A big question arises in the coming back-to-school season: Should children be required to wear masks? Should children go to face-to-face classes?

If we send our children to school without a mask, we increase their risk of catching Covid-19. Some may get sick or die. If we close schools, millions of children will be academically impaired and many may suffer lifelong physical and mental health problems.

For more than a year, we’ve worked with school districts and charter schools in North Carolina, studying the rate of new Covid cases, the effectiveness of mitigation measures like wearing a mask, and the risks associated with it. increased when participating in school-sponsored sports. We’ve learned a few things for sure: While vaccination is the best way to prevent Covid-19, universal mask-wearing is only a turning point, and with mask-wearing in place, the Learning in school is safer and more effective than teaching remotely, regardless of the community. infection rate.

Immunization is the most powerful method to prevent the ill effects of Covid, but students under 12 years of age are not eligible to be immunized. Therefore, wearing a mask is one of the best, most readily available methods to protect children from this disease, with universal mask wearing being one of the most effective and efficient strategies to prevent transmission of SARS-CoV-2 in schools.

The widespread wearing of masks in schools can save many lives. Voluntary mask-wearing in schools would likely be much less effective and could lead to school closures and community transmission of disease. This summer, we saw that voluntary masking was unsuccessful in some schools in Missouri and North Carolina, which has seen an increase in Covid-19 cases and days missed due to quarantine, prompting some school districts to reinstate mask-wearing duties.

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Questions surrounding the Covid-19 vaccine and its implementation.

How do we know that wearing a mask helps prevent spread among unvaccinated people in schools? In July 2020, we and our colleagues developed the ABC Science Collaboration to pair scientists with school and community leaders to ensure that school leaders are informed The most up-to-date, scientific science related to Covid-19 and K-12 schools. In conjunction with North Carolina, the ABC Science Collaborative collected data from more than one million students and staff in the state’s schools between March and June 2021. Several school districts in North Carolina, under dual law. party, is required to submit infection data to the ABC Science Collaborative as a trusted third party.

During that time, more than 7,000 children and adults contracted the coronavirus and attended school while infectious. Because of close contact with those cases, more than 40,000 people have requested quarantine. However, through contact tracing and testing, we only found 363 more children and adults with coronavirus. We believe this low rate of transmission occurs because of the mask-wearing school environment: Both the infected and close contacts wear masks. Schools provide this protection without costly coronavirus screening tests or major overhauls in ventilation systems.

Because North Carolina has a mandatory masking policy for all K-12 schools, we cannot compare schools with masks to schools that do not. To understand the potential impact masks, we looked outside of North Carolina for comparison. Data from our study and from studies conducted in Utah, Missouri, and Wisconsin suggest that the rate of coronavirus transmission in schools is low when schools enforce mask regulations. In contrast, one school in Israel without mask regulations or proper social distancing protocols reported an outbreak of Covid-19 involving 153 students and 25 staff members.

Recent outbreaks at youth camps in Texas, Illinois and Florida show how quickly Covid-19 can spread among adolescents and adults, who are largely unexposed and most unvaccinated, with the potential to spread to surrounding communities. This potential for community spread is the reason schools closed in March 2020.

With the evidence now clear that universal masking is associated with lower levels of transmission, why not request universal respirator use? Why seek to gather hundreds of unvaccinated, unvaccinated individuals in an enclosed space for a few hours a day, five days a week?

Schools that don’t require masks will spread the coronavirus more. And even though the Covid-19 death rate was just 2 per 100,000 school-age children as of April, with more than 50 million children attending public schools in the US, that still means many more children could die. avoidable death in a year.

When all children are immunized, school districts can best serve their students by creating incentives to wear masks and get vaccinated. For example, if universal mask-wearing is enforced or students are immunized, schools decide it is appropriate not to require isolation or post-exposure testing for asymptomatic children and adults. reasonable. Similarly, schools may consider allowing vaccinated students to continue participating in extracurricular activities even if they have been exposed to someone who has tested positive. School districts that do not have universal face coverings should continue to use strategies such as ventilation and social distancing and continue to perform routine testing of unvaccinated students.

In schools that choose to stay open without mask authorization and with limited vaccines, the likelihood of Covid increases. Until all children can be vaccinated, face masks remain a well-studied solution to reducing the risk of Covid. Children should go to school, and we should take steps to keep them safe.

Kanecia Zimmerman is an associate professor of pediatrics at Duke University School of Medicine. Danny Benjamin Jr. is a pediatric-infectious disease specialist at Duke Health and the Kiser-Arena Distinguished Professor of Pediatrics at Duke University School of Medicine.

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