Minnesota health officials recommended Wednesday that schoolchildren and their families get tested for COVID-19 every two weeks as more students return to classrooms.
"This is not a requirement," said Dan Huff, an assistant commissioner at the Minnesota Department of Health. "COVID-19 testing remains an important tool for limiting disease impacts and ending the pandemic as quickly as possible."
The recommendation applies to families whose children leave home for learning, youth sports or extracurricular activities, and they are being asked to continue testing until the end of the school year.
More than 1,700 schools participate in the state's COVID-19 testing program, providing on-site tests to teachers and other workers.
But schools and youth sports organizations are not being asked to administer the tests to children, Huff said. Rather, families can use more than 20 state-sponsored community testing sites, their own health care provider, or the state's at-home testing program.
"We have the test kits ready so we are ready to handle the demand," he said.
It is unclear what impact the recommendation will have on testing volume, which has been trending downward. Last week saw a daily average of 27,000 tests processed, compared with 32,000 in mid-January. During the November surge in cases, more than 51,000 tests were run daily.
Most schools have returned to filling classrooms, with 88% of districts and charter schools offering some form of in-person learning.
At the same time, confirmed cases among students and staff have increased, with about 400 a week, although that is similar to case counts before the winter break.
"We are seeing a slight increase in cases but nothing that is unexpected," said state infectious disease director Kris Ehresmann, adding that some infections originated in community settings rather than within school walls.
Of Minnesota's 480,845 confirmed coronavirus cases, 80,417 have been in those under the age of 20, which represents about 17% of all cases. There have been two COVID-19-related deaths among children out of the 6,443 pandemic fatalities in the state.
Minnesota reported another 761 new cases and nine additional deaths Wednesday. Two of the deaths were among long-term care residents.
A total of 770,021 Minnesotans have received at least one dose of the COVID-19 vaccine, either at community sites, pharmacies, clinics, long-term care facilities or other places.
Of those, 370,981 have received both doses.
The Department of Health estimates that 13.8% of the state population has received one dose, with 42.4% of seniors getting at least one shot.
The Federal Emergency Management Agency awarded Minnesota $3 million to help pay for the costs of running three community vaccination sites.
More than 94,000 COVID-19 vaccine doses have been administered at state-sponsored sites, which initially included several locations that have since been closed.
A fourth permanent site will open at the Mall of America, which is scheduled to give 8,190 doses to school and child-care workers this week.
The vaccine supply is expected to increase after federal regulators give approval to the new Johnson & Johnson vaccine possibly later this week.
After a federal vaccine advisory panel makes its recommendation by Monday, doses are expected to start flowing to the states.
"We are not sure when vaccine could start arriving in Minnesota, but we are told it should be in the short term," Ehresmann said.
The new vaccine requires only one dose and does not have stringent cold storage requirements, making it a good candidate for smaller facilities that lack the deep freezers that are needed for the Pfizer vaccine.
It could also be a candidate for people who face barriers to getting two shots, such as the homeless or those who lack transportation.
Ehresmann said a plan for distributing the vaccine will be made after federal recommendations are finalized.
"There will be some settings where this type of vaccine will be a better fit," she said. "But we will be using this across the board."
The makers of the existing two-dose vaccines are conducting clinical trials to see if their shots are safe and effective for children.
Moderna is testing its vaccine on children 12 to 17, while Pfizer is focusing on the 12 to 15 group because it already has approval to vaccinate those age 16 and 17.
"It is quite possible by late 2021 we will have vaccines for the children," said Dr. Robert Jacobson, a pediatrician at the Mayo Clinic in Rochester.
Trials for those under age 12 won't begin until it can be shown that the vaccine is safe for older children, he said.
"We definitely will need vaccines for children against the COVID-19 infection," Jacobson said. "While the rates of infection and the severity of infection is lower in children, they do get infected."
Jacobson said that even if parents get vaccinated, they still need to maintain COVID-19 safety measures because not enough is known about whether the vaccine prevents transmission, particularly asymptomatic spread.
"This is not the summer for planning family reunions," he said. "Don't change your behavior, don't change your rules on masking, on social distancing, on avoiding crowds."
Likewise, Minnesota health officials said Wednesday that educators who get fully vaccinated should also get tested every two weeks, just as it is now asking of students and their families.
"We feel that two weeks is a good point between being too much for families but also providing us with a really good way of keeping tabs and finding cases early so we can prevent them from spreading," Huff said.
The state's at-home testing program could be a good option, Huff said. Although there were some delays with UPS and the postal service when the program was first launched, the state has been working with the delivery services to avoid future bottlenecks.
"They are now ready to handle what we throw at them," he said.