AURORA – The middle schoolers belting out tunes in the school cafeteria and spooning in mouthfuls of chicken teriyaki and broccoli actually get that they are part of a potentially life-saving science experiment.
As the eighth grade class at Aurora Science & Tech Middle School joins in a chorus of “So, before you go,” gloved researchers from the nearby Colorado School of Public Health are set up in the corner of the cafeteria collecting nasal swabs and face masks with the power to detect the coronavirus.
The middle school adjacent to the University of Colorado Anschutz Medical Campus is part of a dual-purpose surveillance and research study that could create new protocols for future waves of the coronavirus pandemic, or even future pandemics.
About a third of the school’s students and staff have opted into the study that requires them to wear a mask with a sticky, polyvinyl alcohol strip inside, right in front of their nose. Students pick up their masks in the morning, then return them at lunchtime. The study, funded by the World Health Organization, includes the University of Leicester in England as well as CU, which is sending masks to seven university and health campuses in Colorado with a goal of collecting hundreds of coronavirus-positive masks.
The goal is that someday, people could tell by the color of the strip inside their mask whether they are exhaling coronavirus, and whether they are infectious.
At first, the Colorado researchers weren’t getting much response as they looked for K-12 schools to test masks with the strips, which are created by a 3D printer and shipped from England. But then Dr. May Chu, an epidemiology professor at the Colorado School of Public Health, realized how she could sweeten the deal. She offered what schools need — assistance with a COVID-19 testing program that would identify asymptomatic students and staff.
And the middle school, one of only a handful of public, open-enrollment schools in the nation on a medical campus, jumped at the chance.
Once a week for the past month, as the omicron variant has surged in Colorado, public health researchers have set up their testing table inside the school cafeteria. The process is swift and doesn’t cut into learning time. Over three lunch periods — for sixth, seventh and then the eighth graders — students whose parents have opted into the program stop by the table and get their hands squirted with sanitizer. Each writes their name on a nasal swab kit, then swipes their nostrils with a swab.
After lunch, the School of Public Health researchers walk the nasal swabs and the masks to Summit Biolabs, about a block away in the innovation section of the medical campus. And by around dinner time, Aurora Science & Tech Middle School director Rebecca Bloch gets the results of the nasal swab testing. It’s a super fast turnaround for PCR testing, which can take three to five days at other labs.
Six to eight students and teachers, almost every one asymptomatic, have tested positive each week so far. Bloch calls those with positive results the same night. Every time, they’re “shocked,” she said.
“Before, we were just having students or faculty who had symptoms stay home,” the principal said. “This is actually pretty amazing because it’s allowing us to catch the asymptomatic cases.”
Those who test positive, along with the handful of kids at their assigned lunch table who are considered close contacts because they are not wearing masks and are together for longer than 15 minutes, are asked to quarantine. One teacher who was sick but returned to school after a negative coronavirus test, later tested positive during the school screening program.
Parents, especially those with children who are immuno-compromised, appreciate the program, which is gathering more volunteers each week, Bloch said. It started out in early January with 80 participants, and now more than 130 of the 435 people on campus are taking the weekly tests.
Bloch figures there are a variety of reasons why there aren’t more students signed up. “It’s not wanting to fill out a form, even though it’s quick and pretty easy to do,” she said. “Personal feelings about vaccines. Or their child has already had COVID and not realizing there are recurring cases. That’s the big question for me to solve and I’m not quite sure why.”
“It’s actually painless.”
Tell that to Dante House, who is 12 and in seventh grade. Still, he’s willing to deal with the soreness in his nostrils for the good of science.
“My nose feels so weird,” he said, while eating lunch with his friends. “But I still feel this is the only way for us to survive.”
Also, Dante said, the testing is far better than getting coronavirus, which he recently had. “It was terrible for the first two days.”
Few schools in Colorado have taken the state or a private lab, called COVIDCheck Colorado, up on offers of free, regular testing. Less than 1% of the state’s K-12 population is being tested through the state’s federally funded program, according to the latest numbers, released in November, and almost all of those students go to either Jefferson County or Mapleton schools.
The reason is that even with free testing, schools rarely have the staff or the time to set up a testing program. COVIDCheck Colorado, for example, will pay for testing for schools across the state, but schools have to set up their own programs and assign staff to run them. The organization, which provides testing in 11 schools, supplied the nasal swabs for the Aurora middle school and is paying for the testing.
Chu, at the School of Public Health, is hoping the streamlined cafeteria setup at the Aurora school will become a model for others. “We will be better prepared for the next one because we know what to do,” said Chu, who has done surveillance testing for infectious diseases around the world, including for the Ebola virus in Africa. “We still don’t know how this pandemic is going to be.”
She and colleague Dr. Thomas Jaenisch, also an epidemiologist at the Colorado School of Public Health, also have high expectations for their mask-strip study. Jaenisch hopes for a day when people could look at the color of the strip in their mask and know instantly whether they are expelling or exhaling coronavirus.
In early data from people on college and medical campuses, the researchers are seeing that people who test positive via a nasal swab do not test positive via their mask on the same day. And the other way around. What it means, Jaenisch said, is that there is a window of time when people have the virus in their nose but are not exhaling it and are perhaps not infectious.
“The big picture would be finding out how many days in advance of testing the nose, maybe the mask is already positive,” he said. “Or when the mask is not positive anymore and the nose is still positive, does it mean that people still have the virus but they are not infectious or not as much? We want to disassociate being infected and being infectious to others. Those two components are usually just mixed together and we are trying to tease them apart.”
The study aims to include 300 people with the virus — and as many of their contacts as possible — to learn about rates of transmission and how that relates to the virus people are exhaling.
College students started out wearing masks that had two strips — one by the nose and one by the mouth. Researchers have realized that in those that had the virus, it was usually the nasal strip that detected it.
The strips collect bacteria and influenza and any number of particles, so they could be used for a variety of respiratory diseases around the world. The University of Leicester previously used the strips to study tuberculosis transmission in South Africa.
“This strip is like flypaper,” Chu said, “anything sticks to it.”
Both aspects of the project — mask test strips and surveillance testing in schools — are key to ending the pandemic, the researchers said.
The middle school testing program was originally slated to stop next week, but the School of Public Health agreed to keep it going until the omicron variant subsides. Already, Angel Avery, mom to a seventh grader at Aurora Science & Tech Middle School, feels the school is safer than it was. Before Christmas, when her husband had COVID, she tested positive without any symptoms.
“You just know that it’s out there,” said Avery, standing in the school cafeteria. “There are a lot of people out there who don’t have symptoms. Just knowing that kids could be walking around spreading it, having no idea.”
Update: This story was updated to correct the title of Aurora Science & Tech Middle School.