Jan. 5, 2022
Dear Superintendents and School Leaders,

I am writing with several updates since my last message.

Decision Tree Updates
The California Department of Public Health (CDPH) recommendations on isolation and quarantine apply to most settings. However, CDPH directs school leaders to its K-12 guidance for schools, which has not been updated since Nov. 24, for recommendations on quarantine. The result is a complicated mix of guidance, some that applies only to K-12 workers, some that applies only to students, and some that applies to both.

San Diego County Office of Education (SDCOE) staff and the County of San Diego’s school team have revised the COVID-19 Decision Trees for K-12 Schools, which are based on CDPH guidance on isolation and quarantine and local public health orders on isolation and quarantine. Our partners at UC San Diego are working to update the e-Decision Tree, but because the new guidance is dramatically different, it may take them a few more days. We are also updating the Spanish version, and will update you as soon as both are ready.

As you review these tools, it is important to note that the decision trees present the CDPH recommendations for isolation and quarantine. These recommendations are authorized for use by the public health orders on isolation and quarantine, which specify that under specific conditions, people are required to isolate or quarantine, and outline the options for both. But the orders do not require that schools make all of the options available to their students or employees. School leaders can, based on their assessment of the conditions within their communities and schools, choose to make only the more conservative options available.

Conflicting Messages on At-Home Testing
There is a conflict in the CDPH documents on at-home testing. The K-12 Schools Guidance 2021-2022 Questions & Answers states the following:

What type of test may be used to assess a person's status during quarantine or to exit quarantine?
An FDA-approved antigen diagnostic test, PCR diagnostic test, or pooled PCR test is acceptable for evaluation of an individual's COVID-19 status during quarantine...

At this time, at-home testing is not recommended for evaluation of an individual's status during quarantine. CDPH is currently conducting pilot studies to further understand the utility of at-home testing.

But the newly issued CDPH OTC (at-home) test guidance suggests at-home tests can be used to shorten quarantine and isolation and suggests ways schools can verify “unsupervised or unobserved” results:

What are best practices for verification of self-test results?
The following are recommended methods to verify unsupervised or unobserved self-test results. The practices listed below should strongly be considered in any context in which tests are being performed at the request of another entity, such as a school.

  • Use a digital (app-based) platform for test verification, which often includes scanning barcodes; these are available for certain brands of self-tests.
  • Write the name and date on the test card results and send a picture of the card to the requesting entity.
  • Create an attestation form and require signature declaring that the test specimen was obtained from the individual represented on the form, include the date the specimen was collected, and that the test was processed according to the instructions provided.

With access to testing critically constrained at this time, allowing the use of at-home test kits would open an additional channel for testing that:
  • Would allow children and employees to return to work and school more quickly
  • Would, with the recent distribution of home kits to school district and charter schools, improve equity of access for historically marginalized groups
  • Could be the difference for some schools between remaining open or closing due to staffing shortages

The County of San Diego is reviewing this information and considering revision of COVID-19 Decision Trees on this topic.

At-Home Test Kit Update
Thank you for your patience as we work through distributing the 196,560 test kits received from the state for San Diego County's approximately 500,000 students. Today -- our first day of distribution -- we were able to provide test kits to 29 school districts and charter schools. Another four districts and charters are scheduled for pickup tomorrow. And 14 districts and charters received test kits directly from the state prior to winter break.

CDPH has not provided any indication of when to expect the remainder of our county's allocation, except to say they "are working very hard to allocate equitably and quickly within the time and information constraints."

We will be in touch when SDCOE receives additional kits for distribution.

Thank you for all that you do. As always, please reach out if you have any questions.

Sincerely,
Paul

Dr. Paul Gothold
San Diego County Superintendent of Schools
phone: 858-295-6641