OBJECTIVES: Evaluate factors influencing the decision-making processes of school administrators and investigate the existence and use of emergency operations plans (EOPs) during the COVID-19 pandemic. METHODS: Using survey data representative of US K-12 public schools in 2022, the prevalence of 16 factors that influenced reporting school administrators' COVID-19 prevention strategy implementation decision-making (Wave 4; N = 399) and the presence and use of school EOPs (Wave 5; N = 400) are presented overall and by urban-rural classification, poverty level, and school level. Qualitative interviews were conducted with a subset of school administrators and used thematic analysis to understand factors influencing implementation of prevention strategies and emergency preparedness. RESULTS: School district requirements or recommendations (81.6%) was the top reported factor influencing decisions on the use of COVID-19 prevention strategies. Although most schools created or updated their EOP during the 2021/2022 school year (78.1%), only 26.7% implemented or exercised an EOP during the COVID-19 pandemic. Themes from qualitative analysis focused on factors influencing the implementation of prevention strategies, limitations of current EOPs, and importance of continuous investment in school preparedness. CONCLUSIONS: Investing in actions to improve schools' capacity to respond to emergencies such as developing comprehensive EOPs, building partnerships, and defining roles and responsibilities is important.

OBJECTIVE: To understand SARS-CoV-2 transmission in early care and education (ECE) settings, we implemented a Test to Stay (TTS) strategy, which allowed children and staff who were close contacts to COVID-19 to remain in person if they agreed to test twice after exposure. We describe SARS-CoV-2 transmission, testing preferences, and the number of in-person days saved among participating ECE facilities. METHODS: From March 21 through May 27, 2022, 32 ECE facilities in Illinois implemented TTS. Unvaccinated children and staff who were not up to date with COVID-19 vaccination could participate if exposed to COVID-19. Participants received 2 tests within 7 days after exposure and were given the option to test at home or at the ECE facility. RESULTS: During the study period, 331 TTS participants were exposed to index cases (defined as people attending the ECE facility with a positive SARS-CoV-2 test result during the infectious period); 14 participants tested positive, resulting in a secondary attack rate of 4.2%. No tertiary cases (defined as a person with a positive SARS-CoV-2 test result within 10 days after exposure to a secondary case) occurred in the ECE facilities. Most participants (366 of 383; 95.6%) chose to test at home. Remaining in-person after an exposure to COVID-19 saved approximately 1915 in-person days among children and staff and approximately 1870 parent workdays. CONCLUSION: SARS-CoV-2 transmission rates were low in ECE facilities during the study period. Serial testing after COVID-19 exposure among children and staff at ECE facilities is a valuable strategy to allow children to remain in person and parents to avoid missing workdays.