Real-world utilisation of SARS-CoV-2 rapid antigen testing to enable face-to-face learning in Australian schools, an ecological study

Objective

The objective of this study was to describe the use of SARS-CoV-2 rapid antigen testing of COVID-19 contacts in New South Wales schools to determine return to in-person school attendance instead of home quarantine, between 6 November and 21 December 2021.

Methods

COVID-19 school contacts were required to quarantine for two weeks postexposure to the case. Students who opted into daily rapid antigen testing logged their results in a database, prior to school attendance, and obtained SARS-CoV-2 nucleic amplification acid testing on day 12–16. Secondary attack rates (SARs) in schools utilising rapid antigen testing (Test-to-Stay schools) and those not utilising rapid antigen testing (non–Test-to-Stay school) were calculated.

Results

We identified 9,887 people in 293 schools who reported performing at least one rapid antigen test (RAT). The SAR in RAT schools was 3.4% (95% confidence interval: 2.7–4.1) and non-RAT schools was 2.8% (95% confidence interval: 2.4–3.3). A total of 30,535 school days were preserved through this program.

Conclusions

The use of RATs preserved in-person learning without a significant increase to SAR.

Implication for public health

Disruptions in face-to-face learning have long-term detrimental impacts on children and adolescents. Rapid antigen testing has been shown to be beneficial to maintain face-to-face learning in Australian schools and may be a useful method to safeguard from school disruptions in future pandemics.