Testing

Covid Testing

Is COVID-19 testing required for unvaccinated school personnel?

Yes. Beginning September 19, 2021, school personnel who are not fully vaccinated must be tested for COVID-19 at least weekly until they are fully vaccinated. If a school is experiencing an outbreak of COVID-19 and school personnel who are not fully vaccinated may be part of the outbreak, as determined by public health authorities, such school personnel must be tested two times per week for the duration of that outbreak.

What tests may be used for unvaccinated school personnel?

School personnel who are not fully vaccinated must be tested for COVID-19 with either a Nucleic Acid Amplification Test (NAAT), including PCR tests, or an antigen test that either has emergency use authorization by the FDA or is operating per the Laboratory Developed Test requirements by the CMS. The Illinois Department of Public Health recommends PCR testing with less than 48-hour turnaround time. Note that the state’s free school testing programs are currently being prioritized for testing students and should not be utilized for testing unvaccinated school personnel.

For how long will school personnel who are not fully vaccinated need to submit to testing?

All school personnel who are not fully vaccinated must submit to at least weekly testing beginning September 19, 2021, and must continue to submit to at least weekly testing until they are fully vaccinated.

If a school does not operate a testing program, are school personnel required to pay for testing?

A school may, but is not required to, reimburse school personnel for testing performed outside of school using state or local funds, subject to applicable local collective bargaining agreement provisions. Federal funds may be used to purchase appropriate tests and for test administration costs. However, a school may not use federal funds to reimburse school personnel for tests procured by them outside of the school setting. Generally speaking, testing is covered by health insurance, though school personnel should check with their insurance provider. For additional information, see the IDPH Interim Guidance on Testing for COVID-19 in Community Settings and Schools.

May unvaccinated school personnel purchase and self-administer a test and provide test results to the school for required weekly screening for unvaccinated staff?

Yes, though a school may determine its own requirements for test reporting. At-home tests or self-test kits for COVID-19 are available for purchase from retail pharmacies or other outlets. Some of these tests require supervision or proctoring through telehealth, who will then confirm the identity of the person taking the test (e.g., by showing photo ID), while others are fully self-administered. For schools and school districts, at-home or self-tests that are fully self-administered are permissible when the school or school district requires proof of the test result through a video or picture of the test result to be available upon request from the school personnel. If schools or school districts choose to allow their school personnel to use at-home tests that are self-administered to attest to their negative status, they should be aware of the limitations of these tests, such as inadvertent improper administration and difficulty in verifying the reported results against the individual’s identity. Over-the-counter tests are not recommended for students or staff excluded due to COVID-19-like symptoms.

How can school personnel who are not fully vaccinated provide proof of a negative test?

As required by Executive Order 2021-22, school personnel must be tested on site at their workplace or submit proof or confirmation of a negative test obtained elsewhere. Such proof should include a paper or electronic copy of the negative test result for review by the school. There should be sufficient personally identifiable information on the test result to ensure the specimen and result do in fact apply to individual required to test.

CDC guidance for verifying a qualifying negative test result for air travelers indicates that test results must be in the form of written documentation (paper or electronic copy) and must include the following:

Type of test (indicating it is a NAAT or antigen test).

Entity issuing the result (e.g., laboratory, health care entity, or telehealth service).

Specimen collection date. A negative test result must show the specimen was collected within the three days before the flight. A positive test result for documentation of recovery from COVID-19 must show the specimen was collected within the three months before the flight.

Information that identifies the person (full name plus at least one other identifier such as date of birth or passport number).

Test result.

What happens if school personnel undergoing at least weekly testing for COVID-19 receives a positive result?

School personnel who test positive for COVID-19 should immediately isolate at home. Schools must exclude school personnel who are a confirmed case or probable case for five days after the first day of symptoms or the date of the positive viral test for asymptomatic persons. Individuals may return to school after five days if asymptomatic or if symptoms are resolving and must wear a mask at all times around others for five more days.

Must a school exclude unvaccinated school personnel who are testing in accordance with applicable testing requirements while they are awaiting test results?

No. Schools may permit school personnel awaiting weekly test results to be on school premises, so long as the school personnel is not considered a close contact to a confirmed or probable case and is not exhibiting symptoms of COVID-19.

How can testing be used to support in-person instruction?

Screening tests for COVID-19 can support in-person learning by identifying infected persons who are asymptomatic and without known or suspected exposure to SARS-CoV-2. Screening tests are performed to identify persons who may be contagious so that measures can be taken to prevent further transmission. Screening testing should be offered to students who have not been fully vaccinated when community transmission is at moderate, substantial, or high levels (Table 1 in the CDC guidance: “Screening Testing Recommendations for K-12 Schools by Level of Community Transmission”).

IDPH recommends schools acquire parental consent for student testing in advance to accommodate outbreak testing, should the need arise. For schools partnering with SHIELD Illinois for weekly screening, outbreak testing is included in the testing program. For districts without weekly screening, outbreak only testing through SHIELD Illinois is available by completing this interest form: https://bit.ly/3mMejKH. However, prioritization of outbreak testing will be given to districts with weekly screening programs. Schools that fulfill the requirements to implement point-of-care testing as outlined in the IDPH Interim Guidance on Testing for COVID-19 in Community Settings and Schools can also utilize BinaxNOW rapid antigen testing for their outbreak response. BinaxNOW tests can be requested by emailing dph.antigentesting@illinois.gov.

The state has made COVID-19 testing available free of charge to all schools in Illinois through SHIELD Illinois. Those interested in establishing a K-12 testing program using the SHIELD Illinois saliva test should complete this interest form: https://bit.ly/interestedSHIELD. Note: SHIELD Illinois is also able to offer BinaxNOW rapid antigen tracking along with its standard weekly saliva testing program. (See the IDPH Interim Guidance on Testing for COVID-19 in Community Settings and Schools for complete information on testing).

Additionally, testing can be used to keep students in school when identified as classroom close contact through the Test to Stay protocol. 

How can testing be used to support participation in extracurricular activities?

To facilitate safe participation in sports, extracurricular activities, and other activities with elevated risk (such as activities that involve singing, shouting, band, and exercise that could lead to increased exhalation), CDC recommends schools implement screening testing for participants who are not fully vaccinated. According to the CDC, schools should routinely test student athletes, extracurricular participants, coaches, and trainers, and other people (such as adult volunteers) who are not fully vaccinated and could come into close contact with others during these activities. To protect in-person learning at school, CDC recommends that sports that involve sustained close contacts with others and extracurricular activities that involve singing, shouting, band, or exercise, especially when conducted indoors, should be virtual or canceled in areas of high community transmission, unless all participants are fully vaccinated and can maintain social distancing or masking during related activities. For more information on sports, see the IDPH sports guidelines. For additional information on CDC K-12 screening testing recommendations, see table 1 of the new CDC Guidance for COVID-19 Prevention in K-12 Schools.

When a student is tested outside of school, can the school be notified of a confirmed or probable case as quickly as possible?

Schools should ask parents/guardians to notify the school as quickly as possible of any confirmed or probable COVID-19 cases. It is important that schools communicate this expectation to parents/guardians early and often. The local health department (LHD) will also receive a report of a confirmed or probable case from either a lab or provider. However, the report does not necessarily include school information (unless the school was the test submitter). This means that the LHD must obtain this information by interviewing the case/parent/legal guardian. The LHD will notify the school as soon as they have acquired the school information. Schools should identify a point of contact for LHDs, including someone who can be reached after hours.

If a student or staff member presents a note from a health provider or negative COVID-19 test result, for how many days is that test result valid?

A negative polymerase chain reaction (PCR) test is valid only for the day on which it was reported. It denotes that on the day that the sample was collected, the individual being tested did not have any detectable virus in their system. Because the incubation period (time from exposure to infection) for COVID-19 is 2-14 calendar days, a person with a negative test may still develop infection at some point during the incubation period.

When is a confirmatory PCR test required for possible cases in the school setting?

As shown in the CDC’s testing algorithm (see Figure 1) and referenced in IDPH’s Rapid Point-of-Care Testing for COVID-19 in Community Settings and Schools, confirmatory testing for antigen and rapid NAATs is sometimes required when the results are different than what is expected (e.g., positive result in an asymptomatic person with no known exposure). In these circumstances, CDC recommends a lab-based (non-rapid) NAAT (such as a PCR) from a nasal specimen.

Results from COVID-19 point-of-care (POC) antigen tests should be interpreted based upon the test sensitivity and specificity, whether the individual being tested has symptoms, and level of transmission in the community and the facility. A confirmatory NAAT may be needed in certain situations. Because laboratory-based NAATs are considered the most sensitive tests for detecting SARS-CoV-2, they can also be used to confirm the results of lower sensitivity tests, such as POC NAATs, or antigen tests such as BinaxNOW. While the SHIELD Illinois saliva test is a highly reliable laboratory-based NAAT and does not require an additional confirmatory test when used as a primary diagnostic test, CDC recommends collecting and testing an upper respiratory specimen, such as nasopharyngeal, nasal mid-turbinate, or anterior nasal, when using NAATs for confirmatory testing. An upper respiratory test, such as a BinaxNOW rapid antigen test, should be confirmed by a laboratory-based NAAT test performed on an upper-respiratory specimen.

When considering if school personnel or students need to be excluded from in-person learning for a period of time due to COVID-19-like symptoms, if the school personnel/student is a close contact to a confirmed or probable case, the school is experiencing an outbreak, or the local health department (LHD) is requiring validation due to community transmission levels, documentation of a negative NAAT (e.g., RT-PCR) COVID-19 test result is needed. The SHIELD Illinois saliva test is a RT-PCR and can be used in these situations. If the student/school personnel does not have a known close contact, the school is not in outbreak, or the LHD is not requiring confirmatory testing due to the level of community transmission, a negative RT-PCR, rapid molecular (rapid PCR) or negative antigen test is acceptable. (With low pre-test probability, NAAT testing [e.g., PCR] following a negative antigen test is not required.)

A confirmatory PCR test is not recommended after a positive RT-PCR result.

Do fully vaccinated persons need to be tested?

It depends on the circumstances, per CDC’s guidance.

If a fully vaccinated or boosted person develops symptoms of COVID-19, they should be tested, isolated, and excluded from school.

If a fully vaccinated or boosted student or staff has close contact with a confirmed case of COVID-19, they should be tested at least five days after the exposure but are not required to be excluded as long as they remain asymptomatic, test negative if tested,  and have received all recommended COVID-19 vaccine doses, including boosters (if 18 or older) and additional primary doses for some immunocompromised people.

If a fully vaccinated staff or student attends a school or classroom that is currently experiencing an outbreak, that student or staff may have been exposed and should be tested as part of the school’s outbreak testing response.

If a school is conducting screening testing of asymptomatic persons, then a fully vaccinated or boosted (if eligible) person should not be tested as part of screening testing unless recommended to do so in certain situations of heightened transmission risk, such as with some sports activities.