VDH is providing eMed-proctored rapid antigen testing using the BinaxNOW COVID-19 Ag Card Home Test Kit. These tests determine if someone is currently infected with COVID-19 or not. These test kits use a nasal swab for sample collection and test results are available in about 15 minutes.

eMed will provide on-demand telehealth sessions available 24 hours a day, 7 days a week with a Certified Guide to proctor the testing process.  Child care centers do not need to have a prescriber or CLIA waiver. The proctoring service must be used, and the proctor has received specialized training to properly administer these tests.  Additional VDH guidance on how to use the test kits is available:

• VDH Guide to eMed proctored BinaxNOW Antigen At Home Test Kits
• VDH/VDOE Parent Guide for at-home use of eMed proctored BinaxNOW COVID-19 Antigen Test Kits>
• VDH informational session Video Recording and Slide deck (PDF) (18 pp, 667 KB)

Child care facilities are strongly recommended to send test kits home with parents, teachers, or staff to conduct the telehealth testing sessions at home. Child care facilities may also make it possible for families/caregivers to come to the facility to pick up a test kit for at-home testing. Individuals must conduct the test under the observation of the eMed Certified Guide. Those 15 years of age or older may self-collect, and those ages 2-14 must have an adult collect the sample. Information on ID requirements for eMed test kit use can be found on the eMed website: “For managed profiles, children 18 years old do not have to provide an ID; however, the parent/guardian will need to provide their valid photo ID to vouch for the identity of the minor child. Young adults 18 and older will be expected to present their own ID.”

eMed reports test results to VDH. Test results are not directly reported to the child care facility.

VDH guide to assist child care facilities with the testing process [Spanish] (PDF) (4 pp, 70 KB)

eMed Website

• eMed [Spanish]
• eMed Certified Guides (PDF) (4 pp, 70 KB)

Navica

Navica Account [Spanish] : The "create an account" option on the Navica website is available in Spanish. There is a toggle on the top near the toolbar to choose between English and Spanish.

Individuals who test positive for COVID-19 should not attend the child care facility and should report positive results to their child care facility immediately. An individual who is symptomatic or a close contact and who tests positive for COVID-19 should isolate themselves immediately and follow VDH Guidance on COVID-19 Antigen Tests Results (PDF) (2 pp, 250 KB) and Next Steps and What to do if you have confirmed or suspected coronavirus disease (COVID-19)?

Test to Stay (TTS) is a strategy that allows children aged 2 years and older and staff who are either not eligible for COVID-19 vaccines or not up to date on their COVID-19 vaccines to remain in child care or at work. With TTS, close contacts who would normally stay at home during their quarantine period are allowed to attend child care as long as they remain asymptomatic, continue to test negative on repeated COVID-19 tests, and wear a mask at the child care facility. It is included as an option for eligible individuals in the VDH COVID-19 Child Care Facility Guidance. 

Participating staff and students may benefit from COVID-19 testing and early identification of COVID-19, and will benefit from being able to continue to attend child care programs in-person.

No, implementation of Test to Stay is voluntary.

Yes. Facilities can receive and distribute test kits for diagnostic testing of students, teachers, and staff 2 years of age or older who have symptoms of COVID-19 or are close contacts of an individual with COVID-19 even if they choose not to participate in TTS.

In accordance with CDC guidance and COVID-19 Community Level Guidance, VDH recommends that all facilities consider implementing layered prevention strategies based on the COVID-19 Community Level, including vaccination of eligible individuals, masking of individuals 2 years of age or older, physical distancing and cohorting, ventilation, handwashing and respiratory hygiene, and cleaning and disinfecting. Programs that implement TTS should consider the potential additional risk of COVID-19 transmission introduced by allowing known close contacts to remain in the program when making decisions about the right combination of prevention strategies. In addition, VDH recommends child care facilities have adequate resources to conduct TTS, including a designated point of contact who will be responsible for managing testing information, is capable of providing guidance to families, and to whom questions can be referred.

No, this is a voluntary program. Only eligible staff members and children with a signed consent form can participate.

VDH recommends that Test to Stay be open to child care facility staff and children who are:

• 2 years of age or older
• An asymptomatic close contact of an individual with COVID-19 (including exposures occurring at the child care facility, in the community, and in the household)
• Not vaccinated or not up to date on COVID-19 vaccines
• Able to wear a mask at the child care facility for 10 days after the exposure (except when eating, drinking, and sleeping)
• Remain asymptomatic
• Have a signed consent form (by the parent/guardian, if 18 years old)

Yes, even individuals wearing masks are close contacts if they spend 15 minutes or more within 6 feet of someone with COVID-19. For further guidance, please see What to do if you were potentially exposed to coronavirus disease (COVID-19)? - Coronavirus (virginia.gov).

Children younger than 2 years old are not eligible to participate in Test to Stay because they are not recommended to wear masks and the eMed BinaxNOW test kits are not approved for use in this age group. Children under age 2 who are identified as close contacts of an individual with COVID-19 are recommended to quarantine at home for a full 10 days after the exposure.

Written consent should be provided by the individual (in the case of an adult teacher or staff member), or by the parent/guardian (in the case of a child). The participating individual or parent/guardian agrees to:

• Sign the consent form to participate in TTS.
• Conduct active monitoring for signs and symptoms of COVID-19 each day before and after child care program attendance.
• Immediately contact their child’s healthcare provider and child care facility  if any signs or symptoms of COVID-19 develop.
• Stay home and do not attend the child care facility if any signs or symptoms of COVID-19 develop.
• Notify the child care facility of any new or additional close contact exposure to an individual with COVID-19 or suspected COVID-19 that is identified while participating in Test to Stay.
• Promptly leave or pick up their child from the child care program, should they test positive or develop signs or symptoms of COVID-19 while at child care.
• Comply with public health recommendations for quarantine (i.e. stay home away from others) when not attending the child care facility during the 5 day testing period.

One consent form may be used for a specified time period (such as duration of the school year), so that the same consent form can be used for more than one instance of participation in Test to Stay. The sample template consent form includes an opportunity for the parent to withdraw consent at any time. In addition, the facility can obtain a written revocation of consent from parents that can be on file if they decide to opt out at a later time.

No, there are no costs or insurance requirements to participate in Test to Stay. Test kits are provided to participating individuals free of charge.

Details of the recommended testing protocol are available in the VDH Test to Stay Protocol for Child Care Facilities. Individuals participating in Test to Stay should take a COVID-19 rapid antigen test daily for 5 days after the last exposure to the individual with COVID-19 (Day 0). The rapid COVID-19 test may be taken in the morning before attending the child care facility or the evening prior, ideally after 7pm. 

Tests are not necessary on weekends and holidays, but individuals enrolled in TTS should quarantine at home on weekends and holidays during the 5 day testing period. 

The individual must have at least one negative rapid test on or after the 5th day before being released from TTS. If the first day back to child care following an extended break is 10 days or more after the exposure, the student does not need to be tested upon return to school provided that they have not experienced any symptoms.

Participating child care facilities will be responsible for distributing the testing kits. VDH recommends child care facilities consider assigning a designated staff member to oversee the distribution of tests to staff members and/or parents/guardians.

VDH encourages child care centers to develop a secure mechanism (i.e., phone call, encrypted email, password-protected document-share) for receiving results from at-home proctored tests, to protect Protected Health Information (PHI) such as name, date of birth, test results, etc. Child care centers may also consider alternative options such as obtaining parental attestation of the test results before the individual may proceed with participation in child care. For any questions regarding liability around obtaining test results or conducting testing, child care facilities should consult their legal counsel.

A positive rapid test in a staff member or student exposed to COVID-19 during Test to Stay does not require confirmatory PCR testing as per CDC Guidance for Antigen Testing for SARS-CoV-2. Any staff member or student with a positive rapid test should isolate at home immediately and not attend child care.

Individuals who develop symptoms of COVID-19 should isolate themselves at home, regardless of a negative test result, and are no longer eligible to participate in Test to Stay. Duration of isolation will be dependent on testing and/or evaluation by a healthcare provider. Please see the VDH Algorithm for Evaluating a Child with COVID-19 Symptoms or Exposure for detailed guidance on evaluation, testing, and return to the child care facility. 

VDH recommends that when masking is not possible, such as meals, snacks, and naptime, individuals in Test to Stay should be 6 feet away from others for 10 days after the exposure whenever possible, ensuring that children are still safely under provider supervision. This is to minimize the risk of transmission to other individuals within the child care facility.

An individual participating in Test to Stay must have at least one negative rapid test after the last close contact exposure to the individual with COVID-19 (Day 0) and before returning to the child care facility. Therefore, if the testing is being done at home by the parent/guardian, the child would need to be sent home and have a negative test before returning to the facility.

Any individual who tests positive for COVID-19, whether vaccinated or unvaccinated, should isolate at home. This includes individuals who have a positive test result during TTS. If an individual tests positive during their TTS period, the facility must determine who has been in close contact with the COVID-19 positive individual, and alert these close contacts. Individuals determined to be close contacts who are recommended to quarantine may participate in Test to Stay if eligible and consent is given, or complete traditional quarantine at home.

If another close contact exposure to COVID-19 is discovered during the Test to Stay period, the participant’s Day 0 (last day of close contact exposure to the individual with COVID-19) would reset. The participant would need to restart either their at-home quarantine period or Test to Stay testing period. Please refer to the definition of close contact, and note that whether or not this is a new close contact exposure and requires a “reset” is impacted by the information below:

1. People who are exposed to someone with COVID-19 starting from 2 days before they became sick (or 2 days before they tested positive if they never had symptoms) are considered close contacts, and
2. People who are exposed to someone with COVID-19 after they completed at least 5 days of isolation are not considered close contacts.