Alamance-Burlington school board members hesitated this week to apply for a federally-funded grant that would be used to hire 35 Certified Nursing Assistants (CNAs) and six Registered Nurses to test students for Covid-19 – and to perform contact tracing for those who test positive – after several board members raised concerns about privacy and the potential for eventually requiring students to get vaccinated or undergo weekly testing at school.
There would be no “universal” Covid-19 testing for all ABSS students, based on a grant proposal that was presented to school board members Tuesday afternoon.
Instead, the grant money would be used to conduct diagnostic testing for symptomatic staff and students and “screening testing” of students who participate in extracurricular activities that are deemed to put them at increased risk for infection. Middle and high school athletes, as well as chorus and band members, would be tested weekly while participating in those activities – meaning that football players would be tested during football season and so forth, under the proposed testing plan that would be implemented if ABSS were to get the grant.
The school system is seeking a grant for approximately $1.7 million, ABSS chief student services officer Dr. LaJuana Norfleet confirmed Tuesday for The Alamance News. The grant is federally-funded but administered by the North Carolina Department of Health and Human Services (NCDHHS), according to information she presented during the school board’s latest work session.
The grant money would be used to conduct diagnostic PCR (or Polymerase Chain Reaction) testing for staff and students who exhibit symptoms, Norfleet told school board members Tuesday afternoon.
A nasal swab is usually used to collect a sample for “rapid antigen” and PCR testing, but PCR testing is generally considered more accurate because it gives fewer “false negatives” than rapid antigen testing, according to state and federal public health officials. It takes two or three days to get results from PCR tests, while rapid antigen tests produce results in as little as 15 minutes.
“Pooled screening” testing does not give individual results. ABSS would begin pooled screening testing in mid-October at the high schools, starting with athletes and band and chorus members, based on the original timeframe that Norfleet outlined Tuesday. Screening testing would expand to middle schools later, she said, though she didn’t give a specific date.
The proposed weekly testing schedule for ABSS would include: Testing athletes and band/chorus members at ABSS high schools who are currently participating in those activities on Mondays; testing middle school athletes and band/chorus members on Tuesdays; conducting follow-up tests at any high schools where a “pooled test” resulted in a positive case on Wednesdays; and follow-up tests at any middle schools where a pooled test resulted in a positive case on Thursday. There was no mention during the school board’s work session about how long ABSS would continue to conduct diagnostic and pooled testing for Covid-19.
Pooled screening testing would enable ABSS to “have results back for all students prior to, hopefully, their participation in sports or any extracurricular [activities],” Norfleet told school board members. Students who decline to be tested “can’t be excluded for refusing to participate, but it is intended to provide an additional layer of safety,” she insisted.
Plan originally required weekly testing for unvaccinated
athletes and band/chorus members
ABSS originally intended to require screening testing for “all non-vaccinated student athletes, chorus, and band members” as a mitigation measure, based on the proposal that Norfleet presented this week. The proposed testing plan for ABSS also stated that students and staff who are fully vaccinated “may opt out” of testing but “must provide the school nurse with a copy of their Covid-19 vaccination card to opt out.”
However, school board member Donna Westbrooks insisted on stripping any reference to mandatory participation in the testing that would be conducted at ABSS schools. “People would not be required to do this,” Westbrooks said Tuesday afternoon. “We are going to take the word ‘require’ out.” Norfleet agreed to do so.
Amy Widderich, who is the school system’s lead nurse and oversees the school nurses at each of the 35 ABSS schools, stressed that diagnostic testing would be limited to staff and students who begin showing possible symptoms of Covid-19 at school. “It is really intended for people who are sick at school,” she told school board members during their work session. “It removes a barrier for parents [from] making an appointment someplace else.”
The second aspect of the proposed grant and testing schedule is focused on athletics, which puts students at higher risk of infection due to close contact during practice sessions and games, Widderich explained Tuesday afternoon. “We wanted to start with athletics to help cut down on spread during that,” she said.
An outside vendor that’s been approved by NCDHHS would collect and test samples and return the results to ABSS, Norfleet said Tuesday. The discussion at the work session didn’t touch on whether there would be an exemption for students or staff who’ve developed “natural immunity,” meaning those who’ve had and recovered from Covid-19.
The Covid-19 student guidelines that ABSS developed for the 2021-22 school year state that isolation is “required for all presumed or confirmed cases” but provides an exemption for symptomatic students with a negative test result, or if the student has gone 10 days without symptoms and 24 hours without a fever without using a fever reducer. Students who are fully vaccinated and aren’t displaying symptoms don’t need to quarantine; nor do students who’ve tested positive for Covid-19 within the last three months and are asymptomatic, under the ABSS guidelines.
The school system is also following NCDHHS guidelines, which do not recommend quarantine for students who are exposed at school “if masks are worn appropriately and consistently” by the infected person and any close contacts, though that provision doesn’t apply to potential exposure during extracurricular activities.
The 35 new CNAs would be supervised by each ABSS school nurse, while the six RNs would serve as floaters, meaning they could collect and review Covid-19 vaccination cards “for those opting out” of testing due to being fully vaccinated. The six RNs could also help set up testing areas; select random pools for testing; and assist school nurses in isolation rooms for confirmed or suspected positive cases, she said.
“Our nurses are spending a lot of extra time devoted to Covid-19 procedures, which is prohibiting them from completing some of their regular duties,” Norfleet told school board members this week.
Widderich said her work days typically last at least 10 hours. Once she finishes her work day at Turrentine Middle School, she starts calling “close contacts” (i.e., anyone who has been within six feet of someone who tests positive for Covid-19 for more than 15 minutes, regardless of whether masks were worn) around 6:00 p.m. and finishes around 10:00 p.m., Widderich said.
School board member Sandy Ellington-Graves said she thought that the Alamance County health department was responsible for conducting contact tracing. “We haven’t asked the public or parents what they think,” she pointed out Tuesday. “Are we adding a job to do something we cannot effectively manage?”
“When it comes to contact tracing, we are a unit assisting the health department,” Norfleet explained.
Ellington-Graves also said it’s incumbent upon parents and students to exercise common sense with Covid-19. “If you’re sick, you stay home; if you test positive, you stay at home,” she said. “[With this] our nurses are policing our students rather than caring for them.”
“When you changed it to a voluntary basis, are you not defeating the whole reason this grant was set up?” asked school board member Patsy Simpson, who participated in the work session by phone and indicated that the program was intended to cut down on the spread of Covid-19. “I understand if a certain portion of the community thinks we are overstepping our boundaries,” she said, but added that she thinks the additional support is needed now.
Though Ellington-Graves almost immediately apologized for using the word “policing,” she also worried about violating the privacy of ABSS students and their families.
“We are also identifying who’s vaccinated and who’s not? Is that not an invasion of privacy at this point?” – school board member Sandy Ellington-Graves
“We are also identifying who’s vaccinated and who’s not,” Ellington-Graves asked Norfleet. “Is that not an invasion of privacy at this point?”
“Right now, individuals have an opportunity to share whether they are or are not vaccinated,” Norfleet said. “We can’t require whether you share that information or whether you participate.”
Parental consent, Norfleet emphasized, would be required in order for any student to participate in diagnostic or pooled testing. Individual test results would be shared with each student, as well as the nurses, and anonymous test data would be uploaded to the NCDHHS Covid-19 database, she said.
At the same time, the additional support personnel would be able to assist with contact tracing, the student support services officer said Tuesday. “Thinking beyond just testing, that would not be an all-day event,” she said. “We could layer them with additional responsibilities to help with the contact tracing.” People who are hired temporarily to help with contact tracing wouldn’t need to be licensed as CNAs, Norfleet said, adding that ABSS will consider applicants who are qualified to work as teacher assistants and/or have similar experience with school-age children.
“I think the federal government, in my opinion is trying to be real slick, painting this pretty picture, giving us the ability to hire nurses. But I think, eventually, they are going to strong-arm our students into doing something they may not be comfortable with, which is either getting vaccinated or get tested.” – school board member Ryan Bowden
School board member Ryan Bowden urged his fellow board members to be mindful of the potential ramifications of accepting the federal grant money.
“I think the federal government, in my opinion is trying to be real slick, painting this pretty picture, giving us the ability to hire nurses,” Bowden said Tuesday. “But I think, eventually, they are going to strong-arm our students into doing something they may not be comfortable with, which is either getting vaccinated or get tested.”
Norfleet said she’s not aware of any “additional expectations that have been conveyed” in exchange for the Covid-19 testing grants. She said that, while Monday was the deadline for submitting a grant application to NCDHHS, the school system will remain eligible to submit its application later this month. The term of the grant would be one year, Norfleet added.
School board members have agreed to resume their discussion about the proposed grant at their next regularly-scheduled meeting on September 27.
Related coverage of ABSS and Covid: Clusters identified at three schools: https://alamancenews.com/three-abss-schools-have-cluster-of-covid-19-cases/
OTHER ABSS COVERAGE:
ABSS to lease office building in downtown Burlington: https://alamancenews.com/abss-to-lease-office-building-on-south-main-st-in-burlington-for-ec-pre-k/