To: Secretary Marylou Sudders, MA HHS

From: Almudena Abeyta, Superintendent of Chelsea Public Schools

Dianne Kelly, Superintendent of Revere Public Schools
Dr. Douglas Golenbock, MD; Chief of Infectious Disease, UMass Medical
Dr. Nira Pollock, MD, PhD; Associate Director, Infectious Diseases Diagnostic Lab, Boston Children's Hospital
Dr. Jesse Boehm, PhD, Institute Scientist, Broad Institute

Re: Safer Teachers, Safer Students: Back-to-School SARS-CoV-2 Testing Collaborative Pilot
Date: October 2nd, 2020

Challenge:

Every school day this Fall, roughly 1 out of 90 children and staff in our public schools will present with symptoms
(cough, sore throat, etc) that partially overlap with those of COVID-19. Thus, each district in the Commonwealth must
have access to testing capacity to identify those who are infected with SARS-CoV-2 within 24 hours, such that districts
can isolate individuals and reduce transmission. Such testing will also facilitate the return to school for those who are not
infected, thereby preserving the workforce and reducing unnecessary quarantines. Furthermore, existing safety measures
whose implementation is proposed are proving insufficient to reduce fear amongst teachers and parents given that
they do not provide actual evidence of the number of asymptomatic SARS-CoV-2 cases in our public schools.

Solution:

To address these challenges, six diverse public school districts (Revere, Chelsea, Somerville, Wellesley, Watertown,
Brookline) have launched the “Safer Teachers, Safer Students: Back-to-School SARS-CoV-2 Testing Collaborative Pilot,”
to assess the feasibility and value of viral testing in the public school setting for the Commonwealth. We believe
this multi-district pilot is the first of its kind in the public school setting, both in the State of Massachusetts and
in the Nation. If successful, this effort will demonstrate how to reduce fear and anxiety about return-to-school, pave the
way toward ensuring that in-person public school K-12 learning can continue as long as possible, and increase safety of
both teachers and students. Critically, it will create a generalizable framework that any town in the Commonwealth
can follow. We have selected these six communities as a start given (a) their different choices about back-to-school
(hybrid/remote), (b) different geographies and likely infection rates, (c) community compositions, and (d) the fact that the
Superintendents and School Committees in each district have already confirmed their willingness to participate together in
a pilot. Since launch, over 10 additional districts have expressed interest in joining the Collaborative.

Goals:

● Ensure access to PCR-based testing with (<24hr) turn-around times for all teachers, staff and students that are
experiencing symptoms of COVID-19 and contacts of confirmed cases; this will enhance safety, and reduce
unnecessary quarantine and out-of-school time;
● Pilot a surveillance infrastructure to test asymptomatic individuals in school buildings on a weekly basis so as to
provide real time data to determine whether safety precautions are working or not; this will reduce fear and help
schools stay open for in person learning as long as possible, even if a resurgence of cases occurs;
● Establish logistical proof-of-concept for testing such that any town in MA is well-positioned to (a) implement a
similar program and (b) quickly pivot to incorporating lower-cost tests and a broader based roll-out as such tests
become available later in the Fall/Winter.

Collaborative Principles:
 1. We believe access to testing for symptomatic individuals (and contacts of confirmed cases) with (<24hr)
turn-around times should be universal, regardless of income, ethnicity, geography, or social status;
2. We believe that decision-making on the transition states between remote, hybrid and full time in person
should be driven by data on the number of cases in school and the presence or absence of in-school
transmission. We believe SARS-CoV-2 testing of symptomatic and asymptomatic students and staff is required
to collect such data;
3. We believe that testing in the public school setting should be made available at cost, with no profit motive;
4. We believe that the best technologies and approaches for testing should be available in public schools
earlier, or at the same time, than for-profit corporations. We expect the technology landscape to rapidly evolve
and our plans will be modular to account for this;
5. We believe that our educators deserve access to high quality testing programs equivalent to those
available to for-profit corporations;
6. We believe that the development of a general framework of best practices for how public school SARS-
CoV-2 testing adds the most value is urgent. This is a matter of social justice. It will be accelerated by working
together and sharing information transparently.

Components and Operational Strategy:

The six districts have already begun assessing the feasibility of four types of testing over a 12 week period running
October 1st through December 1st:

1. Symptomatic Testing and Contact Tracing: this testing will be covered by insurance.
2. Time Zero Benchmark Testing: one-time testing of all staff and students prior to back-to-school.
3. Weekly Assurance Testing for Staff: continuous monitoring of staff given their diversity of hometowns.
4. Longitudinal Surveillance: weekly monitoring of all individuals in selected schools to provide real time estimation
of risk in buildings and provide evidence of whether our safety protocols are working or not.

The six communities have already selected initial Operations Partners and Testing Laboratories. These organizations
(including both private vendors, non-profit research labs and Stop the Spread Sites) are currently supplying rapid
turnaround (~24hr) PCR-based testing utilizing anterior-nasal (shallow) swabs or saliva tests. Wellesley has just
completed testing 5000 students and staff over a 5 day period with the successful identification of positive cases. Other
districts (Revere, Watertown) are starting to test staff his week. The Metrics of Success include (a) number of tests
performed, (b) average testing turn-around times, (c) number of positive cases removed from public schools, (d) number
of days of in-person learning compared to control districts and (e) subjective assessment of safety amongst teachers,
parents and students

Requests for the Secretary:

1. Designate the Collaborative as a State-supported pilot Program. This branding will help raise awareness and
private funds for the program, and will ensure we can work with the State House hand-in-hand to ensure it is
structured in a way to provide helpful guidance that can be acted on in December.

2. Configure existing Stop the Spread Sites to support public schools in red districts. This public investment
can be efficiently leveraged for public school teachers and students with minor modifications including courier
services to schools and expedited routing of tests to laboratories that can turn around results quickly.

3. Create partnerships between every public school district and a local community hospital who will ensure
expedited testing for symptomatic individuals. This will ensure that unnecessary out-of-school time.
4. Require insurers operating in the Commonwealth who cover public school teachers and K-12 students to
reimburse costs of asymptomatic assurance testing. As costs of such testing drop, a clear strategy to ensure
that all forms of SARS-CoV-2 testing are reimbursable will unleash waves of testing in public schools, which in turn
will give each of them the very best chances of staying open as long as possible.