Have you seen the NYMag article “The Science of Masking Kids at School Remains Uncertain?” And if so do you mind addressing it/giving your thoughts? I’ve seen it shared a lot recently. Thanks!
One last comment- what is your analysis of this recent CDC paper- this scares the heck out of me. https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e2.htm?s_cid=mm7035e2_w. THis school did everything in terms of mitigation, but a single infected teacher can still infect 12/24 kids who were wearing masks, with open windows, distanced and with a hepa filter, and only with occasionally taking his/her mask off.
My child's school (elementary) will likely require masking. They will generally maintain 3 feet spacing as much as is possible with wiggly little kids. However, they currently plan on having lunch in the cafeteria with about 100+ kids per lunch period. They state it is safe due to adequate spacing between students. (There may also be unmasked gym and music/singing classes also, but this remains to be seen). It seems to me that this may undermine everything and it makes me very uncomfortable. What is your take on the risks of indoor, unmasked, 25 minute lunches with 100 unvaccinated students who will likely yell to communicate with friends? I am scheduling a phone call with the principal in a few days to discuss and would appreciate any solid science you have. Alternative accommodations have been denied thus far.
Check out episode 66 of the Osterholm Update from CIDRAP. It's long and will give you than you need, but it'll give you the science. I feel like I should give fair warning though- it'll also make you really nervous about sending your kid to school.
Thank you for recommending that podcast - very informative (and sobering). He addresses covid in schools with Delta partway through the podcast, at 47:37.
I am wondering if there is any information on this-since I am seeing a lot of pushback on masking measures with this being one of the reasons...Young children are at a point where a lot of their social learning is dependent on facial cues and such. Obviously under normal circumstances, we would not put face coverings on for this reason. These are not normal circumstances.
When the 1918 flu pandemic happened - were there any areas that largely did do masking, and if so, are there any studies around that looked at how children at the ages of 2-8 turned out developmentally, even though facial cues were not as available? If they were developmentally stunted in this regard, were they able to recover? How long did it take if so? Does this even make sense?
I don't know if I am making any sense here, but hopefully you can figure out what I am trying to get at...fingers crossed.
I'll admit, I haven't done a deep dive in Google Scholar looking for this specific research, but I have a PhD in education, so do know some things. First, most kids are at home where they are seeing caregivers' faces without coverings. It isn't as though they never see faces. Second, by kindergarten (and really earlier), kids totally understand that there are different rules in different contexts and they adapt accordingly. They'll know how to read eyes and eyebrows in school, and whole faces at home. Third, we often don't give kids enough credit for their resiliency. Of the many things I might be worried about, masks and facial expressions are way down on the list.
But, there is an exception to this broad rule: Children who are struggling with phonemic awareness and phonics—the ability to hear individual letter sounds and connect them to the written letters—need to be able to see mouths pronouncing words. This will not be an issue for the majority of students! But those who are identified as needing additional support would likely benefit from teachers wearing the masks that allow the mouth to be seen. Or, read aloud outside. While eventually it will be cold up north, it isn't yet. And down here in Texas, we're just getting to the point where we can be outside without dying.
Masks were adopted earlier in some cities in the 1918 pandemic, and those tended to have fewer cases and deaths than places that decided to delay or forego mask mandates. The differences between Philadelphia (delayed mask requirement until the spread was well established) vs St Louis (initiated mandatory masks with nearly the first case) was stark.
Thank you for newsletters. One item that for the life of me I can't seem to find information on is how to treat Vaccine efficacy and what it means when there is a breakthrough infection.
My understanding is that when they give a number such as pfizer is 94% effective, they mean that it is 94% more effective at preventing illness than in the unvaccinated, and this is calculated using clinical trials where they double blind their subjects and thus controlling for behavior, and the vaccinated get 94% less sick than the unvaccinated.
So what happens when you have a disease that is 2x as infectious? And how can they study waning efficacy in a non-double blind situation (i.e. control for behavior). Is the vaccine working to prevent infection per exposure to the virus, or is the relative efficacy based on an individual's immune system?
For example, if it is per exposure, then even a fully vaccinated person who makes good anti-bodies can and will get sick if they end up in close proximity for a long long time. (i.e. the Maine situation), or is it that the vaccines give differing individual reactions such that one person can be exposed repeatedly and still resist infection, while another vaccinated person can be exposed for a short time and still get infected with a smaller viral load?
This question isn't just a matter of figuring out waning immunity for everyone, but seems to have an application for our own mitigation measures.
Hello, Dr. Jetelina - I've been a fan of your newsletter for months now and have links to your posts on my website, covidsafeschools.org. I have also referenced your work on the new website, everyschoolsafeandopen.org, created by the SalivaDirect team at the Yale School of Public Health.
I would love it if you would take a look at the site - it includes a comprehensive list of government funding sources that schools can access for COVID-19 mitigation and testing, as well as easy-to-understand guidance and links on best practices for COVID mitigation and testing in the K-12 setting. The goal is to give administrators and families not just advice, but concrete tools that they can use to make their schools as COVID-safe as possible. Rosy Hosking of the Broad Institute called it "Wirecutter for COVID-19 in schools."
Thank you for everything you do - you are a guiding light through the storm of the pandemic.
Our school district’s policy, following CDC guidance, is that students sitting 3 feet away from a COVID-positive student will not be considered close contacts if both students were wearing “well-fitting" masks. Do you agree with this policy? If not, what might make more sense? Thanks.
Here is something that while sounding humorous - and perhaps worthy of an Ignoble Award - is something of a question that remains unanswered that could be easily studied. I suppose the common wisdom is that Coronavirus is not transmitted via the GI tract. But it certainly could be introduced in the mouth and esophagus.
What happens at the other end? Could Flatulence be a possible and currently unrecognized source of airborne virus? I am not trying to ignore the seriousness of this emergency (especially with many dear friends in the Medford, Oregon area!) but until someone actually tests this, we don't actually know this as fact!
It may be that masking is only 50% effective, especially for those who eat legumes. The loose fitting clothing could be as worthless as a neck gaiter. Certain smells of "unknown" origin while at a bookstore for example indicate that volatiles are passing through that fabric. But what else could be?
re the Humor aspect of this, we are already laughing about Horse Dewormer as some are trashing their livers with it. I know one such person who claims it will save him. My Greek brother-in-law and his wife, my baby sister and their two daughters claim that Garlic will save them. They said they would wait until full FDA approval. My vaxxed nephew and I are wondering what new excuse they will come up with!
Betsy Brown MD alerted many of us to your work. Thank You for this service!!!!
Have you seen the NYMag article “The Science of Masking Kids at School Remains Uncertain?” And if so do you mind addressing it/giving your thoughts? I’ve seen it shared a lot recently. Thanks!
One last comment- what is your analysis of this recent CDC paper- this scares the heck out of me. https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e2.htm?s_cid=mm7035e2_w. THis school did everything in terms of mitigation, but a single infected teacher can still infect 12/24 kids who were wearing masks, with open windows, distanced and with a hepa filter, and only with occasionally taking his/her mask off.
My child's school (elementary) will likely require masking. They will generally maintain 3 feet spacing as much as is possible with wiggly little kids. However, they currently plan on having lunch in the cafeteria with about 100+ kids per lunch period. They state it is safe due to adequate spacing between students. (There may also be unmasked gym and music/singing classes also, but this remains to be seen). It seems to me that this may undermine everything and it makes me very uncomfortable. What is your take on the risks of indoor, unmasked, 25 minute lunches with 100 unvaccinated students who will likely yell to communicate with friends? I am scheduling a phone call with the principal in a few days to discuss and would appreciate any solid science you have. Alternative accommodations have been denied thus far.
Check out episode 66 of the Osterholm Update from CIDRAP. It's long and will give you than you need, but it'll give you the science. I feel like I should give fair warning though- it'll also make you really nervous about sending your kid to school.
Thank you for recommending that podcast - very informative (and sobering). He addresses covid in schools with Delta partway through the podcast, at 47:37.
Do u have a 1-pg summary of benefits of masks/mitigation measures that I can present at my school board meeting tomorrow? Thank u!
@Katelyn Jetelina @Your Local Epidemiologist -
I am wondering if there is any information on this-since I am seeing a lot of pushback on masking measures with this being one of the reasons...Young children are at a point where a lot of their social learning is dependent on facial cues and such. Obviously under normal circumstances, we would not put face coverings on for this reason. These are not normal circumstances.
When the 1918 flu pandemic happened - were there any areas that largely did do masking, and if so, are there any studies around that looked at how children at the ages of 2-8 turned out developmentally, even though facial cues were not as available? If they were developmentally stunted in this regard, were they able to recover? How long did it take if so? Does this even make sense?
I don't know if I am making any sense here, but hopefully you can figure out what I am trying to get at...fingers crossed.
I'll admit, I haven't done a deep dive in Google Scholar looking for this specific research, but I have a PhD in education, so do know some things. First, most kids are at home where they are seeing caregivers' faces without coverings. It isn't as though they never see faces. Second, by kindergarten (and really earlier), kids totally understand that there are different rules in different contexts and they adapt accordingly. They'll know how to read eyes and eyebrows in school, and whole faces at home. Third, we often don't give kids enough credit for their resiliency. Of the many things I might be worried about, masks and facial expressions are way down on the list.
But, there is an exception to this broad rule: Children who are struggling with phonemic awareness and phonics—the ability to hear individual letter sounds and connect them to the written letters—need to be able to see mouths pronouncing words. This will not be an issue for the majority of students! But those who are identified as needing additional support would likely benefit from teachers wearing the masks that allow the mouth to be seen. Or, read aloud outside. While eventually it will be cold up north, it isn't yet. And down here in Texas, we're just getting to the point where we can be outside without dying.
Thank you!!
Masks were adopted earlier in some cities in the 1918 pandemic, and those tended to have fewer cases and deaths than places that decided to delay or forego mask mandates. The differences between Philadelphia (delayed mask requirement until the spread was well established) vs St Louis (initiated mandatory masks with nearly the first case) was stark.
Thank you for newsletters. One item that for the life of me I can't seem to find information on is how to treat Vaccine efficacy and what it means when there is a breakthrough infection.
My understanding is that when they give a number such as pfizer is 94% effective, they mean that it is 94% more effective at preventing illness than in the unvaccinated, and this is calculated using clinical trials where they double blind their subjects and thus controlling for behavior, and the vaccinated get 94% less sick than the unvaccinated.
So what happens when you have a disease that is 2x as infectious? And how can they study waning efficacy in a non-double blind situation (i.e. control for behavior). Is the vaccine working to prevent infection per exposure to the virus, or is the relative efficacy based on an individual's immune system?
For example, if it is per exposure, then even a fully vaccinated person who makes good anti-bodies can and will get sick if they end up in close proximity for a long long time. (i.e. the Maine situation), or is it that the vaccines give differing individual reactions such that one person can be exposed repeatedly and still resist infection, while another vaccinated person can be exposed for a short time and still get infected with a smaller viral load?
This question isn't just a matter of figuring out waning immunity for everyone, but seems to have an application for our own mitigation measures.
Thanks!
Hello, Dr. Jetelina - I've been a fan of your newsletter for months now and have links to your posts on my website, covidsafeschools.org. I have also referenced your work on the new website, everyschoolsafeandopen.org, created by the SalivaDirect team at the Yale School of Public Health.
I would love it if you would take a look at the site - it includes a comprehensive list of government funding sources that schools can access for COVID-19 mitigation and testing, as well as easy-to-understand guidance and links on best practices for COVID mitigation and testing in the K-12 setting. The goal is to give administrators and families not just advice, but concrete tools that they can use to make their schools as COVID-safe as possible. Rosy Hosking of the Broad Institute called it "Wirecutter for COVID-19 in schools."
Thank you for everything you do - you are a guiding light through the storm of the pandemic.
Our school district’s policy, following CDC guidance, is that students sitting 3 feet away from a COVID-positive student will not be considered close contacts if both students were wearing “well-fitting" masks. Do you agree with this policy? If not, what might make more sense? Thanks.
Is the August 31 webinar on school mitigation posted somewhere? txs
I love your work Katelyn!!!
Here is something that while sounding humorous - and perhaps worthy of an Ignoble Award - is something of a question that remains unanswered that could be easily studied. I suppose the common wisdom is that Coronavirus is not transmitted via the GI tract. But it certainly could be introduced in the mouth and esophagus.
What happens at the other end? Could Flatulence be a possible and currently unrecognized source of airborne virus? I am not trying to ignore the seriousness of this emergency (especially with many dear friends in the Medford, Oregon area!) but until someone actually tests this, we don't actually know this as fact!
It may be that masking is only 50% effective, especially for those who eat legumes. The loose fitting clothing could be as worthless as a neck gaiter. Certain smells of "unknown" origin while at a bookstore for example indicate that volatiles are passing through that fabric. But what else could be?
re the Humor aspect of this, we are already laughing about Horse Dewormer as some are trashing their livers with it. I know one such person who claims it will save him. My Greek brother-in-law and his wife, my baby sister and their two daughters claim that Garlic will save them. They said they would wait until full FDA approval. My vaxxed nephew and I are wondering what new excuse they will come up with!
Betsy Brown MD alerted many of us to your work. Thank You for this service!!!!
Casey
THANK YOU for addressing this! Great information!