The vast majority of Nebraska is composed of rural territory: wide swaths of land occupied by pockets of roughly 2,500 people. Despite the state’s diffuse populous, it, like others, has struggled to contain the spread of COVID-19 over the past year.
School officials are especially wary, despite the Centers for Disease Control and Prevention’s recently released guidelines that reduce social distancing for students to 3 feet. Towns in rural Nebraska and several other regions around the U.S. are investing in new measures to keep schools safe from COVID-19 and future viral outbreaks. To finance these initiatives, they’re turning to local government organizations as well as corporate sponsors.
A health tech company called Kinsa has sent some 21 school districts and six private schools in Nebraska 13,000 of its smart thermometers to help keep better track of sick students. School principles and nurses get a digital dashboard where they can view students’ anonymized symptom and fever data, broken down by grade. Parents are encouraged to take their children’s temperature before coming into school, where students are also required to wear masks.
“Nebraska is very independent,” says Burke Harr, a former state senator who now counsels the Nebraska Cooperative Government, a group that ensures 93 small counties and towns in the state have the funding for roadway repairs and other common local infrastructure. “We were trying to find the least intrusive way to help predict where COVID may or may not be and to stop its spread or to at least alert us of where there was an issue.”
In May 2020, Nebraska saw a small spike in cases, a significant portion of which were coming from meatpacking plants. Then in November, the state saw a steep incline, reaching a peak of 3,500 new cases per day. Some of the most high-risk areas were also some of the least populated. Boone County, for example, currently has one of the worst rates of COVID-19 infection in the state and has a population of only 5,200.
“It hit rural Nebraska because there were less precautions taken,” says Harr, noting that in some parts of the state you’d be hard-pressed to find someone wearing a mask. “There isn’t the compactness of the cities, but there were spreader events. I mean, it’s as simple as birthday parties, right?”
The Cooperative was interested in helping restart Nebraska’s economy. To do that, it needed to find a way to reopen schools; the hope now is that the distribution of Kinsa smart thermometers will help manage future outbreaks. “The idea was, schools can super-clean if they know there’s an outbreak, but if they don’t know where it is or what the cause is, or if it’s delayed, it could spread beyond there,” Harr says.
The Nebraska Cooperative Government, which earns much of its money through taxes on casinos, offered to pay for the thermometers so that school districts wouldn’t have to pull from their own funding. But elsewhere around the country, funding for school health products remains a major concern.
“We wanted to offer something to our staff and our students to assure them that we were doing everything in our power to make schools safe,” says Meg Dussault, superintendent for Sharon Public Schools, a small district of 3,588 students in Massachusetts. Dussault wanted to do pooled testing for her schools, which is more efficient and less expensive than doing individual COVID-19 tests for every student. A pooled test is what it sounds like: multiple samples (in this case, of saliva) pooled together in a single container and tested as a group. But even pooled testing was too expensive. “We were pricing out a bunch of companies and we were finding that was not something we could afford and we were getting discouraged,” Dussault says.
Ultimately, her district was able to work with a testing service called Concentric by Ginkgo through a pilot program for schools, which the synthetic biology company Gingko Bioworks initially funded. The Massachusetts Department of Education is now paying for a portion of pooled testing across the state to help schools spot potential new cases of COVID-19 in classrooms. Concentric is conducting weekly testing at 332 schools in 46 school districts in the state, covering a total of 137,000 teachers and students in Massachusetts (around the country, it works with a total of 800 schools). Another testing company, CIC Health, is providing pooled testing to an additional 492 schools with 160,000 teachers and students in the state.
In the Sharon School District, on average, Dussault says, only about one person in an entire school population typically shows up positive in pooled tests, though she notes some students and teachers are not participating. The goal is to catch asymptomatic COVID-19 cases. So far, it seems to be working. “It helps us know how to caution ourselves, how to treat our buildings, and it just makes coming to this building day to day bearable for everybody,” Dussault says.
But when the current pilot ends on April 18, the district may have to figure out how to fund the program itself. “Every night we are crossing our fingers and toes hoping the state continues to fund for the remainder of the school year. But if not, we have got to find funding because we don’t feel that we can go without it,” Dussault says.
With government money in short supply, schools in Little Rock, Arkansas, are getting funding from an unlikely source: brand sponsorship. Before the pandemic, the Little Rock School District had been interested in implementing Kinsa’s influenza surveillance program, which it offers to low-income schools around the country to limit student illness and absence. Its flu tracking and projections have been shown to be in line with those of the CDC.
When the pandemic hit, there was renewed interest in Kinsa’s smart thermometers, but the money from the federal Coronavirus Aid, Relief, and Economic Security Act had already been spent on broadband for students, digital devices, and personal protective equipment. “It was going to be difficult, because we could not identify the financing for [the thermometers],” says Jay Barth, Little Rock’s chief education officer.
But through conversations with Kinsa, Barth was able to find a backer. Lysol, which has been supplying schools with cleaning supplies, educational materials on COVID-19 safe practices, and floor markers for maintaining social distancing, is paying for the district’s schools to roll out Kinsa’s thermometers and its health surveillance platform at least for an initial pilot period. Lysol also funded a similar pilot for 237 schools in Broward County, Florida (the region used federal pandemic funding to hire more school nurses). Lysol has pledged to spend $20 million over the next three years on school health programs, including on Kinsa’s fever-screening system.
Little Rock schools want to take a more proactive approach to student health, not just in preventing COVID-19 outbreaks, but also stopping the spread of other viral illnesses like the flu, which can lead to a substantial number of absences. The goal is to keep students healthy and schools open. “Every time you prevent having to shut down a school, that prevents disruption to student learning,” Barth says.
The district serves 24,000 students across 44 schools, but so far only 1,000 families have signed up to receive the free thermometers. There is still a month left for families to sign up.
Other cities working with Kinsa are further along. The company has sent out 35,000 thermometers to schools in New Orleans, and another 15,000 in Philadelphia. But distributing thermometers is only half the battle. School districts will have to convince families to actually use them.
Back in rural Nebraska, Harr says families have used the smart thermometers with varying frequency. “People’s usage was pretty high in November and December and then it dropped after Christmas when they came back from Christmas break,” he says. “I know that was one of the concerns.”
Harr says that Kinsa has offered assistance in getting people engaged with the program, including sending out email reminders to parents, nudging them to use their thermometers. “It’s up to the school how much they want to enforce it,” he says. “But it gives them a chance to take control of the situation.”