President-elect Joe Biden is weighing a multibillion-dollar plan for fully reopening schools that would hinge on testing all students, teachers and staff for Covid-19 at least once a week, according to four people with knowledge of the discussions.

The proposal under consideration calls for the federal government to cover the cost of providing tests to K-12 schools throughout the country. These could then be administered regularly by staff at each school, providing results in minutes.

The developing plan closely tracks with recent recommendations from The Rockefeller Foundation to invest billions into the creation of a K-12 testing system that would reassure teachers and students it is safe to resume in-person schooling. Biden has vowed to reopen the majority of schools within his first 100 days in office, amid growing concerns about the educational and mental health toll that months of remote learning has taken on a generation of students.

But such a strategy would require a sharp increase in the manufacturing of rapid tests and new lab capacity being brought online over the next several months, as well as incentives to convince states and local school districts to adopt the more intensive testing regime.

Biden transition officials are still trying to determine the exact price for regular testing in the nation's schools. One person close to the deliberations pegged the cost at between $8 billion and $10 billion over an initial three-month period.

That would likely need to be funded through a new coronavirus aid package that Biden has pledged to pursue as soon as he takes office next year.

"It's certainly the presumption of the Biden effort that there will be an opportunity for him to pass an economic stimulus Covid relief bill in the first 100 days, and in that bill should be money for schools," the person close to the deliberations said.

Biden’s transition team has not responded to multiple requests for comment.

The emerging school testing plan represents a core element of the incoming president's effort to bring the pandemic under control and get most students back in the classroom as soon as possible.

Biden said earlier this month that reopening most schools is one of his top three pandemic-related priorities. And his choice for education secretary, Miguel Cardona, spent recent months pressing for the continuation of in-person learning as Connecticut's education commissioner.

Transition officials have spent weeks developing the reopening proposal, which will likely also recommend investments in upgrading schools' air filtration systems and other infrastructure that could help guard against the virus' spread.

Several diagnostics manufacturers and labs are in ongoing discussions with the Biden team about how to source tests and implement the screening plan, according to multiple people familiar with the discussions.

The transition team has also had conversations with the Rockefeller Foundation about school screening. “The Rockefeller Foundation and the Biden team are in lockstep on how to do K-12 testing,” a diagnostics industry source said.

Rockefeller Foundation spokesperson Ashley Chang declined to comment on the group’s interactions with the Biden team. “Our plan to safely reopen — and keep open — America's schools speaks for itself,” Chang said. “This can be achieved by mounting an extraordinary scale up of testing in K-12 schools, where teachers and staff are tested twice a week and students once a week through the end of the school year.”

The organization released a white paper last week that proposed testing all students once a week and teachers twice a week, at an estimated cost of $42.5 billion for the remainder of the current school year — far higher than the price tag for Biden’s nascent plan. Rockefeller suggested starting the screening program in elementary schools in early February, followed by middle schools by mid-February and in high schools by March.

The Biden team is discussing testing students, teachers and staff only once a week, and saving money and time by relying on rapid tests rather than lab-based PCR testing, according to a person familiar with the discussions. Another way to cut down on the cost of the program would be to pool samples from multiple students and test them using PCR at regional testing labs across the country that could be opened, according to the Rockefeller plan.

That strategy represents a break from the Trump administration's approach toward efforts to reopen schools. The federal government bought more than 150 million Abbott rapid tests in recent months with the goal of helping states boost testing in schools, but let states decide how to use most of that supply. Many governors chose to use the tests more broadly, limiting the help for schools, and millions of the rapid tests have not been used yet.

Trump testing czar Brett Giroir last week acknowledged that universities’ repeated testing of students and staff during the past months helped limit infections. But the HHS official pointed to recent CDC research that suggests mitigation measures like installing plexiglass shields, wearing masks, using hand sanitizer and cleaning supplies can help minimize the risk of Covid-19 spread for younger students.

“Any suggestion that the nation requires hundreds of millions or perhaps billions of more tests in order to open schools is contrary to the evidence and dangerous to our children,” Giroir told reporters.

Susan Van Meter, executive director of diagnostics lobby AdvaMedDx, said that while school-aged children appear less likely than adults to spread the virus, the risk is not zero.

“Individual member companies — and we represent all of them — are appreciating dialogue with the transition about the continual effort to ramp up testing and extend reach of testing, including for K-12 schools,” Van Meter said.

Health technology diagnostics company Color, which has worked with California officials and diagnostics manufacturer PerkinElmer to coordinate Covid-19 testing for the state’s recently opened laboratory, released a white paper and transmission model this month examining how testing could help K-12 schools reopen.

“Proactive testing of teachers and staff once or twice a week can help catch introductions early, before they spread widely through the school,” the Color paper states. “Especially in secondary schools, once- or twice-weekly testing amongst students should also be considered to further reduce the likelihood of a large outbreak amongst the full population.”

The Biden team has yet to finalize the testing plan, and several key elements that could determine its scope remain in flux. Officials haven’t determined how to incorporate private schools into the proposal, or what incentives are needed to get states and localities to follow the recommendations.

Also unresolved is whether the federal government would cover the cost of school testing programs that are already in place. And while Biden advisers and The Rockefeller Foundation have both argued that the federal government should use the Defense Production Act to increase the country’s testing capacity, it’s not clear how quickly that would increase the supply of rapid tests.

Color CEO Othman Laraki told POLITICO putting in place a K-12 screening system could be difficult, given the need to navigate the relevant science, the logistics of rolling out tests to students and teachers and the politics of building community support from parents and teachers’ unions. “The big part of this is kinda solving those three problems at the same time,” Laraki said.

Just creating enough testing capacity will be challenging, said Julie Khani, the president of the American Clinical Laboratory Association. The lab lobby, whose membership includes LabCorp and Quest Diagnostics, believes “significant investment” into new machines, testing supplies, lab staff, reporting systems and transportation logistics would be necessary.

“We remain focused on working with policymakers to ensure labs can make these investments and increase capacity for the innovative diagnostics our country needs, now and in the future,” Khani said.

Biden’s team has kept a close eye on the plan's price tag, amid worries that Republicans will resist the president-elect’s calls for passing another massive stimulus package early next year.

Officials in particular have discussed testing students, teachers and staff more frequently than once a week, but are wary that could send the plan’s cost ballooning.

"We had debates about how much you should test, should it be twice a week," said a person close to the deliberations. "But that doubles the price."

Politico