I strongly disagree with the idea that masks shouldn’t be required in schools if they’re not required elsewhere in the community. Children have to go to school, so given that masks are most effective when everyone is wearing them, I’d feel much better about my child’s chances of not getting COVID in school if everyone were masked, even if masks aren’t required elsewhere in the community. True, it wouldn’t make sense for me to send my child in a mask, and then have him hang out maskless at a crowded arcade, but I can choose not to bring him to the arcade. I can’t choose not to bring him to school (unless I homeschool). There may be other reasons not to require masks in schools, but not having masking elsewhere in the community doesn’t seem to be one of them.
Can we talk about the fact that for the third year in a row the CDC is not releasing return to school guidance until after most of the schools in the south have already started (including in their home base of Atlanta!)? How do they expect to have any influence when schools had to come up with their COVID policies by early July to be ready for the August start date? Just frustrates me as a Houston pediatrician. We don't all live in the Northeast!
I hope you will consider reframing your mention of having kids wear masks in schools when communities are not as placing the burden on them. As a pediatrician and parent, I think that this is an unfair comparison. Kids do need to go to school and there are vulnerable kids (and staff) who need to be there. I think that we should see it as a unique space, in the same way masks are required in health care when they are not necessarily in the community. We do need to protect the safety of school for all the kids, teachers, staff, and their families. The burden only happens when not everyone in the school is required to wear a mask, which places a burden on only some of the kids. When everyone wears them, the masks are not a burden, they are a protection that keeps schools and communities safe, healthy and functional.
Thank you for all of your hard work. Please reconsider this messaging.
Wholeheartedly agree with this comment. I can choose where in the community we go as a family, but I have to send my child to school. Wearing a mask when others are wearing a mask is not a burden for her. Wearing a mask when she's the only one is a burden because she is singled out. If everyone (or even half) wore them, that wouldn't be an issue. I believe public schools, health care facilities, and other places where immunocompromised people HAVE to be should at the very least follow the CDC recommendations and require masks when the community level is high. Instead here I sit a week out from school starting with community levels high and transmission rates very high, and I have to decide if I will ask my child to be (likely) the only kid in her class wearing a mask (I'm often the only one wearing one when I go places here).
I echo this, as a family with an elementary educator, two elementary schoolers (in the same class, in part to lessen exposures) and a middle schooler. We have some vulnerability in our home (8 year olds were preemies and had rad), but even moreso we have vulnerable friends and family members, one in particular who is severely immune compromised/at risk. We mask for ourselves, but also so we can see those we love with minimal exposure to them. We also take other measures-testing before visiting, gathering outside when feasible, additional quarantining/degrees of protective measures when reasonable etc. We have covered deck/patio spaces, but that only goes so far in the Pacific NW during fall/winter. We do all we can within reason (including providing air purifiers for my husband and our little guys' classrooms), but our kids have to unmask for lunch indoors, being one of a few is exhausting. My husband's AC in his classroom hasn't worked correctly in years and is yet to be fixed (and they go in circles every time it's reported, his admin is doing all the right things, but the district facilities continue to go around and around with him about it), teaching while masked when your classroom temp is rising into the upper 70's or 80's is miserable and distracting for him and his students...
The more we work together, the safer and better off we all will be.
Our district has reduced the number of excused days after a pos to 3, principals can choose to excuse another 2. I'm absolutely furious. As a parent of a (masked) child who was infected by a pos child being sent to school unmasked (and that child returned on day 6 and infected are least 3 more), it feels like a punch in the gut to parents who believe covid should be taken seriously. My kids tested pos on rapid for 9 days and 10 days. I feel helpless knowing I cannot homeschool them and they attend a great school, but that we are rolling the dice with their long term health daily. ETA: our district returned to school yesterday, so many schools are already at least a week in!
I absolutely love this, and am so grateful for all you do to help sort through what we need to be thinking about, what's sensible and what's not, and especially what the data are telling us. I'm particularly pleased to see what you're saying about going back to school/what happens in school, as that's so important for millions of children! The one comment I'll make is that when you say "I don’t think it makes sense for a school to mandate masks if the larger community does not do so either. We shouldn’t ask students to hold down the fort if the larger community hasn’t also committed either", the difference is that other students are forced to be in school, whereas (some) adults do have options as to how much they want to be out and about in the community. I'm coming from a perspective of seeing how much terrified parents can absolutely disrupt a school year (as can parents who think all restrictions should be lifted entirely), so to me, mandating masking for positive cases in schools might be a bit of a sensible middle ground?
thanks for your comment! and your great points. i completely agree that schools should be a safe place, but they can’t and won’t be virus free. i’m just not convinced the epidemiological benefit of mandating masks is large enough for schools to fight this fight, especially if we get vaccination rates up and ventilation systems in place. many will disagree and that’s okay
For those of us who are at higher risk and have to send our kids to school, it’s hard. The reality on the ground is the ventilation changes and vaccination uptake won’t happen in many parts of the country. If we don’t mandate masks, the burden is borne entirely by families like mine. The same is true vis a vis access to professional spaces for people like me.
So I think when people say “masks aren’t worth it” what we hear is “no mitigation efforts will happen going forward and you’re on your own.” It’s certainly not what you intend, but we know from experience that is how it will be interpreted.
I feel this too. My daughter wore a mask to school last year. They stopped mandating them in school in November 2021 (right in time for Omicron). By the end of the school year there were only 2 kids in her class wearing a mask. I'm struggling right now because my brain says she should mask when she goes back next week as case rates are very high here and even our community level is high, but I don't know if I have the heart to ask her to do it when she'll most certainly be the only one. She has no trouble wearing a mask physically, but it's a lot to ask her to be singled out. If others would wear them when rates are high, it would make a big difference for those of us who are higher risk or have immunocompromised family.
Can school districts set up, under local control, dual use systems where parents who want their masked children to be among masked children, have dedicated classrooms for that, and conversely parents who strongly object to masking, have similarly set up classrooms?
It may depend on which state one lives in and how much latitude the sd's and esd's are given by statute. Here in Oregon we have local control and much variation is tolerated within the overarching reach of Salem, I believe. Staffing would definitely be a problem I think.
The only issue with grouping such students together is that you could get immunocompromised kids clustering, which could be a really bad idea for the same reason that people with cystic fibrosis are supposed to avoid one another. Tricky.
well, it's not the only issue... as Michael mentions below, staffing (and classroom space) is a *huge* issue. If you have, say, 10 kids whose parents want them to be masked, in a district where most classrooms have 25 kids, you either need to add an extra classroom/teacher, or make the other classrooms that much bigger to take the overflow. And once you get out of elementary school, where the kids have different teachers and different classrooms, it's practically impossible.
The fact that schools can't and won't be virus free seems to be the exact reason masks should be required during periods of high community transmission. Especially if kids don't have to test negative to return and can't be required to wear masks after day 5. Increasing vaccination rates and improving ventilation also extremely important of course, but will take time, and may not happen at all in some communities, unfortunately.
Couldn't it be under the teacher's jurisdiction, per classroom? That would be a pretty good norm to promote, for when they become adults - follow the rules of the person you're visiting. Teachers could be given broad discretion to set their own rules, clearly indicated in their syllabi. For instance, they could be authorized to mark a student as absent when they don't comply.
Unfortunately I think we need to have a higher standard in schools, as another commenter started, because they're not optional. We have different rules about who and what are allowed in schools. Masks are working well in the hospitals I work at. The kids in our daycare do a great job with masking, albeit in a community that masks. I am skeptical we'll be able to get vaccines and ventilation upgraded, especially in low SES schools. Until then, masks can be a great equalizer.
Every time my kid gets sick, my patients get cancelled. They get rescheduled weeks, months later. If I were in different circumstances, I'd be unemployed by now. This is not just about the kids. Who is going to watch them when they're home? We need to do better for the kids, parents, women...it all leaks outside the school. If we don't take proper mitigation measures, it will keep repeating.
I have the privilege of living in a community that shares this view and I understand it's not typical. But it doesn't mean we don't advocate for better.
With masked kids in your daycare, how has on-premises transmission been? And do you know how the ventilation situation is in that space? I imagine it's a good anecdotal model for elementary schools.
Good question! Hard to know how much transmission has been within classroom vs community. We get emails when there are cases but no indication as to source of exposure. Looking at the most recent series of cases, only one of the 10+ cases (defined as date of positive) in our most recent classroom was within 5 days of another case. We did have several weeks in a row of a case occurring 7-10 days after the last one, so perhaps there was some long incubation period, but probably unlikely? The teachers never got sick. They mask all the time.
It's hard to know if it's masks or something else, and of course the masks come off at meals and naps. Other strategies our center uses are air purifiers with HEPA filters with good CADR, lots of time outside, and vaccination. Staff is fully vaccinated and most kids are well on their way at this point. Kids testing positive have been excluded for 5 days, no testing requirement to come back that I'm aware of, but I know at least some parents chose to keep their kids home until negative on RAT. That is the one thing I'd like to see implemented since these kids do remove their masks at meals and nap.
Well, it has happened. Your "Isolation" paragraph above shows that protecting others is not as important as keeping parents in the work force and kids in school. Quoting the CDC now huh? Wow. Just, wow.
I'm sure that's what it is. The seduction of power and influence. So very sad to see though. I relied on this newsletter for 100% science-based information for so long.
I am very disappointed about your statement regarding student masking. I must respectfully request that you reconsider telling children not to mask in areas of high transmission. Children should be learn to protect themselves and their friends and vulnerable family members by wearing masks despite the stupidity in the larger community.
"The study results showed that a total of 1,539 subjects were analyzed from 13 studies, including four community-based and nine healthcare-based studies. Among these, 243 subjects had SARS-CoV-2 infections, including 97 who did and 146 who did not wear facemasks. The team noted that the probability of contracting a COVID-19 disease was 7% for mask wearers and 52% for non-mask wearers. The relative risk of getting infected by SARS-CoV-2 was 0.13 for mask wearers" Given the number of vulnerable children, those who have vulnerable family members, the inevitability of further COVID mutations, new variants and the high level of transmission, it seems more important than ever to teach students to do the right thing and set an example for their foolish elders. We must ensure that the next generation takes infectious disease more seriously than the multitude of adults currently trying to pretend that an active pandemic is over.
So up to this point, I have thought you were reasonable. You spent time in Washington DC and now you sell the public, especially children and school staff, down the river. Thanks a lot. 😢🙄. It is not okay to minimize the effects of this disease that is running rampant with no effort to prevent it, and to tell us it is okay to get it because there are treatments, and that if we do get it, maybe we can mask, but we shouldn't isolate or quarantine. Wtf kind of public health info is this? No mention of long term effects of a virus that effects every system in the body. As someone who has post viral syndrome from EBV, no one wants to be consigned to this the rest of their life. How can we tell which people will be affected? We can't. And no mention of monkeypox, another virus that affects children the most. Unsubbing.
As someone whose health has been totally trashed by long covid, I feel your frustration. I wouldn't wish this outcome on my worst enemy. But.. YLE has criticized the agencies more often than followed their ever changing lines. People like YLE, have been the target of harassment and death threats and have taken personal risks to take the principled stands they have. None of us could have done more!
I agree with you that this has been a great column. I am worried because I can see signs that the independent, objective evaluations are being eroded by getting closer and closer to the "official line". I've seen this before with people I've respected but who become "snared" by the plaudits of the "in crowd' of experts.
The thing about the in crowd is that they mean well, but don't believe in telling the public the truth. The believe in telling the public the fibs and half truths that will get the public to do what's in the public's best interest. And that works for a little while. But it's herding people, not informing them, and after a while everybody figures out what's going on and becomes angry, cynical and mistrustful, and thereafter you can't herd them towards safety and you can't inform them of what is safe either because they no longer see you as a provider of information.
The only part of this I don't understand is why the in crowd -- the government officials -- do not understand this. It is really not that hard to observe or to understand.
We are “kindred souls”. Sadly it is the way of bureaucracies - even the most well intentioned ones. “Talking down” to people, instead of respecting them, with the resulting loss of credibility is so harmful. As you say, cynicism leads to anger and mistrust and even the correct messages can’t get through.
She has in the past been critical. It seems to me I'm noticing a trend in the other direction though -- but still hoping it's just a random fluctuation.
I have appreciated your column ever since I first started reading it. I am very disappointed in this article - except for some of the information about ventilation - because it seems to "parrot" the suggestions/"guidance" from authorities (like the CDC) whose advice seems to be too driven by concerns about how they will be greeted and adopted by the general society. The "science" should be the focus of this article - not what is deemed socially feasible.
Ventilation and air purification are truly powerful interventions, though, & well-supported by science.
If you are annoyed by her positions on sick kids in school & school masking -- well, so am I. However, as she points out, there's not a lot of point in having everyone mask in schools if nobody is masking anywhere else.
It does seem like she is moving more in the direction of supporting the government, though. I expect that she is being courted by the powers that be to become allied in various ways with the CDC and all the other slo-mo, dysfunctional gov't bureaucracies, because she is smart, likable & lots of people follow her blog and trust her. Of course a lot of us will quickly move to not following and trusting her if it seems like she's being turned into a "meat puppet" for the government.
There's a massive begged question in your second paragraph. Specifically, it's the sentence that refers to "CDC and all the other slo-mo, dysfunctional gov't bureaucracies."
I'm completely fed up with the right wing, Reagan-era "the government is the problem" attitude. You'd think we would have seen what rubbish that is by now. The CDC has been not always been correct in its recommendations, granted, especially under TFG's misrule, but on the whole they have done a decent job with coping with a rapidly changing viral environment.
You also seem to have forgotten earlier articles in which Dr. Jetelina has taken issue with CDC recommendations. Don't mistake a failure to align with your beliefs as evidence that Dr. Jetelina has become sort of sucker for Evil Government Propaganda.
I hear you. Listen, I'm very far from being right wing. In fact, I'm pretty leftie. I am not against big government, I am against ineffective government agencies. Our CDC etc.have not done a good job with covid. Want some evidence? Out of about 200 countries, the US ranks 172nd in total covid deaths per 100,000. (https://coronavirus.jhu.edu/data/mortality) 7 countries out of 8 have done better than us. And we're a rich country, full out outstanding research and medical institutions. It takes some serious bungling to start off with such a good hand and still flunk covid as badly as we have.
As for Dr. Jetelina, I'm not convinced that she's getting sucked into being a spokesperson for the government, I'm just worried that she is.
Oh, I completely agree that, for an allegedly prosperous first world nation, we have done a pathetic job of fighting SARS-Cov-2. I would argue that it's not entirely logical to blame *all* of that on the CDC. You're right that we should have been doing this better, but there are multiple reasons for that including:
1) The lack of affordable universal health care
2) The lack of anything remotely resembling a public health infrastructure
3) An extremist political movement that continues to make NOT fighting the virus an index of tribal loyalty, and actively attacks any measures that could be used effectively against it.
Indeed, I'd say that it's wildly unrealistic to expect the CDC to combat the level of weaponized pseudoscience we're all faced with. The COVID-19 pandemic has bee accompanied and enabled by a a misinformation and propaganda pandemic.
I understand your worry, but I don't see it as really being justified at this point.
Yes, I agree with you about 1-3 above, & I don't know what the CDC or any other agency can do about the weaponized pseudoscience. However, the CDC is currently doing things that alienate people like me, & I'm as pro-science as you can get. They've got a better chance against the pseudoscience bunch if the rest of us still feel allied with the CDC. Here are 3 things they could do that I think would at least help:
(1) Be more frank and transparent. Honestly I think it would be helpful for somebody in government to openly address the fact that we have done badly, and what a mess it is, and to own up to past mistakes.
(2) Be informative and honest about ongoing decisions. For instance, regarding the guidance regarding return to work 5 days after diagnosis with covid: There is abundant evidence that many people are not only contagious on days 6 and beyond, but highly contagious. And of course half the US, including medical personnel, wear ineffective surgical masks with big gaps through which their covid-filled breath comes puffing out with every exhale. I can see the argument for having people return to work anyway: We need people at work, to keep things running. And anyhow, so few people take any precautions these days that the extra virus these still-contagious people are adding to the environment may not make public places much more virus-filled than they already are. But then the CDC needs to *say* that: The advantages of having having still-contagious people return to work outweigh the disadvantages. And then add: People returning to work should not just mask, but should wear a high quality mask, such as an n95.
(3) Solicit communications from the public. Right now, even the doctors and scientists I know feel unable to contact the CDC with opinions, research findings, and questions. Of course there are numbers they can call -- but there's no line for professionals to call where they know they are giving info to someone who understands it and will pass it on for consideration. Members of the public, too, would benefit from being able to actually give the CDC some feedback. Why not have some kind of town hall meeting or helpline or even an online forum where the CDC responds to reasonable questions and concerns?
You are so absolutely right. I especially like your comments on honesty and candor and admitting to past mistakes. The CDC couldn't and can't solve all the problems of COVID but they should stand up as a source of information that we can trust. It isn't "right wing" to find many bureaucracies to be hidebound and slow to act and slower to acknowledge mistakes. And slow to admit that they are making "tradeoffs" between safety for individuals in the near term and the needs of society to keep going. All people are asking for is candor and respect, not condescenion.
"... the CDC is currently doing things that alienate people like me, & I'm as pro-science as you can get. They've got a better chance against the pseudoscience bunch if the rest of us still feel allied with the CDC." What a great sentence! Thanks
I work with classroom ventilation systems every day to try to manage infectious disease risks and am concerned about the advice to 1) limit CO2 levels to less than 800 ppm and 2) to set up cross ventilation in classrooms. This is because 1) there has been no correlation in the data that I have collected between CO2 levels (a gas) with virus levels (particles) and 2) because the potential sources of Covid virus are in the classroom, strong directionality in air movement risks creating a superspreader event, if, for example, an unknowingly infectious individual is upwind (i.e. next to the fan) of the rest of the class. As you note, there is little science available that explains what "improving ventilation" means in this context. In my experience, mask use, which is a significant challenge in a high communication environment such as a classroom, is likely to be much more effective than ventilation measures.
I understand re fan concern; a CO2 monitor is helping judge how fresh (not stuffy) a room is (lower CO2 = more fresh air). If a room has good ventilation, that’s more fresh air and less air coming from everyone breathing if that makes sense? And filtration is helpful because any virus in the air is “trapped” on the filter. Corsi Rosenthal boxes are cheaper than HEPA, easy to build and highly effective at reducing viral load in the air https://news.3m.com/2022-02-24-3M-scientists-This-Corsi-Rosenthal-box-movement-is-legit
These things - ventilation, filtration and universal masks would REALLY lower the risk of contracting covid during in person schooling. Why it’s not being done is a mystery to me.
Check out Joey Fox on Twitter (https://twitter.com/joeyfox85) he has MANY threads on the science of this and how to optimize spaces with things like CR boxes. The main point is that if your steady state CO2 is under 800 (preferably around 600) then an individual breath is getting mixed/diluted quickly. Remaining stagnant air can then be cleaned through HEPA (CR). In this situation, the main concern is face-to-face communication, which masks can take care of.
If your CO2 is above 1000, then the air is not being moved/diluted that fast and that brings the risk of virus particles remaining in the air. In that case, you need greater HEPA filtration to remove it and/or masks. Without those, it creates risk.
For your risk example above of directionality, if the virus particles remained concentrated and moved en masse, then that would be a concern. However, if CO2 levels remain low, that means that fresh air is mixing well with it, so in this case the cloud of virus particles is quickly being diluted and dispersed into lower concentrations.
two questions: if windows in a home are left open when workmen come in to do repairs, how long after their departure (assume they are masked and in the house for an hour and a half) do you think it will take to make it safe to use the living space without masking -a couple of hours, couple of days...?; maybe a simpler one, are ceiling fans effective at improving the situation?
In general, I would assume that if your window are open in a space, you're looking at about 2 air exchanges per hour. You can accelerate that by pointing a fan to blow outward across the space. If you have a HEPA filter (or make your own Corsi-Rosenthal Box for about $60), you can add about 2 air exchanges in addition to filtration in there. You usually want about 5-6 air exchanges to totally clear a space, so probably about 2 hours if you're just opening windows? But I have only learned from people like Joey Fox on Twitter, I'm definitely not an expert. This article may help too https://www.nature.com/articles/7500229#:~:text=Opening%20windows%20had%20the%20largest,for%20short%20periods%20of%20time.)
Under the same facts, where in the room would you place the HEPA purifier (which I have recently purchased for just such occasions)? For instance if someone is coming to service the fridge, and the kitchen is off the living room?
Your note on CO2 vs. aerosol particles is interesting. I have been measuring both, though not carefully enough to develop their correlation ... relationship. CO2 must be more widespread and more well-mixed than aerosols since the aerosol signal should be dominated by occasional coughing, sneezing and perhaps talking.
I have also had to deal with extraneous sources of CO2: propane heaters and stoves and, surprisng to me, the diurnal cycle of soil respiration which can really throw off sensor calibration (which usually assumes outdoor air is close to 400 ppm) But CO2 also has much to offer in improving ventilation and filtration through artificial seeding of the air with it. As you say, random attempts at ventilation can make things worse: the good strategy of lifting the air everywhere upward, away from face level, with exhaust fans is rarely mentioned.
If you have some more detail of your work i'd be very interested. It's been a hard sell, getting schools, etc interested . My informal website is www.ocean.washington.edu/research/gfd/AIR Peter Rhines (Univ of Washington fluid dynamics faculty emeritus, formerly ocean/atmosphere/climate science) rhines@uw.edu
Regarding your recommendations for schools: I think you're dead wrong. I get that very few children get severely ill from covid. I also get that missing a bunch of school is bad for kids. But what about the accumulating evidence of damage to the body from covid? For instance, here's a study of decline in cognitive skills after covid:
And then there's the possibility that some damage covid does to the body will not manifest itself for a decade or 2. I know none of this is for sure, but there seems to be enough indirect evidence for parents to be legitimately concerned about their child having covid -- especially since it seems likely that with such weak protective measures in the schools, kids are likely to have covid SEVERAL TIMES A YEAR.
The CDC guidelines indicate the unvaccinated (with no prior COVID in the last 90 days) should quarantine if exposed. As you indicated, most pre-school and grade-school students are unvaccinated. Per the CDC, they should quarantine if exposed.
You don't remind people that infectiousness begins before symptoms, and that there is a reasonable percentage of asymptomatic cases that shed as much virus. Your position seems to be that these infectious periods should be spent in the classroom.
It appears that "masking is not legally required" is effectively practiced as "masking is only for the other person". When schools aren't legally required to enforce masking, they won't require masks of even those obviously sick, much less those that should quarantine, lest they get sued.
Consider a policy of all students in a classroom wearing a mask if any student in the classroom is out sick. The masking acts as a pseudo-quarantine. Those students exposed (by the sick student) who might be infectious but not (yet) symptomatic are in class, but wearing a mask. No one's Civil Rights are stomped on by this. It can be uniformly applied. Parents will be happy that the schools are taking care of the otherwise quarantined child.
Then there is the issue of children that are sent to school when sick, or develop symptoms while in school. Especially, if the child refuses to wear a mask properly & consistently. To avoid more absences in the future., the school should isolate these children from the apparently healthy children. How should this be done if, say, 5% of the children are dropped off while sick?
Consider a no-fault drop-off of sick children at school, like some jurisdictions allow babies to be dropped off at fire stations? The parents won't/can't deal with the sick child. Allow them to drop the child off with notification that the child is sick so he/she can be isolated with other sick children rather than sit in the classroom. (This grates on my sensibilities, but I can see it might reduce in-classroom spread.)
The utility of ventilation & filtration is good in theory & practice, but if it wasn't already budgeted & implemented, it isn't going to be in place for this back to school season.
I'd love a future post on how to assess risk in the long term for Covid, especially for kids- not only long Covid, but things that may come up later (diabetes, chronic issues, reactivation akin to shingles). My daughter is finally vaccinated (hooray!!!), and I'm still struggling with risk calculations because I'm concerned about the long term. Usually, I feel like I'm the only one, but from the fb comments today, it seems like there are others among your readers who share those questions.
1. Beef up the public health curriculum probably starting in middle school and move it out of the elective category. But be prepared for political fights at the school boards.
2. Add sections on virology, microbiology, pathogens, to the electives for the STEM tracking students. Add history of pandemics to the electives for everybody, college track or cte track. Such courses can be career changers.
3. In general, the trend has been increasing emphasis on engineering and applied in 9- 12, so add bio engineering, bio informatics, etc. to the electives for grades 11 and 12.
Oh yes, I forgot..the history of pandemics, goes to the courses fulfilling social science graduation requirements. And you have to get the buy-in from the state system of higher ed K-16 alignment folks, that all this curriculum counts for college-preparatory credit. Best possible world is if you can get the state higher ed system to count some of the STEM stuff for running start college credit!
Given what we've just gone through, this is the ideal time to push this curriculum revamp agenda; the window of opportunity will start closing soon!
I'm glad you brought up curricula. I feel like part of the reason that mask mandates have been so contentious is because we've been assuming that enforcement requires direct confrontation. For schools, when conditions warrant it, we could treat "following public health guidance" as a three credit course, potentially impacting the student's GPA.
Thank you so much for continuing to keep us updated on the latest guidance. I'm wondering if I have misunderstood the masking data, or if the data has changed? I want to follow the science! I have asking (not requiring) my students to mask. I was hoping that by doing so, I was limiting the spread. I know that very few students mask outside of my classroom, but I thought the masking provided a layer of protection during the time they were with me. Is the data showing that masking is largely ineffective, if it's not practiced consistently in and out of the classroom? I don't have control over school-wide ventilation, so masking seemed to be the area where I could contribute. If that's not the case, then I definitely want to know.
Masking does work in the given time and space with the usual caveats of fit, type of mask, etc. But yes, in any situation indoors, the more that people wear, the more the community protection. On an individual level, if a student doesn't wear it outside of your class and hangs out with an infected person, they risk getting sick. But if your goal is to control what you can, you are doing the community a service by asking. To help quantify this, check out this simulator from MIT: https://indoor-covid-safety.herokuapp.com/apps/advanced
Please see my comment above. Masking definitely does make a difference and you should feel comfortable asking your students to please mask for the benefit of their peers. It’s much better than knowing that they have killed a classmate by bringing Covid into the classroom. thank you
I strongly disagree with the idea that masks shouldn’t be required in schools if they’re not required elsewhere in the community. Children have to go to school, so given that masks are most effective when everyone is wearing them, I’d feel much better about my child’s chances of not getting COVID in school if everyone were masked, even if masks aren’t required elsewhere in the community. True, it wouldn’t make sense for me to send my child in a mask, and then have him hang out maskless at a crowded arcade, but I can choose not to bring him to the arcade. I can’t choose not to bring him to school (unless I homeschool). There may be other reasons not to require masks in schools, but not having masking elsewhere in the community doesn’t seem to be one of them.
Can we talk about the fact that for the third year in a row the CDC is not releasing return to school guidance until after most of the schools in the south have already started (including in their home base of Atlanta!)? How do they expect to have any influence when schools had to come up with their COVID policies by early July to be ready for the August start date? Just frustrates me as a Houston pediatrician. We don't all live in the Northeast!
I hope you will consider reframing your mention of having kids wear masks in schools when communities are not as placing the burden on them. As a pediatrician and parent, I think that this is an unfair comparison. Kids do need to go to school and there are vulnerable kids (and staff) who need to be there. I think that we should see it as a unique space, in the same way masks are required in health care when they are not necessarily in the community. We do need to protect the safety of school for all the kids, teachers, staff, and their families. The burden only happens when not everyone in the school is required to wear a mask, which places a burden on only some of the kids. When everyone wears them, the masks are not a burden, they are a protection that keeps schools and communities safe, healthy and functional.
Thank you for all of your hard work. Please reconsider this messaging.
Wholeheartedly agree with this comment. I can choose where in the community we go as a family, but I have to send my child to school. Wearing a mask when others are wearing a mask is not a burden for her. Wearing a mask when she's the only one is a burden because she is singled out. If everyone (or even half) wore them, that wouldn't be an issue. I believe public schools, health care facilities, and other places where immunocompromised people HAVE to be should at the very least follow the CDC recommendations and require masks when the community level is high. Instead here I sit a week out from school starting with community levels high and transmission rates very high, and I have to decide if I will ask my child to be (likely) the only kid in her class wearing a mask (I'm often the only one wearing one when I go places here).
I echo this, as a family with an elementary educator, two elementary schoolers (in the same class, in part to lessen exposures) and a middle schooler. We have some vulnerability in our home (8 year olds were preemies and had rad), but even moreso we have vulnerable friends and family members, one in particular who is severely immune compromised/at risk. We mask for ourselves, but also so we can see those we love with minimal exposure to them. We also take other measures-testing before visiting, gathering outside when feasible, additional quarantining/degrees of protective measures when reasonable etc. We have covered deck/patio spaces, but that only goes so far in the Pacific NW during fall/winter. We do all we can within reason (including providing air purifiers for my husband and our little guys' classrooms), but our kids have to unmask for lunch indoors, being one of a few is exhausting. My husband's AC in his classroom hasn't worked correctly in years and is yet to be fixed (and they go in circles every time it's reported, his admin is doing all the right things, but the district facilities continue to go around and around with him about it), teaching while masked when your classroom temp is rising into the upper 70's or 80's is miserable and distracting for him and his students...
The more we work together, the safer and better off we all will be.
Our district has reduced the number of excused days after a pos to 3, principals can choose to excuse another 2. I'm absolutely furious. As a parent of a (masked) child who was infected by a pos child being sent to school unmasked (and that child returned on day 6 and infected are least 3 more), it feels like a punch in the gut to parents who believe covid should be taken seriously. My kids tested pos on rapid for 9 days and 10 days. I feel helpless knowing I cannot homeschool them and they attend a great school, but that we are rolling the dice with their long term health daily. ETA: our district returned to school yesterday, so many schools are already at least a week in!
I absolutely love this, and am so grateful for all you do to help sort through what we need to be thinking about, what's sensible and what's not, and especially what the data are telling us. I'm particularly pleased to see what you're saying about going back to school/what happens in school, as that's so important for millions of children! The one comment I'll make is that when you say "I don’t think it makes sense for a school to mandate masks if the larger community does not do so either. We shouldn’t ask students to hold down the fort if the larger community hasn’t also committed either", the difference is that other students are forced to be in school, whereas (some) adults do have options as to how much they want to be out and about in the community. I'm coming from a perspective of seeing how much terrified parents can absolutely disrupt a school year (as can parents who think all restrictions should be lifted entirely), so to me, mandating masking for positive cases in schools might be a bit of a sensible middle ground?
thanks for your comment! and your great points. i completely agree that schools should be a safe place, but they can’t and won’t be virus free. i’m just not convinced the epidemiological benefit of mandating masks is large enough for schools to fight this fight, especially if we get vaccination rates up and ventilation systems in place. many will disagree and that’s okay
For those of us who are at higher risk and have to send our kids to school, it’s hard. The reality on the ground is the ventilation changes and vaccination uptake won’t happen in many parts of the country. If we don’t mandate masks, the burden is borne entirely by families like mine. The same is true vis a vis access to professional spaces for people like me.
So I think when people say “masks aren’t worth it” what we hear is “no mitigation efforts will happen going forward and you’re on your own.” It’s certainly not what you intend, but we know from experience that is how it will be interpreted.
I feel this too. My daughter wore a mask to school last year. They stopped mandating them in school in November 2021 (right in time for Omicron). By the end of the school year there were only 2 kids in her class wearing a mask. I'm struggling right now because my brain says she should mask when she goes back next week as case rates are very high here and even our community level is high, but I don't know if I have the heart to ask her to do it when she'll most certainly be the only one. She has no trouble wearing a mask physically, but it's a lot to ask her to be singled out. If others would wear them when rates are high, it would make a big difference for those of us who are higher risk or have immunocompromised family.
Can school districts set up, under local control, dual use systems where parents who want their masked children to be among masked children, have dedicated classrooms for that, and conversely parents who strongly object to masking, have similarly set up classrooms?
We tried asking for that last year and were told it was illegal.
It may depend on which state one lives in and how much latitude the sd's and esd's are given by statute. Here in Oregon we have local control and much variation is tolerated within the overarching reach of Salem, I believe. Staffing would definitely be a problem I think.
The only issue with grouping such students together is that you could get immunocompromised kids clustering, which could be a really bad idea for the same reason that people with cystic fibrosis are supposed to avoid one another. Tricky.
well, it's not the only issue... as Michael mentions below, staffing (and classroom space) is a *huge* issue. If you have, say, 10 kids whose parents want them to be masked, in a district where most classrooms have 25 kids, you either need to add an extra classroom/teacher, or make the other classrooms that much bigger to take the overflow. And once you get out of elementary school, where the kids have different teachers and different classrooms, it's practically impossible.
The fact that schools can't and won't be virus free seems to be the exact reason masks should be required during periods of high community transmission. Especially if kids don't have to test negative to return and can't be required to wear masks after day 5. Increasing vaccination rates and improving ventilation also extremely important of course, but will take time, and may not happen at all in some communities, unfortunately.
Couldn't it be under the teacher's jurisdiction, per classroom? That would be a pretty good norm to promote, for when they become adults - follow the rules of the person you're visiting. Teachers could be given broad discretion to set their own rules, clearly indicated in their syllabi. For instance, they could be authorized to mark a student as absent when they don't comply.
Unfortunately I think we need to have a higher standard in schools, as another commenter started, because they're not optional. We have different rules about who and what are allowed in schools. Masks are working well in the hospitals I work at. The kids in our daycare do a great job with masking, albeit in a community that masks. I am skeptical we'll be able to get vaccines and ventilation upgraded, especially in low SES schools. Until then, masks can be a great equalizer.
Every time my kid gets sick, my patients get cancelled. They get rescheduled weeks, months later. If I were in different circumstances, I'd be unemployed by now. This is not just about the kids. Who is going to watch them when they're home? We need to do better for the kids, parents, women...it all leaks outside the school. If we don't take proper mitigation measures, it will keep repeating.
I have the privilege of living in a community that shares this view and I understand it's not typical. But it doesn't mean we don't advocate for better.
With masked kids in your daycare, how has on-premises transmission been? And do you know how the ventilation situation is in that space? I imagine it's a good anecdotal model for elementary schools.
Good question! Hard to know how much transmission has been within classroom vs community. We get emails when there are cases but no indication as to source of exposure. Looking at the most recent series of cases, only one of the 10+ cases (defined as date of positive) in our most recent classroom was within 5 days of another case. We did have several weeks in a row of a case occurring 7-10 days after the last one, so perhaps there was some long incubation period, but probably unlikely? The teachers never got sick. They mask all the time.
It's hard to know if it's masks or something else, and of course the masks come off at meals and naps. Other strategies our center uses are air purifiers with HEPA filters with good CADR, lots of time outside, and vaccination. Staff is fully vaccinated and most kids are well on their way at this point. Kids testing positive have been excluded for 5 days, no testing requirement to come back that I'm aware of, but I know at least some parents chose to keep their kids home until negative on RAT. That is the one thing I'd like to see implemented since these kids do remove their masks at meals and nap.
Well, it has happened. Your "Isolation" paragraph above shows that protecting others is not as important as keeping parents in the work force and kids in school. Quoting the CDC now huh? Wow. Just, wow.
Hope it's not the result of spending too much time in DC. Powerful "experts" can be very seductive
I'm sure that's what it is. The seduction of power and influence. So very sad to see though. I relied on this newsletter for 100% science-based information for so long.
I am very disappointed about your statement regarding student masking. I must respectfully request that you reconsider telling children not to mask in areas of high transmission. Children should be learn to protect themselves and their friends and vulnerable family members by wearing masks despite the stupidity in the larger community.
Please consider this article : 8-2-22 Study shows probability of getting COVID for mask wearers vs. non-mask wearers By Bhavana Kunkalikar Reviewed by Aimee Molineux https://www.news-medical.net/news/20220802/Study-shows-probability-of-getting-COVID-for-mask-wearers-vs-non-mask-wearers.aspx
"The study results showed that a total of 1,539 subjects were analyzed from 13 studies, including four community-based and nine healthcare-based studies. Among these, 243 subjects had SARS-CoV-2 infections, including 97 who did and 146 who did not wear facemasks. The team noted that the probability of contracting a COVID-19 disease was 7% for mask wearers and 52% for non-mask wearers. The relative risk of getting infected by SARS-CoV-2 was 0.13 for mask wearers" Given the number of vulnerable children, those who have vulnerable family members, the inevitability of further COVID mutations, new variants and the high level of transmission, it seems more important than ever to teach students to do the right thing and set an example for their foolish elders. We must ensure that the next generation takes infectious disease more seriously than the multitude of adults currently trying to pretend that an active pandemic is over.
So up to this point, I have thought you were reasonable. You spent time in Washington DC and now you sell the public, especially children and school staff, down the river. Thanks a lot. 😢🙄. It is not okay to minimize the effects of this disease that is running rampant with no effort to prevent it, and to tell us it is okay to get it because there are treatments, and that if we do get it, maybe we can mask, but we shouldn't isolate or quarantine. Wtf kind of public health info is this? No mention of long term effects of a virus that effects every system in the body. As someone who has post viral syndrome from EBV, no one wants to be consigned to this the rest of their life. How can we tell which people will be affected? We can't. And no mention of monkeypox, another virus that affects children the most. Unsubbing.
As someone whose health has been totally trashed by long covid, I feel your frustration. I wouldn't wish this outcome on my worst enemy. But.. YLE has criticized the agencies more often than followed their ever changing lines. People like YLE, have been the target of harassment and death threats and have taken personal risks to take the principled stands they have. None of us could have done more!
I agree with you that this has been a great column. I am worried because I can see signs that the independent, objective evaluations are being eroded by getting closer and closer to the "official line". I've seen this before with people I've respected but who become "snared" by the plaudits of the "in crowd' of experts.
The thing about the in crowd is that they mean well, but don't believe in telling the public the truth. The believe in telling the public the fibs and half truths that will get the public to do what's in the public's best interest. And that works for a little while. But it's herding people, not informing them, and after a while everybody figures out what's going on and becomes angry, cynical and mistrustful, and thereafter you can't herd them towards safety and you can't inform them of what is safe either because they no longer see you as a provider of information.
The only part of this I don't understand is why the in crowd -- the government officials -- do not understand this. It is really not that hard to observe or to understand.
We are “kindred souls”. Sadly it is the way of bureaucracies - even the most well intentioned ones. “Talking down” to people, instead of respecting them, with the resulting loss of credibility is so harmful. As you say, cynicism leads to anger and mistrust and even the correct messages can’t get through.
She has in the past been critical. It seems to me I'm noticing a trend in the other direction though -- but still hoping it's just a random fluctuation.
I have appreciated your column ever since I first started reading it. I am very disappointed in this article - except for some of the information about ventilation - because it seems to "parrot" the suggestions/"guidance" from authorities (like the CDC) whose advice seems to be too driven by concerns about how they will be greeted and adopted by the general society. The "science" should be the focus of this article - not what is deemed socially feasible.
Ventilation and air purification are truly powerful interventions, though, & well-supported by science.
If you are annoyed by her positions on sick kids in school & school masking -- well, so am I. However, as she points out, there's not a lot of point in having everyone mask in schools if nobody is masking anywhere else.
It does seem like she is moving more in the direction of supporting the government, though. I expect that she is being courted by the powers that be to become allied in various ways with the CDC and all the other slo-mo, dysfunctional gov't bureaucracies, because she is smart, likable & lots of people follow her blog and trust her. Of course a lot of us will quickly move to not following and trusting her if it seems like she's being turned into a "meat puppet" for the government.
There's a massive begged question in your second paragraph. Specifically, it's the sentence that refers to "CDC and all the other slo-mo, dysfunctional gov't bureaucracies."
I'm completely fed up with the right wing, Reagan-era "the government is the problem" attitude. You'd think we would have seen what rubbish that is by now. The CDC has been not always been correct in its recommendations, granted, especially under TFG's misrule, but on the whole they have done a decent job with coping with a rapidly changing viral environment.
You also seem to have forgotten earlier articles in which Dr. Jetelina has taken issue with CDC recommendations. Don't mistake a failure to align with your beliefs as evidence that Dr. Jetelina has become sort of sucker for Evil Government Propaganda.
I hear you. Listen, I'm very far from being right wing. In fact, I'm pretty leftie. I am not against big government, I am against ineffective government agencies. Our CDC etc.have not done a good job with covid. Want some evidence? Out of about 200 countries, the US ranks 172nd in total covid deaths per 100,000. (https://coronavirus.jhu.edu/data/mortality) 7 countries out of 8 have done better than us. And we're a rich country, full out outstanding research and medical institutions. It takes some serious bungling to start off with such a good hand and still flunk covid as badly as we have.
As for Dr. Jetelina, I'm not convinced that she's getting sucked into being a spokesperson for the government, I'm just worried that she is.
Oh, I completely agree that, for an allegedly prosperous first world nation, we have done a pathetic job of fighting SARS-Cov-2. I would argue that it's not entirely logical to blame *all* of that on the CDC. You're right that we should have been doing this better, but there are multiple reasons for that including:
1) The lack of affordable universal health care
2) The lack of anything remotely resembling a public health infrastructure
3) An extremist political movement that continues to make NOT fighting the virus an index of tribal loyalty, and actively attacks any measures that could be used effectively against it.
Indeed, I'd say that it's wildly unrealistic to expect the CDC to combat the level of weaponized pseudoscience we're all faced with. The COVID-19 pandemic has bee accompanied and enabled by a a misinformation and propaganda pandemic.
I understand your worry, but I don't see it as really being justified at this point.
Yes, I agree with you about 1-3 above, & I don't know what the CDC or any other agency can do about the weaponized pseudoscience. However, the CDC is currently doing things that alienate people like me, & I'm as pro-science as you can get. They've got a better chance against the pseudoscience bunch if the rest of us still feel allied with the CDC. Here are 3 things they could do that I think would at least help:
(1) Be more frank and transparent. Honestly I think it would be helpful for somebody in government to openly address the fact that we have done badly, and what a mess it is, and to own up to past mistakes.
(2) Be informative and honest about ongoing decisions. For instance, regarding the guidance regarding return to work 5 days after diagnosis with covid: There is abundant evidence that many people are not only contagious on days 6 and beyond, but highly contagious. And of course half the US, including medical personnel, wear ineffective surgical masks with big gaps through which their covid-filled breath comes puffing out with every exhale. I can see the argument for having people return to work anyway: We need people at work, to keep things running. And anyhow, so few people take any precautions these days that the extra virus these still-contagious people are adding to the environment may not make public places much more virus-filled than they already are. But then the CDC needs to *say* that: The advantages of having having still-contagious people return to work outweigh the disadvantages. And then add: People returning to work should not just mask, but should wear a high quality mask, such as an n95.
(3) Solicit communications from the public. Right now, even the doctors and scientists I know feel unable to contact the CDC with opinions, research findings, and questions. Of course there are numbers they can call -- but there's no line for professionals to call where they know they are giving info to someone who understands it and will pass it on for consideration. Members of the public, too, would benefit from being able to actually give the CDC some feedback. Why not have some kind of town hall meeting or helpline or even an online forum where the CDC responds to reasonable questions and concerns?
You are so absolutely right. I especially like your comments on honesty and candor and admitting to past mistakes. The CDC couldn't and can't solve all the problems of COVID but they should stand up as a source of information that we can trust. It isn't "right wing" to find many bureaucracies to be hidebound and slow to act and slower to acknowledge mistakes. And slow to admit that they are making "tradeoffs" between safety for individuals in the near term and the needs of society to keep going. All people are asking for is candor and respect, not condescenion.
"... the CDC is currently doing things that alienate people like me, & I'm as pro-science as you can get. They've got a better chance against the pseudoscience bunch if the rest of us still feel allied with the CDC." What a great sentence! Thanks
Thanks for your sensible comment
I work with classroom ventilation systems every day to try to manage infectious disease risks and am concerned about the advice to 1) limit CO2 levels to less than 800 ppm and 2) to set up cross ventilation in classrooms. This is because 1) there has been no correlation in the data that I have collected between CO2 levels (a gas) with virus levels (particles) and 2) because the potential sources of Covid virus are in the classroom, strong directionality in air movement risks creating a superspreader event, if, for example, an unknowingly infectious individual is upwind (i.e. next to the fan) of the rest of the class. As you note, there is little science available that explains what "improving ventilation" means in this context. In my experience, mask use, which is a significant challenge in a high communication environment such as a classroom, is likely to be much more effective than ventilation measures.
I understand re fan concern; a CO2 monitor is helping judge how fresh (not stuffy) a room is (lower CO2 = more fresh air). If a room has good ventilation, that’s more fresh air and less air coming from everyone breathing if that makes sense? And filtration is helpful because any virus in the air is “trapped” on the filter. Corsi Rosenthal boxes are cheaper than HEPA, easy to build and highly effective at reducing viral load in the air https://news.3m.com/2022-02-24-3M-scientists-This-Corsi-Rosenthal-box-movement-is-legit
These things - ventilation, filtration and universal masks would REALLY lower the risk of contracting covid during in person schooling. Why it’s not being done is a mystery to me.
Check out Joey Fox on Twitter (https://twitter.com/joeyfox85) he has MANY threads on the science of this and how to optimize spaces with things like CR boxes. The main point is that if your steady state CO2 is under 800 (preferably around 600) then an individual breath is getting mixed/diluted quickly. Remaining stagnant air can then be cleaned through HEPA (CR). In this situation, the main concern is face-to-face communication, which masks can take care of.
If your CO2 is above 1000, then the air is not being moved/diluted that fast and that brings the risk of virus particles remaining in the air. In that case, you need greater HEPA filtration to remove it and/or masks. Without those, it creates risk.
For your risk example above of directionality, if the virus particles remained concentrated and moved en masse, then that would be a concern. However, if CO2 levels remain low, that means that fresh air is mixing well with it, so in this case the cloud of virus particles is quickly being diluted and dispersed into lower concentrations.
two questions: if windows in a home are left open when workmen come in to do repairs, how long after their departure (assume they are masked and in the house for an hour and a half) do you think it will take to make it safe to use the living space without masking -a couple of hours, couple of days...?; maybe a simpler one, are ceiling fans effective at improving the situation?
I don't know enough to be able to answer those specifics but Kashif Pirzada (https://twitter.com/KashPrime/status/1555914126026805248) hosts Twitter spaces twice a week where you can listen in and leave questions like this.
In general, I would assume that if your window are open in a space, you're looking at about 2 air exchanges per hour. You can accelerate that by pointing a fan to blow outward across the space. If you have a HEPA filter (or make your own Corsi-Rosenthal Box for about $60), you can add about 2 air exchanges in addition to filtration in there. You usually want about 5-6 air exchanges to totally clear a space, so probably about 2 hours if you're just opening windows? But I have only learned from people like Joey Fox on Twitter, I'm definitely not an expert. This article may help too https://www.nature.com/articles/7500229#:~:text=Opening%20windows%20had%20the%20largest,for%20short%20periods%20of%20time.)
thanks for the helpful - and candid/honest answer. If two hours may be enough, then it sounds like two days would certainly do it. Yes?
Oh for sure. Note that my comment was only about air exchanges but there's also the fact that the virus decays in the air (and if it hits UV from sunlight), so 2 days should be more than enough. Especially if you have a HEPA or CR box running the whole time. More info here: https://www.healthline.com/health-news/how-long-is-the-coronavirus-infectious-when-its-in-the-air
Under the same facts, where in the room would you place the HEPA purifier (which I have recently purchased for just such occasions)? For instance if someone is coming to service the fridge, and the kitchen is off the living room?
Your note on CO2 vs. aerosol particles is interesting. I have been measuring both, though not carefully enough to develop their correlation ... relationship. CO2 must be more widespread and more well-mixed than aerosols since the aerosol signal should be dominated by occasional coughing, sneezing and perhaps talking.
I have also had to deal with extraneous sources of CO2: propane heaters and stoves and, surprisng to me, the diurnal cycle of soil respiration which can really throw off sensor calibration (which usually assumes outdoor air is close to 400 ppm) But CO2 also has much to offer in improving ventilation and filtration through artificial seeding of the air with it. As you say, random attempts at ventilation can make things worse: the good strategy of lifting the air everywhere upward, away from face level, with exhaust fans is rarely mentioned.
If you have some more detail of your work i'd be very interested. It's been a hard sell, getting schools, etc interested . My informal website is www.ocean.washington.edu/research/gfd/AIR Peter Rhines (Univ of Washington fluid dynamics faculty emeritus, formerly ocean/atmosphere/climate science) rhines@uw.edu
Regarding your recommendations for schools: I think you're dead wrong. I get that very few children get severely ill from covid. I also get that missing a bunch of school is bad for kids. But what about the accumulating evidence of damage to the body from covid? For instance, here's a study of decline in cognitive skills after covid:
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00324-2/fulltext
Here's one of brain changes showing up on scans after covid
https://media.nature.com/original/magazine-assets/d41586-022-00503-x/d41586-022-00503-x.pdf
And then there's the possibility that some damage covid does to the body will not manifest itself for a decade or 2. I know none of this is for sure, but there seems to be enough indirect evidence for parents to be legitimately concerned about their child having covid -- especially since it seems likely that with such weak protective measures in the schools, kids are likely to have covid SEVERAL TIMES A YEAR.
Do you recognize that your position on quarantine is contrary to the CDC's position?
https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html (last updated Mar. 30, 2022)
The CDC guidelines indicate the unvaccinated (with no prior COVID in the last 90 days) should quarantine if exposed. As you indicated, most pre-school and grade-school students are unvaccinated. Per the CDC, they should quarantine if exposed.
You don't remind people that infectiousness begins before symptoms, and that there is a reasonable percentage of asymptomatic cases that shed as much virus. Your position seems to be that these infectious periods should be spent in the classroom.
It appears that "masking is not legally required" is effectively practiced as "masking is only for the other person". When schools aren't legally required to enforce masking, they won't require masks of even those obviously sick, much less those that should quarantine, lest they get sued.
Consider a policy of all students in a classroom wearing a mask if any student in the classroom is out sick. The masking acts as a pseudo-quarantine. Those students exposed (by the sick student) who might be infectious but not (yet) symptomatic are in class, but wearing a mask. No one's Civil Rights are stomped on by this. It can be uniformly applied. Parents will be happy that the schools are taking care of the otherwise quarantined child.
Then there is the issue of children that are sent to school when sick, or develop symptoms while in school. Especially, if the child refuses to wear a mask properly & consistently. To avoid more absences in the future., the school should isolate these children from the apparently healthy children. How should this be done if, say, 5% of the children are dropped off while sick?
Consider a no-fault drop-off of sick children at school, like some jurisdictions allow babies to be dropped off at fire stations? The parents won't/can't deal with the sick child. Allow them to drop the child off with notification that the child is sick so he/she can be isolated with other sick children rather than sit in the classroom. (This grates on my sensibilities, but I can see it might reduce in-classroom spread.)
The utility of ventilation & filtration is good in theory & practice, but if it wasn't already budgeted & implemented, it isn't going to be in place for this back to school season.
Let's hope they finish the task before Christmas break.
I'd love a future post on how to assess risk in the long term for Covid, especially for kids- not only long Covid, but things that may come up later (diabetes, chronic issues, reactivation akin to shingles). My daughter is finally vaccinated (hooray!!!), and I'm still struggling with risk calculations because I'm concerned about the long term. Usually, I feel like I'm the only one, but from the fb comments today, it seems like there are others among your readers who share those questions.
Some other random ideas for the schools.
1. Beef up the public health curriculum probably starting in middle school and move it out of the elective category. But be prepared for political fights at the school boards.
2. Add sections on virology, microbiology, pathogens, to the electives for the STEM tracking students. Add history of pandemics to the electives for everybody, college track or cte track. Such courses can be career changers.
3. In general, the trend has been increasing emphasis on engineering and applied in 9- 12, so add bio engineering, bio informatics, etc. to the electives for grades 11 and 12.
That's it!
Oh yes, I forgot..the history of pandemics, goes to the courses fulfilling social science graduation requirements. And you have to get the buy-in from the state system of higher ed K-16 alignment folks, that all this curriculum counts for college-preparatory credit. Best possible world is if you can get the state higher ed system to count some of the STEM stuff for running start college credit!
Given what we've just gone through, this is the ideal time to push this curriculum revamp agenda; the window of opportunity will start closing soon!
I'm glad you brought up curricula. I feel like part of the reason that mask mandates have been so contentious is because we've been assuming that enforcement requires direct confrontation. For schools, when conditions warrant it, we could treat "following public health guidance" as a three credit course, potentially impacting the student's GPA.
Watch the evening news for the angry confrontations that would set up at the sb's!
There's always Zoom
Thank you so much for continuing to keep us updated on the latest guidance. I'm wondering if I have misunderstood the masking data, or if the data has changed? I want to follow the science! I have asking (not requiring) my students to mask. I was hoping that by doing so, I was limiting the spread. I know that very few students mask outside of my classroom, but I thought the masking provided a layer of protection during the time they were with me. Is the data showing that masking is largely ineffective, if it's not practiced consistently in and out of the classroom? I don't have control over school-wide ventilation, so masking seemed to be the area where I could contribute. If that's not the case, then I definitely want to know.
Masking does work in the given time and space with the usual caveats of fit, type of mask, etc. But yes, in any situation indoors, the more that people wear, the more the community protection. On an individual level, if a student doesn't wear it outside of your class and hangs out with an infected person, they risk getting sick. But if your goal is to control what you can, you are doing the community a service by asking. To help quantify this, check out this simulator from MIT: https://indoor-covid-safety.herokuapp.com/apps/advanced
Please see my comment above. Masking definitely does make a difference and you should feel comfortable asking your students to please mask for the benefit of their peers. It’s much better than knowing that they have killed a classmate by bringing Covid into the classroom. thank you