A UC San Diego lab has created a program to offer low-cost, rapid coronavirus tests to local schools and organizations, and La Jolla’s reopened private schools are in varying phases of participation, hoping to control the spread of COVID-19 among their students and staff.
The Expedited COVID IdenTification Environment, or EXCITE, lab has developed a test to detect the virus in less than 24 hours, according to professor Louise Laurent, vice chairwoman for translational research in obstetrics, gynecology and reproductive sciences. Laurent is one of the leaders of EXCITE, along with Rob Knight, founding director of the Center for Microbiome Innovation and a professor of pediatrics and computer science and engineering, and Gene Yeo, a professor of cellular and molecular medicine and co-director of the Bioinformatics and Systems Biology Graduate Program.
The test is administered on school sites via an anterior nose swab (taking a sample from the nasal membrane), which is considered less invasive than a nasopharyngeal swab (taking a sample from the uppermost part of the nose and throat), and is much less costly. Private school officials said EXCITE can process the tests for roughly a third of the price of other mobile labs and testing providers that cost $110 to $150 per test.
The purpose of the EXCITE lab “is to provide large-scale COVID testing to frontline responders and educational institutions,” Laurent said. The lab also is providing testing for UC San Diego’s “Return to Learn” program, as well as the San Diego Fire-Rescue Department, she said.
This kind of testing program is important “in order to safely conduct activities such as education, where people need to be in the same room at the same time. We really need a quick way to identify people who are asymptomatic to help contain outbreaks,” Laurent said.
The public San Diego Unified School District announced Nov. 10 that its students and employees would receive coronavirus testing every two weeks under a proposed agreement with UCSD Health.
The plan would provide access to PCR testing (a swab to detect an active infection) on district campuses, according to a statement from SDUSD, San Diego County’s largest school district. Testing frequency would be adapted over time and based on virus and transmission rates, district officials said.
District leadership approached the EXCITE lab to ask “if we had sufficient capabilities to satisfy” its testing requirements, Laurent said, though she wasn’t able to say whether EXCITE is the lab the district would use. “We are ready if and when called upon to do that,” she said.
District Communications Director Maureen Magee could not immediately be reached for comment Nov. 11.
San Diego Unified currently is in Phase 1 of its reopening plan, in which appointment-based in-person learning resumed Oct. 13 for some elementary school students “who have been uniquely identified by their teachers as experiencing learning loss,” according to SDUSD, which said its reopening plan was established in collaboration with UCSD.
The district said last month that the earliest all elementary school students would be allowed to return to campuses for part-time in-person learning in Phase 2 is Jan. 4, and the earliest that middle and high school students could return is Jan. 25.
“This testing program is an essential part of our plan to continue teaching students in the middle of a global pandemic,” Superintendent Cindy
Marten said. “The science is clear. We can prevent 90 percent of disease spread at schools simply by putting in place a robust testing program.”
No decision had been reached on whether the testing would be mandatory, as SDUSD said it first wants to assess voluntary compliance rates once the testing begins.
Fred Wu, chief medical officer for Scripps Health Inpatient Providers, acted as the liaison to help get the EXCITE program into area private schools, with the eventual goal of seeing the program throughout public schools, he said.
Wu, who has three children in La Jolla public schools, said, “If you’re going to open schools again without testing, you’re just asking for disaster.” He wants to “show that it can be done as cheaply as possible,” he said.
Testing programs are designed “to catch [COVID cases] before they can spread to anybody else,” he said. “At this point, I know three families with deaths from COVID. It’s real, and if you can try to prevent that, why not?”
Wu worked with friends and colleagues Chris Freundt, Lisa Lowe Hiller and Hala Madanat to inform schools about the EXCITE tests.
La Jolla Country Day School, The Bishop’s School, San Diego French-American School and The Evans School, all private schools in La Jolla, have signed on to test their staff and students. Academy of Our Lady of Peace in San Diego also is participating. All schools have designed varying plans for implementation.
The program was first implemented three weeks ago at La Jolla Country Day, where Head of School Gary Krahn already had been testing staff and students before they were allowed back on campus Sept. 14, using Sofia 2 rapid antigen testers, which give results in 15 minutes.
The EXCITE tests, he said, “are so much cheaper, and they do it for the right reasons … to make our community a safer place.”
Krahn said LJCDS is testing all of its 250 employees and 1,127 students (except the 150 to 200 who have opted to remain in distance learning) every three weeks in staggered groups.
Testing is mandatory at LJCSD, Krahn said. “If you make it voluntary, then you really don’t have a testing program.”
“We have not had one complaint” about the program from anyone in the LJCDS community, Krahn said.
Madanat, vice president of research and innovation at San Diego State University and former director of the university’s public health department, said the ideal testing frequency is weekly for adults, though every two weeks is sufficient.
“Testing frequency is very important because that’s how we catch it early on,” said Madanat, whose daughter is in the online learning program for San Diego French-American School. “You have the ability to catch individuals who are pre-symptomatic or asymptomatic.”
Keeping school campuses closed is “not sustainable,” Madanat said. A testing program aimed at surveillance will facilitate people “moving on with our lives,” she said.
The program, she hopes, will show schools that have not yet reopened that “it’s not impossible to do testing. There’s a system, and we can make it work.”
The EXCITE program is “very heartening, after several disheartening months,” said Lowe Hiller, an emergency room doctor for Sharp Memorial Hospital in San Diego and the VA hospital in La Jolla. She said the program is important “because I know that we are having a significant amount of asymptomatic spread, and I know that we need our kids in school and our businesses open.”
Lowe Hiller, who has two children attending San Diego French-American School and teaches at the UCSD School of Medicine, works with Madanat to advise SDFAS on implementing the testing program. She said regular testing of students and staff means “you have the data to show that … opening a school safely can be done. It gives us more mitigation of the risk that’s out there.”
Before SDFAS welcomed students back to campus Aug. 28, the school paid about $8,500 to test its 80 employees, a price that wasn’t sustainable for repeated testing, Head of School Mark Rosenblum said.
With the EXCITE program, SDFAS is testing its staff, split into two 40-person cohorts, every week, with each member tested every two weeks.
The school began testing students Nov. 10, aiming to test 25 percent of them each week. Testing is voluntary for students and is not available to siblings or parents, nor is it available yet to students who are symptomatic, though Rosenblum hopes to be able to offer that by January.
“I hope it stops the spread of COVID if it comes on our campus,” Rosenblum said. “I hope it reassures people in their choice to send their kids to campus.”
Michael Beamer, assistant head of school at Bishop’s, which restarted in-person instruction Sept. 2, said he learned about the EXCITE program through Freundt. The school began using the program to test its employees three weeks ago, shifting from the mobile clinic it had been using since August, and began testing students a week ago.
All adults “who have contact with others on campus” are tested weekly, Beamer said, which amounts to about 170 people.
Bishop’s had aimed to test 10 percent of the 800 students every month, but will increase that to 20 percent to 25 percent per month “with the way the disease is trending in San Diego,” he said. That means roughly 50 student tests per week across all grades.
Under the current staggered schedule, one-third of the student body is on campus at any given time.
Student testing is not compulsory, Beamer said, but most parents are “thrilled” by it. “It adds some comfort to know what their status is,” he said.
Staff members also have been supportive of the testing program, he said, and “recognize that what we’re trying to do in schools is relatively high-risk. In a pandemic, it is unnatural to bring people together. This program really offers peace of mind.”
Bishop’s is using the EXCITE program for testing of asymptomatic students only, Beamer said. Anyone with symptoms is directed to his or her health care provider for testing and management.
Freundt, whose younger daughter attends high school at Bishop’s, said tapping into the “world-class testing abilities” of UCSD and having the program at Bishop’s gives him assurance of safety for his daughter as well as hope for other schools being able to open.
“I feel grateful that my daughter is able to learn in person,” he said. “It changes things significantly.”
Representatives of The Evans School declined to comment.
— City News Service contributed to this report. ◆