Local school districts have been grappling with the option of mandating masks, with at least five recently opting for masks in all grades. But the decision was taken out of the hands of local school officials Tuesday when acting state Secretary of Health Alison Beam issued a mandate for universal masking from pre-school and day care through 12th grade.
“The reality is extremely different than it was a month ago,” Beam said during a virtual media conference that included Gov. Tom Wolf, Secretary of Education Noe Ortega, Acting Secretary of Human Services Meg Snead, and President of the Pennsylvania Chapter of the American Academy of Pediatrics Dr. Trude Haecker. All of them voiced support for the move.
Wolf said the mandate falls under authority granted through the state’s Disease Prevention and Control Act, not under any emergency declaration, which bypasses restrictions on the governor’s emergency authorities put in place through a referendum to amend the the state Constitution approved by voters in May.
Wolf and Beam both said the move makes sense because every county in the state is experiencing high transmission rates of COVID-19, and masks are proven way to reduce transmission, thus allowing students to stay in school. Luzerne County’s rate of new cases per 100,000 over 14 days has risen by nearly 250% from Aug. 1 through Tuesday.
At area school board meetings, parents have increasingly argued that masks should be a parent’s choice, citing studies they contend show masks have little or no impact on the spread of the virus, or that show masks cause other health problems for children. The public comment section of Crestwood School District’s Monday meeting ran about 30 minutes and was almost completely devoted to debate about a mask mandate.
But the science backing the usefulness of such a mask mandate is strong, supported most recently by a large study from Duke University, according to Dr. Alison Brodginski, director of infectious diseases in Geisinger’s northeast region.
Brodginski pointed out that the focus has shifted dramatically compared to the start of school last year, when community transmission was relatively low locally and guidance usually talked of modes of education (full-remote, hybrid and in-class). This year, the transmission rates are high and the delta variant of the virus has become the dominant form, which is “much more transmissible.”
This year, there is scant talk of modes of education, and a lot of discussion about how to keep children in schools five days a week.
The Centers for Disease Control and Prevention guidance “doesn’t even talk about modes,” Brodginski said. “We want to get these kids back to in-person learning safely. So how do we do it? There is a layering approach of mitigation strategies. The first is vaccination. If you are eligible, please get vaccinated.”
But there is no vaccine approved for children under 12, and the delta variant is proving more transmissible among children than the previous strain, so masking makes sense. “We know masking works. There were studies done by two Duke University scientists who reviewed the data from March, 2021 through June 2021 in over 100 school districts and charter schools.
They found that, when masks are consistently and effectively worn, “it effectively prevented transmission of the virus, even on a bus, even when not social distancing.” That last part is important in justifying masks in school, Brodginski added.
“Again, going back to the number one goal that we want in-person classes, that’s the best learning environment, so if we can’t distance six feet or even three feet, we know if kids consistently and effectively mask the level of transmission is going to be much less. And this is from really good data.”
Brodginski could not respond to specific studies cited by parents opposed to mask mandates at school board meetings, but she did caution that not all studies are created equal.
“You have to be very cautious when citing something. Is it a study that is peer reviewed and validated by the science community?” She noted one “study” that alleges students suffered dizziness, headaches and other effects from masks turned out to be a survey of parents by a school district. “It was a biased survey of mask skeptics.”
Brodginski also said claims that masks increase carbon dioxide in the blood don’t stand up the science involved. Properly designed and worn masks reduce the transmission of COVID-19 by reducing the amount of virus-carrying particles getting breathed into the air around a person. Carbon dioxide “are really tiny, tiny molecules, much smaller than COVID-19 viral particles, so CO2 passes easily through a mask.”
Of course, the key is mask design. “To stop the larger particles, masks should be 2 layers of breathable material,” she said, noting it’s common sense not to use a mask that “makes it difficult for the child to breath.”
“I think it’s fair to say ‘let’s make sure we’re looking at any potential implications of wearing or not wearing a mask, whether emotional or educational. These are all fair and valid questions. But to question the validity of masks in protecting from respiratory tract infection, there’s no reason to keep searching for an answer We have the answer.”
Regarding some claims that masking can actually increase the risk of getting a respiratory infection, Brodginski said the evidence shows quite the opposite. While a person could theoretically pick up a disease from touching some infected surface and then touching their face or mask, that’s rare and easily avoided by frequent hand cleaning and proper mask hygiene.
“There are theoretical risks that could happen, but a mask increasing any infection is completely false. We saw that with our non-existent flu season.” The lack of flu cases this past winter has been widely credited to the use of masks in the battle against COVID-19. “When you look at rhino virus and RSV (respiratory syncytial virus) we did see a bit of a bump up, but that’s when masking restrictions were removed.”
The bottom line: The delta variant of COVID-19 is changing the risk to children who cannot yet be vaccinated. Masks can reduce the transmission of the COVID-19, they reduce the need to quarantine if exposed to someone who has the virus, and they reduce the risk of being closer to people than six feet or even three feet of social distancing. All of which increases the odds of keeping schools open for all students five days a week.