The state Health Department is allowing local health departments to make decisions allowing parents to avoid 10-day COVID-19 quarantines.

The Health Department published a memo addressing “test-to-stay” guidelines that would allow children to return to school after COVID-19 symptoms have subsided, allowing children to test out of quarantine and creating an exemption to weekly testing for unvaccinated staff or teacher testing for recently recovered COVID-19 cases.

Test-to-stay would allow students who are a close contact of someone with COVID-19 to remain in school as long as they take a COVID-19 test every day for seven days after they are exposed. The state Health Department isn’t recommending local health departments use test-to-stay but is giving them the option.

“At this time, the (state Health Department) does not recommend (test-to-stay),” the memo said. “However, if LHDs (local health departments) choose to allow (test-to-stay) to occur in schools within their jurisdiction, (the state Health Department) encourages them to ensure the following:

The school/district must have a written protocol that: (A) Considers equity (i.e., families should not have to pay for testing, or if they do, then the inability to pay should not prevent a student from being eligible for TTS).

See SCHOOL, (B) includes actions to follow-up on transmission (e.g., contact tracing) in the event that an individual tests positive. And (C) other factors deemed essential or important by the LHD or school.

The daily test must be conducted and the results received before the school day begins, and positive individuals excluded/isolated per existing procedures.

If the test is done in an unmonitored setting (e.g., home), a mechanism to ensure that the test is done correctly and on the correct person must exist.

The exposed person who is allowed to remain in school through TTS must still be quarantined outside of school instruction/academic periods (on weekends/holidays when the seven-day TTS period is still active, but no school test is required; after school/evenings; no community activities or extracurricular participation including clubs, sports, arts/performance activities, etc.).”

Massachusetts has been using test-to-stay protocols. According to the Associated Press, more than 2,200 Massachusetts schools have signed up to participate in at least one of three types of COVID-19 testing: test and stay, symptomatic testing, and pooled testing, which allows schools to test samples in batches and then individually if COVID-19 is detected in the pooled batch.

Since the beginning of the school year, results from pooled testing show pool positivity rates of less than 1%, and test and stay — which is used to test close contacts — has saved about 25,000 school days for students who would have otherwise had to quarantine, the Republican governor said.

Test-to-stay has also resulted in staff shortages in schools to keep up with the demand for testing. Last week, Massachusetts Gov. Charlie Baker activated up to 450 members of the Massachusetts National Guard, up to 200 of whom will help with COVID-19 testing in school. The company contracted to handle Massachusetts’ testing had a difficult time keeping up with demand. Of the more than 2,200 schools to sign up, 1,410 had conducted test-to-stay, symptomatic or pooled testing the week of Oct. 17, according to the Massachusetts Department of Elementary and Secondary Education.

The Centers for Disease Control haven’t yet endorsed test-to-stay, but Dr. Rochelle Walensky, CDC director, indicated the CDC was working with states to evaluate test-to-stay, with additional guidance to come.

“So, we are working with states to evaluate a test-to-stay policy as a promising potential new strategy for schools,” Welensky said on Oct. 13. “And we anticipate that there will be guidance forthcoming.”