Thursday, October 21, 2021

Opinion: Schools should do away with mask mandates by the end of the year

Opinion: Schools should do away with mask mandates by the end of the year
A girl passes a "Welcome Back to School" sign as she arrives for the first day of class at an elementary school in New York on Sept. 13. (Mark Lennihan/AP)
Joseph G. Allen is an associate professor and director of the Healthy Buildings program at Harvard University’s T.H. Chan School of Public Health. He co-wrote “Healthy Buildings: How Indoor Spaces Drive Performance and Productivity.”

It’s time to set firm dates for ending masking in schools.

The risk of covid-19 to kids is already very low. And with the expected arrival of vaccines for 5-to-11-year-olds in early November, schools should be able to lift their mask mandates by the end of the year at the latest.

This is true even in areas where schools do not require vaccines for kids. To be clear, I fully support such mandates. My 15-year-old and 12-year-old are already vaccinated, and my 9-year-old will get the shot on the first day it’s approved for his age. But vaccine mandates do not have to be a precondition to end masking.

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Right now, schools have to craft policies based on acceptable risks. Now that children will soon have access to vaccines, all parents will have the tools to send their kids to school with the assurance that they will be safe, even without masks.

Data from all over the world affirms that the risk of severe outcomes from covid-19 is extremely low for kids. In highly vaccinated New England, the hospitalization rate right now for kids under 17 is about 7 per 10 million. That is not a typo.

At the worst of the delta surge in Florida, the hospitalization rate for this age group was about 1 per 100,000. It has since dropped sharply in that region, and is now approaching 1 per million again. And these are overestimates of hospitalization risk for 5-to-11-year-olds, since the Centers for Disease Control and Prevention’s data lumps them together with the slightly higher-risk 12-to-17-year-olds.

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The same low risk for kids holds true for mortality, where the risk for 5-to-11-year-olds has consistently been about 1 per 1 million. Serious covid-related conditions, such as multisystem inflammatory syndrome and long covid, are rare, too.

The CDC is meeting on Nov. 2 and 3 to make the final recommendation on vaccines for 5-to-11-year-olds. Health officials should be preparing now to administer these vaccines on the first day they’re allowed. With full protection of the two-dose regimen kicking in one month after the second shot and strong protection one month after that, that would mean children who receive their shot immediately would be fully vaccinated around the third week of December. In other words, there should be no mask mandates for kids in schools in the new year — or even earlier.

Why do we need such a quick timeline? Because if we don’t set hard deadlines, it’s easy to see how schools could sleepwalk into indefinite masking for kids for at least this entire school year.

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Last year, a major concern was that kids might infect their high-risk teachers or parents. But both of those groups have now had access to vaccines for at least six months. Many of them have access to booster shots, as well, and can continue to wear a high-grade mask to protect themselves if they remain concerned.

As for adults who remain unvaccinated, the delta variant will find them eventually, and, when it does, their risk of severe outcomes remains high. But kids should not have to bear the burden of reckless adults any longer than they already have.

Here are four things we should do to prioritize the health of children:

Mandate vaccines for all adults in schools, as Los Angeles and New York City have done. We know this causes vaccinate rates to rise sharply. New York City’s Department of Education saw its rate spike from around 50 percent in early August to 95 percent.
Host at-school vaccination clinics for 5-to-11-year-olds in every school in the country. Any family that wants their child vaccinated should have that opportunity as soon as vaccines are available. No more crossing our fingers and hoping that people will find a local clinic or CVS to go to. We must bring the vaccines to the students. The time to prepare for this is now.
Expand use of rapid antigen tests so we can end the unnecessary quarantining of kids. Quarantines are a blunt instrument to control spread by assuming every close contact might be infectious. Rapid tests solve that problem by revealing who is actively infectious.
Improve ventilation and filtration. This helps reduce the amount of virus anyone in a classroom will inhale, which lowers the likelihood of infection and likely lowers severity if infected. This is not hard or expensive. The stimulus money is there, and solutions such as installing portable air cleaners with HEPA filters are evidence-based and easy to implement. Size them right, and plug them in. That’s it.
This also isn’t about whether masks work. They do. But as with all control measures, there is a time and place for them. We shouldn’t extend controls beyond what’s necessary, or else we lose the public’s trust. The best thing about masks is that if things change for the worse — and they might — then we just pull the masks back out of the drawer. But we must be just as willing to put them away when things look better.


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