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SAN ANTONIO — Last Thursday, Ciara Brown, a senior at Fox Tech High School in San Antonio, stood on a small white desk, lowered her face mask, and performed a test still nonstandard in American schools: rub a cotton nose.

“Testing is very easy,” he said. “It’s not as scary as I thought – it’s not such a big deal on the brain.”

The United States has been battling Covid testing since the early days of the pandemic. Now, almost two years later – and weeks into another school year interrupted by Covid – school systems across the country are struggling with the role of testing in keeping kids safe and in the classroom.

Some, like Ciara’s in Texas, all went in; others do not offer any Covid tests. And yet others say they want to do more testing but don’t have the resources or are stumbled by obstacles and delays.

Numerous school districts in the San Antonio area reflect the country’s political rifts. Some counties have taken multiple measures, including testing, to protect themselves from the virus. Some have very little defence.

Despite the worst of the early-test supply shortages receding and states receiving federal money, $10 billion from the American Recovery Plan, Many school districts are still struggling to implement school-based Covid testing programs.

A pediatrician and researcher at RAND Corporation, Dr. “There’s a lot more to testing than just clearing a nose or spitting into a test tube,” said Laura Faherty. who read school-based Covid testing.

A series of tests in Texas

School systems like Miss Brown that have managed to create large-scale testing programs are a case study of how much effort went into it.

San Antonio Independent School District offers weekly tests to each student and staff; this is a commitment that requires overseers to collect nasal swabs on district campuses three days a week. A single collection event can take hours.

However, the program, a partnership with the not-for-profit Community Labs, is largely voluntary, and despite the district’s efforts, many families have not signed up; About 30 percent of students participate.

Ms. Brown, who has two immunocompromised family members, was eager to enroll. “I can’t live with myself knowing that the Covid snatches were because of me,” he said. “The only thing I really care about is knowing that I can keep them safe, myself, my friends, even strangers.”

However, in the Boerne Independent School District, where masks are optional, testing is also optional and can be done at the campus clinic by appointment only.

While the district said that anyone who is sick should not come to school, symptomatic people “will not be referred for testing or even sent home unless they are.”failing to attend teaching”

Pediatric cardiologist who treats COVID patients, Dr. Heather Riebel said she was “very careful” not to bring the virus home. Now she worries that her children may be more likely to get it at school.

He picked up his fifth grader from school once this fall, after being exposed to infected students five times in one week. Dr. “This is extremely discouraging,” Riebel said. (District officials did not respond to numerous requests for talks.)

Elsewhere in San Antonio, the Northside Independent School District has taken a middle ground: it fast-tests students and staff members who are symptomatic, but students can only be tested with parental consent.

Investigator Brian Woods did not rule out the possibility of wider screening should cases escalate. But the region is facing severe staffing shortages, making it difficult to scale up testing at the moment. “We are not at that point yet,” he said.

The region is tracking people, but distribution has been bumpy. An elementary school might turn to cafeteria cameras to help identify students’ close contacts. But they weren’t studying the day Andrea Ochoa’s 10-year-old daughter later had lunch with a student who tested positive.

Ms. Ochoa, who has autoimmune problems, only learned of the exposure from her daughter the following week.

“I don’t feel sorry for a child getting sick,” said Ms. Ochoa. “But I don’t want gossip among young children to be the way we parents figure out how to defend our children.”

Policy patchwork

San Antonio is a microcosm of programs in schools across the country, even as the federal government dedicates more resources to testing.

Dr. “While some of the logistics are getting easier, there’s a pretty fragmented approach from school district to school district about whether and how testing is used,” Faherty said.

In Illinois, all public schools except Chicago are eligible for the free SHIELD test: weekly saliva tests developed by the University of Illinois at Urbana-Champaign.

But neighboring Iowa turned down the $95 million allocated for testing under the American Recovery Plan. The state’s education ministry says other resources are available for schools; some counties distribute take-home test kits, which are available free of charge from the state lab.

Even in states with coordinated programs, attendance can be spotty. As of September 21, only 24 percent of Virginia’s public school departments had enrolled in their school. federally funded testing programprovides access to pooled PCR testing and home testing kits on a regular basis.

Elsewhere, the rise in late summer cases has confused schools.

Robert Wood Johnson Foundation president and former deputy director of the Centers for Disease Control and Prevention, Dr. “It’s a game of catch,” said Richard Besser. “You can’t ask schools to implement broad-based testing protocols after the school year has started when materials, staff, and logistics are not in place.”

Illinois’ SHIELD program was bombarded with last-minute recordings; As of September 21, 43 percent of participating public schools had enrolled after August 23, the SHIELD representative said.

The program takes three to six weeks to start; A few weeks into the school year, most participating schools have not yet started testing.

Chicago Public Schools has its own schedule, which is constantly delayed. The district initially said the weekly screening would be open to any student. When schools open on August 30. The district now says the program will be fully operational by the end of September, tying the delay to the testing company’s need to run background checks on its employees.

Local parents have expressed frustration with the changing timelines and slow updates. “There’s no clear line of communication,” said Debora Land, a high school sophomore in the area and a parent representative on the local school council. “Parents were like, ‘What’s your plan, what’s your plan, what’s your plan?’ he asks.”

The district said that as of September 17, only 3 percent of students had enrolled in the testing program.

In New Orleans, the district has actively encouraged families to enroll in its weekly PCR testing program – it offers multilingual online registrations and enrolls in a state-run program that pays students to have Covid testing, said district spokesman Richard Rainey.

But local schools had to weather Delta and Ida, Category 4 hurricanes that stripped the city’s power, temporarily closed public schools and suspended testing. “After the storm passed, we quickly returned to restart the regime within a week,” Mr. Rainey said.

A village is driving

Increasing demand for testing has also strained supplies. In Fresno, California, the school district was unable to replenish its stock of rapid antigen tests, and as a result had to cut back on its testing for student athletes.

But the biggest challenge many schools face is finding staff. Berkeley Unified School District used state money to hire seven people to run its Covid testing team, then plowed into its own coffers to recruit 14 more.

For many areas in low-income communities, such financial outlay may be impossible. Dr. “We need to make sure the resources are there, especially in the communities that are most affected,” Besser said.

Protocols that work at low transmission rates can become unsustainable when rates increase. Alachua County, Fla. allows quarantined students to return to school early if they test negative for the virus on the fifth day of their quarantine.

During the worst of the August surge, nurses at some schools were testing as many as 40 to 50 quarantined students each morning.

Inspector Carlee Simon said schools had to hope that no one would need medical attention within the hour or two it could take to test all these students. “It’s like a kid not having an asthma attack or everybody needs an EpiPen.” “Our nurses were in a full-time job before Covid. Now Covid is a business.”

The workload eased, but 15 nurses quit in the first month of school.

In Grapevine, Texas, the school district’s test center received so much demand in early September that appointments were booked days in advance. Amy Taldo, who runs the site, said she doesn’t have the staff to expand it. “I need an army,” he said.

And testing is just the first step. At the San Antonio Independent, when students or staff test positive, a team of nurses conducts a grueling contact tracing protocol.

District nurse Lynn Carpenter requests detailed seating charts from all her teachers to identify a single high school student’s close contacts. “I need to know, is it on the tables or on the table, how far apart are the tables?” said.

If the student is an athlete, coaches are also called in with questions about training and games. “It’s just one type of fungus coming out,” he said.

Working from a windowless, bare-walled office, Ms. Carpenter sometimes needs several days to complete a single case. He made phone calls to seriously ill staff, some of whom burst into tears. “This is heartbreaking work,” he said.

Vaccination for children 5-11 years old can be authorized as soon as next monthfurther protection of primary schools. But even then, most young children can take months to get vaccinated, and Dr. Many may never be vaccinated, Besser said.

So schools are moving forward with what they have: limited staff and limited time.

“I think it’s a very valuable thing we’re doing,” said Ms. Carpenter. “I look forward to the day when this is over and I can go home.”