary restraining order against a mask mandate in St. Louis County.

Last week, Kauerauf said the new law is one "that haunts me." But despite the law's impact on local officials' pandemic response, Kauerauf said Wednesday his concern is making sure local officials have accurate information about the virus and are making decisions based on what they know are the facts.

"None of those laws will prevent people from wearing masks," he said. "The laws will provide more of a mechanism for the approval process."

When asked if he feels the attorney general's office has accurate information on masks and how to stop the virus' spread, Kauerauf said that would be a question for the attorney general's office.

The Missouri Independent is a nonprofit, nonpartisan news organization covering state government and its impact on Missourians.