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EDMUND G. BROWN JR.
Governor

State of California—Health and Human Services Agency
California Department of Public Health


August 19, 2022


TO:
All Californians

SUBJECT:
Testing Framework for K–12 Schools for the 2022–2023 School Year


Background

This document aims to inform California's K-12 schools of anticipated changes to COVID-19 testing strategies for the 2022-2023 school year.  It is intended to support current and ongoing planning processes.

Testing remains a key mitigation layer to detect and curb transmission of COVID-19 in school settings.  To date, more than 78.3 million tests have been administered at schools, and nearly 32 million over-the-counter (OTC) tests have been distributed by state agencies to local school communities.  

The following list describes current and anticipated updates to COVID-19 testing operations for K-12 schools:

  • Currently, California is offering COVID-19 OTC tests to all county offices of education (COEs) for use by public and private school students and staff for return from summer break testing. CDPH has communicated with COEs about this program, and COE distribution is well underway in most counties; for more information, please contact your local COE.
  • Starting August 15, 2022, CDPH will be able to offer direct ordering of COVID-19 OTC tests to schools.  Schools may use OTC tests to supplant on-site testing in many situations. Such efforts will be paired with ongoing statewide, school-focused educational materials to facilitate proper OTC use, particularly in communities with limited English proficiency and/or lower health literacy. 
  • CDPH recommends that antigen tests be considered the primary option for detecting COVID-19 in schools, compared to PCR tests.  Both the professional, on-site antigen tests as well as the OTC at-home antigen tests have been effective in identifying persons who have infectious levels of all known variants of SARS-CoV-2.  PCR tests are highly sensitive, but their utility is greatest as a confirmatory test in appropriate situations, and/or in clinical settings.  If you are currently participating in a CDPH school-based PCR testing program, please email schooltesting@cdph.ca.gov for more information about transitioning to an antigen testing program in preparation for fall and to learn more about available resources.
  • CDPH will continue to support professional on-site antigen testing programs in the 2022-2023 school year. However, the volume of anticipated on-site testing is likely to decrease with the increased availability and ease of OTC tests. We anticipate the workload for on-site testing to substantially decrease for the 2022–2023 school year as OTC testing will often meet testing needs. Thus, state support for school-based testing staff (via Personnel Support Program vendors and Personnel Grants) will be appropriately reduced. More information regarding these programs will be provided following enactment of the 2022–23 state budget.

Because of the long turnaround time of PCR testing, we recommend PCR testing in the following situations:

There are some limited circumstances where PCR or other molecular tests may be appropriate in the school setting. 

  • People at high risk for hospitalization or death from COVID-19 benefit from early treatment and should have an immediate PCR (or other molecular) test and repeat an antigen test (at-home tests are acceptable) in 24 hours if the PCR result has not returned. Sometimes people with COVID-19 have a negative antigen test in the first days of symptoms. PCR (or other molecular tests) may detect the virus earlier than an antigen test. For low-risk people, repeat an antigen tests (at-home tests are acceptable) in 24-48 hours. Individuals may consider repeat testing every 24-48 hours until a positive test or until symptoms improve.
  • When a participant has ambiguous or invalid antigen test results even on a repeat test. Schools can consider also repeating antigen test in 24-48 hours as an alternative. 
These updates and anticipated changes are based on current scientific knowledge and anticipated trends. As noted in the SMARTER plan, and as we have all experienced, COVID-19 trends shift rapidly and California's response to conditions in schools must remain nimble, adaptive, and responsive to dynamic challenges.