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Safely open Tennessee's schools by 'pool testing' students | Opinion

Dr. Manoj Jain and Christine Richards
Guest Columnists
  • Dr. Manoj Jain is an Infectious Disease Physician based in Memphis, TN.
  • Christine Richards is a Retired FedEx Corporation Executive based in Memphis, TN.

Each child is unique. Likewise, each school is different.  

The geographic and the demographic profile along with the level of cooperation and collaboration between administration, teachers, parents, and students all weigh into the critical decision of if, when, and how schools should open during the COVID-19 pandemic.  

One size guideline may not fit all schools, so individual administrations have the burden of the decision.  The public health officials and advisors are providing guidance on the thresholds namely the number of new cases, the transmission number, and the positivity rate, under which it will be unsafe to open schools.

In ways, these are “guardrails” of a sort. However, below the threshold, the decision to open the schools is up to individual municipalities and superintendents.


Davidson and Shelby County Schools have decided not to open in-person, while In Shelby County the suburban, charter, and private schools are crafting a plan for in-person and virtual teaching.  

If we follow the science and ask, “Is it safe to open my school?” The answer lies hidden within the data on the prevalence of the virus in a given community. In this case, the community is the school community, comprised of teachers and students as well as parents and administrators. We need data on what is the baseline asymptomatic positivity rate most importantly among the teachers and students. Otherwise, we are “flying blind.” 

We need not guess or extrapolate this, rather we can test.

A few days before the start of school, the school can conduct a health fair where people are socially distanced, where extensive education on masking, washing, and distancing would be provided.

Additionally, schools can offer nasal swab PCR testing to every student and teacher. Augmenting education with routine nasal swab testing will provide essential information on the prevalence of the infection in the school population.  

Yes, our testing resources across the nation and in our city have been constrained with reagent and pipets shortages. Yet, samples for asymptomatic testing can be tested with a very different low-cost large volume methodology called “pool testing.” Here five or seven samples are pooled into one test tube.

If the one test tube is negative, then all the pooled samples are resulted as negative and if positive, the original samples are run individually to determine the positive individual.

For two of our labs in Memphis, Poplar Healthcare and AEL, these techniques have been cleared for use by the FDA under the emergency use authorization.  

The baseline positivity data of teachers and children will empower the school administrators, teachers, parents, and health officials with the essential data to determine if a particular school should or should not open. The testing can be repeated every two to three weeks depending on the outcome of the initial testing to maintain a safer environment and immediately address any change in status. 

The major concern for many to routine testing is the cost. No doubt a regular PCR test is expensive at about $100 or $150 per test. However, the pooled sample test cost is about $25-30, and since it can be self-administered for older children and adults the administration fee can be reduced.  

With no clear national guidance, with tremendous variability in school populations and school systems, many school administrators are left to navigate and innovate on their own. 

Adding “pool testing” as part of the armamentarium to the masking, distancing and washing can be a game-changer to safely open schools and to keep them open.  

Dr. Manoj Jain is an infectious disease physician based in Memphis.

Christine Richards is a retired FedEx Corp. executive based in Memphis.