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> This ensures that the work is purely the students

I don't know in the US, but in my part of the world, teachers have always assumed that anything that isn't done in person in front of an examiner has not value because students do cheat or get help. Maybe you would get a bit of extra-credits for the homework and that's it.

And for high-stake competitive exams, it's 100% in-person.

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How does that work with disability accommodations for students that have to be at home?

A strict system does not contradict making accomodations for those that need them. All countries do it differently but in several European countries you even have graduation certificates that may indicate if you followed a special curriculum or had some accomodations, if relevant for the final result/report.

I meant: how is actual testing carried out?

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