Mount Sinai seeks to expand virus screening program in schools

Every week, Students at KIPP Infinity Middle School in West Harlem line up in a large auditorium and take their seats on designated floor marks, making sure to stand six feet apart. Then they lower their masks and fill sterile tubes with their spit.

Teachers at the school try to make the experience fun, by hosting competitions to see who can fill their tube fastest and by having dance contests while the students wait for their classmates to finish.

“It’s kind of nice,” said Bradley Ramirez, a seventh grader at the school who enjoys math and Minecraft. “It’s much better than just sticking a stick in your nose.”

Bradley and his classmates are participating in a pilot coronavirus testing program created by the Mount Sinai Health System, the Pershing Square Nonprofit Foundation and KIPP NYC, a network of 15 local charter schools. Since the beginning of March, the program has carried out more than 13,000 saliva tests on students, teachers and staff at KIPP, identifying dozens of cases of the virus.

Now Mount Sinai and Pershing Square hope to expand. On Tuesday, they announced the Mount Sinai Covid Lab initiative, inviting other charter schools, as well as local businesses and organizations, to enroll in the saliva-based testing program. They are putting the finishing touches on a new lab that they believe will be able to process up to 100,000 coronavirus tests per day and are preparing a formal proposal to bring the program to New York public schools this fall.

The announcement comes the day after Mayor Bill de Blasio said the city planned to completely reopen schools, eliminating distance learning, in the fall.

“The way you keep a school safe, the way you make teachers feel comfortable with schools reopening, the way parents feel comfortable sending their child, that’s that you have a test program, ”said William A. Ackman, a hedge fund. director who founded the Pershing Square Foundation.

The testing program began in December, when Mr. Ackman decided he wanted to find a way to get New York’s kids back to school and approached Mount Sinai with a proposal: What if he provided funding for the hospital to build a lab that could process 100,000 coronavirus tests a day? The hope was that the lab could devote some of that capacity to corporate clients, such as companies that wanted to test their employees, and use the proceeds to fund large-scale testing for schoolchildren in New York City.

Mount Sinai quickly agreed. “We have started a concerted effort around which the people of Mount Sinai really rallied,” said Dr. David Reich, President and Chief Operating Officer of Mount Sinai Hospital. “It’s just one of those projects where you never have to worry about people showing up to your Zoom meeting – they’re all there and they’re all smiling.”

The Pershing Square Foundation, whose trustees are Mr. Ackman and his wife, Neri Oxman, agreed to provide $ 20 million, and Mount Sinai began converting a former lab space on its downtown campus into a hub. treatment of high volume coronavirus tests.

At the time, scientists at Icahn’s Mount Sinai School of Medicine were among a number of groups across the country working to develop saliva-based coronavirus tests. Standard diagnostic tests are known as PCR tests, which can detect even minute amounts of virus in biological samples. During the first few months of the pandemic, these tests typically required healthcare professionals to stick a swab deep into a patient’s nasopharynx, a procedure that can be deeply uncomfortable and put clinicians at risk.

Many scientists have come to believe that saliva-based PCR tests would be safer and less invasive. They would also be much more suitable for young children than deep nasopharyngeal swabs. “A brain spoon, for a child?” Is that so? It’s a no-no, ”said Dr Alberto Paniz-Mondolfi, a Mount Sinai pathologist who led the development of the new saliva test.

As the partnership between Mount Sinai and Pershing Square began to take shape, Dr Paniz-Mondolfi and his colleagues stepped up their work, validate their saliva test in 60 adult patients. But they knew that in the real world, children couldn’t always be relied on to follow clinical procedures to the letter.

“When we start getting this from schools, we’ll have pieces of pretzels, old gum floating around in the saliva,” Dr Paniz-Mondolfi said.

So Dr Paniz-Mondolfi and his colleagues asked their own children to make a sacrifice for science: munch on an array of junk food, including pizza and Oreos, then spit in test tubes. Using these samples, the researchers confirmed that even if a student’s sample was contaminated with any of these foods, the tests should still work properly.

“It was a practical science, designed by parents to get their children back to school,” said Dr Paniz-Mondolfi.

Then it was time to pilot the tests in a real school environment. In January, Mount Sinai connected with KIPP NYC, which had been offering distance education since last spring. But he was hoping to reopen his schools in March, and administrators knew they would need to do some sort of virus screening in schools.

“One of the biggest fears we had was about what it would mean to keep students safe,” said Glenn Davis, principal of KIPP Infinity Middle School.

Mount Sinai and KIPP NYC have agreed to launch a pilot saliva test in five schools. The testing program, which eventually grew to include nine KIPP schools, was free for schools and mandatory for all students who chose to resume in-person learning. (Some families have chosen to continue their education at a distance.)

Students, teachers and staff are tested once a week. Medical assistants from Mount Sinai oversee the collection of saliva and pack the barcode tubes into coolers for transport back to the lab. (The samples are currently being processed at an existing lab on Mount Sinai, but will be sent to the new lab when it opens next month.)

During the pilot, 99.2% of test results were returned within 24 hours, according to Mount Sinai. Students or staff who test positive should usually be quarantined for 10 days.

If a student tests positive, Mount Sinai also offers to send a team of “tampons” to their home to administer free coronavirus tests to their family members and close contacts.

“We have detected a few mini epidemics this way and hopefully have stopped them from spreading through this screening program among schoolchildren,” said Dr Reich.

Between March 10, the start date of the pilot project, and May 9, Mount Sinai performed 13,067 tests and identified 46 cases of coronavirus, for a positivity rate of 0.4%. There have been no known false positives or false negatives, Says Mount Sinai.

The Mount Sinai team submitted the data to the Food and Drug Administration, hoping to receive emergency use authorization for the test.

Later this week, Mount Sinai will submit a formal proposal to New York City to offer its testing program to the city’s public schools when they reopen in the fall. Mount Sinai declined to disclose the terms of the proposal, including what it plans to charge schools for the tests, but says it hopes to attract commercial clients to help cover, if not eliminate, the costs of the schools.

In the meantime, he approaches other charter school organizations in the city to use his tests during their summer sessions and programs.

“We can’t just sit there when this lab goes live in June and say, ‘OK, we’ll wait until September,’” Dr Reich said. “Before fall, we have to do a lot of testing.” The lab will initially have the capacity to run 25,000 tests per day, with the option of increasing to 100,000 if interest is sufficient.

For its part, KIPP NYC plans to expand the program to all of its schools in the fall, although testing frequency may change, said Efrain Guerrero, general manager of KIPP NYC operations. “I think parents see it and the staff see it as an added safety measure that they appreciate,” he said. “For us, it is obvious to continue to test at a certain frequency.”

Bradley’s mother Olga Ramirez initially hadn’t wanted him to return to learning in person. “I was very scared at first,” she says. But Bradley, who desperately wanted to go back to school, managed to convince her, with the help of an informational video about the Mount Sinai testing program.

Ms. Ramirez now believes going back to school was the right decision. Bradley’s virus tests have all come back negative and his grades have been on the rise since returning to in-person learning.

“I have seen his grades improve a lot and I feel my son is in good hands,” she says. She is not alone, she added. “There are so many mothers who feel like me.”

Elda Cantú contribution to translation.

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