This past month, a familiar sight at Edina High School was a weekly line of students waiting to get tested at Door 6 as part of Test The Nest: a collaborative research program in partnership with UnitedHealth Group (UHG) that was piloted this past April. Those who chose to participate were tested in pools of ten, allowing for their results to be processed in a more cost-effective manner. Students were tested weekly on Tuesdays and received results within 24 hours, which allowed the school to respond quickly to positive results by retesting positive pools of students and conducting contact tracing. 

Test The Nest was piloted first at Washington International School, a relatively small school with a student body of fewer than 1,000 students. After a successful run at the school, the principal investigator from UHG was in contact with members of the Edina School Board, who saw the potential for Test the Nest to be implemented at EHS. “We were confident enough with the learnings from our Washington School, which was smaller, to move on to a medium-size [school],” Bethany Hyde, development director at UHG, said. “Having a local partner is great because we are testing a near-site model. So the lab is not on-site, but in, you know, within a couple [of] miles.” EHS is the first school in Minnesota that has partnered with UHG in conducting this testing program.

So how does pooled testing work? 

After waiting in line and checking in with parent volunteers, students are responsible for using swabs to take their own samples. Swabs are collected in tubes of 10 students; after the testing window, which is usually from 7:30 AM to 9:30 AM at EHS, they are sent to the testing site at UHG. 

After ensuring that all of the samples are accounted for, scientists mix the samples with saline. The Polymerase Chain Reaction (PCR) machine indicates any positive COVID-19 tests in each swab group by detecting viral copies. However, since the samples are pooled, the machine won’t specify which individual swab tests positive. 

To describe how the pooled testing process works, Hyde and her colleagues use the “smoke detector” analogy. “A smoke detector is going to go off when there’s a danger like COVID [in each of the testing groups],” Hyde said. “It’s not gonna tell you exactly where the fire is, but it’s going to tell you what room it’s in. Then the individual testing is getting into that room and finding the exact fire and putting it out.” 

If a positive result is found, all ten students in the testing pool are notified and are responsible for getting individual COVID-19 tests, either from UHG or a different provider. If a student tests negative, they can return to school the next day, as per school policy. 

Pooled testing with PCR is an approach that’s become more prevalent with COVID-19. “Since the onset of COVID, it’s fast, it’s cheap. It’s easy to do. It doesn’t take a lot of time to learn how to do it, or to interpret results,” Kristi Norton, Vice President of Query Lab, said. Another advantage of pooled testing is that it allows schools to monitor asymptomatic students and faculty. 

While UHG is responsible for testing all the swabs, EHS volunteers facilitate the day-to-day responsibilities of testing students and managing their consent forms. Throughout the process, Hyde has recognized the importance of communication and awareness. “It’s pretty easy for students, you know, just to walk by, and so we’re working really closely with the school to help students understand the community and the school to communicate why it’s so important to get tested on a regular basis.” 

They’re also committed to ensuring that all students know that testing is available and easing their fears. “Are there things that we can do to help them either ease their fears, or make sure that they have the right information and understand how it works so that they feel comfortable with participating?” Hyde said. 

Edina Public Schools and UHG are also hoping to encourage more caution surrounding COVID-19 in addition to testing. “[Testing] is just another mitigation strategy, and what [UnitedHealth Group] are hoping is that it also will help change behavior,” Principal Beaton said. Though the end of the school year will conclude the testing taking place at the high school, COVID-19 testing remains essential, even amidst the rising vaccinations. “Edina was willing to take risks and try this, and I think it says a lot about the administration and the leadership and wanting to make sure that they were truly doing everything they could to keep schools open and keep students safe,” Hyde said.