Are Mask Requirements in Schools Necessary to Control COVID-19?
This week two Texas judges issued temporary restraining orders that allow public schools in Bexar and Dallas counties to require that staff and students wear face masks as a safeguard against COVID-19. The legal issue is whether Texas Gov. Greg Abbott’s executive order banning such mandates fits within his authority under the Texas Disaster Act of 1975. But the wisdom of requiring masks in schools depends on whether the public health benefits of that precaution outweigh the burdens it imposes on students and employees. On that point, the evidence is not nearly as clear as mandate enthusiasts imply.
Two important facts should inform decisions about face masks in schools.
First, COVID-19 infections among children and teenagers are rarely life-threatening. According to the “current best estimate” from the Centers for Disease Control and Prevention (CDC), the infection fatality rate (IFR) for people younger than 18 is 0.002 percent. By contrast, the CDC estimates that the IFR for COVID-19 among people 65 or older is 9 percent, 4,500 times as high. The estimated IFRs for other age groups fall between those two extremes: 0.05 percent for 18-to-49-year-olds and 0.6 percent for 50-to-64-year-olds.
Second, COVID-19 vaccines are currently available to all Americans 12 or older, and the vaccination rate is especially high among older Americans, which helps explain why the recent surge in cases has not been accompanied by a commensurate increase in deaths. For teachers and other staff members who are concerned about catching COVID-19 in school, vaccination sharply reduces the risk of infection and is even more effective at preventing severe cases. The same goes for students 12 or older.
Keeping those facts in mind, what is the evidence that face masks play an important role in preventing school-related COVID-19 outbreaks? In a New York Times opinion piece published yesterday, Duke University pediatrician Kanecia Zimmerman and We Studied One Million Students. This Is What We Learned About Masking.”
Here is how Zimmerman and Benjamin describe the results of their study, which was based on data from March through June 2021:
During that time, more than 7,000 children and adults acquired the coronavirus and attended school while infectious. Because of close contact with those cases, more than 40,000 people required quarantine. Through contact tracing and testing, however, we found only 363 additional children and adults acquired the coronavirus. We believe this low rate of transmission occurred because of the mask-on-mask school environment: Both the infected person and the close contact wore masks.
That belief is not actually supported by Zimmerman and Benjamin’s study. Since all the North Carolina public schools they studied had universal masking, there was no control group of schools without that requirement. It is therefore impossible to say whether the low rate of secondary transmission can be attributed to the mask policy. “Because North Carolina had a mask mandate for all K-12 schools,” Zimmerman and Benjamin concede, “we could not compare masked schools to unmasked schools.”
In lieu of a control group, Zimmerman and Benjamin cite a few COVID-19 outbreaks that they attribute to a lack of universal masking. Here are the cautionary examples they mention:
• This month in North Carolina, Mooresville Graded Schools and the Union Academy Charter School decided to require masks after “both experienced outbreaks during the first days of the new school year,” the ABC affiliate in Charlotte reports. An elementary school in the Mooresville system identified “nine positive cases,” while the charter school saw “at least 14 confirmed COVID-19 cases.”
• In Illinois last month, Springfield Public Schools began requiring masks during a summer session, citing “an increase in COVID-19 positive cases among SPS students and staff.”
• In May 2020, an Israeli public school had an outbreak that involved “153 students and 25 staff members” who “were confirmed as COVID-19-positive.” The outbreak was
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