COVID-19 Test Allocation Strategy to Mitigate SARS-CoV-2 Infections across School Districts

In response to COVID-19, schools across the United States closed in early 2020; many did not fully reopen until late 2021. Although regular testing of asymptomatic students, teachers, and staff can reduce transmission risks, few school systems consistently used proactive testing to safeguard return to classrooms. Socioeconomi-cally diverse public school districts might vary testing lev-els across campuses to ensure fair, effective use of lim-ited resources. We describe a test allocation approach to reduce overall infections and disparities across school districts. Using a model of SARS-CoV-2 transmission in schools fit to data from a large metropolitan school dis-trict in Texas, we reduced incidence between the highest and lowest risk schools from a 5.6-fold difference under proportional test allocation to 1.8-fold difference under our optimized test allocation. This approach provides a roadmap to help school districts deploy proactive test-ing and mitigate risks of future SARS-CoV-2 variants and other pathogen threats.