COVID-19 test-to-stay program for K-12 schools: Opt-in versus opt-out consent model

Anton Ivanov, Ujjal Kumar Mukherjee, Subhonmesh Bose, Sridhar Seshadri, Ronald Watkins, Albert Charles England, Jacqueline Suriano, Mehmet Eren Ahsen, Sebastian Souyris

Research output: Contribution to journalArticlepeer-review


The Centers for Disease Control and Prevention promoted the Test-to-Stay (TTS) program to facilitate in-person instruction in K-12 schools during COVID-19. This program delineates guidelines for schools to regularly test students and staff to minimize risks of infection transmission. TTS enrollment can be implemented via two different consent models: opt-in, in which students do not test regularly by default, and the opposite, opt-out model. We study the impacts of the two enrollment approaches on testing and positivity rates with data from 259 schools in Illinois. Our results indicate that after controlling for other covariates, schools following the opt-out model are associated with 84% higher testing rate and 30% lower positivity rate. If all schools adopted the opt-out model, 20% of the total lost school days could have been saved. The lower positivity rate among the opt-out group is largely explained by the higher testing rate in these schools, a manifestation of status quo bias.

Original languageEnglish (US)
Article number108770
Issue number1
StatePublished - Jan 19 2024


  • Research methodology social sciences
  • Social sciences
  • System management

ASJC Scopus subject areas

  • General


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