On September 1, 2021

Universal masking in schools should not be a debate

Editor’s note: This commentary is by five medical doctors, Meghan Gunn, Ebrahim Ghazali, Judy Orton, Ann Marie Swann and Jaclyn Lozier; Kelsey Pierce and Emily Rice, physician’s assistants; Bridget Bromirski, pediatric nurse practitioner; and Lynn Mann, doctor of osteopathic medicine.

We are writing this in response to the many “anti-masking in school” groups that have been created in our area. We are very concerned about the misinformation that is being spread and would like the opportunity to share evidenced-based information here.  

Children in our area are already going back to school and this year is different than last year for several reasons. We have more strategies to prevent the spread of Covid and there are many vaccinated students and staff. However, we also have many students who are too young to be eligible for the vaccine. 

Children under 12 as an unvaccinated group were recently highlighted by Benjamin Lee, M.D. an associate professor in pediatrics at the University of Vermont Larner College of Medicine who has been involved with epidemiological studies on Covid-19. “We have to come to the recognition that the pandemic is not over. … We still have a large group of susceptible people in our state. And that’s young children,” Lee said in a recent interview. 

There is a vast amount of research that shows that masking works to both block the release of respiratory particles into the environment and as a filter to protect the mask-wearer from exposure to infectious droplets. This research can be demonstrated in both lab testing and in real-world data by many studies. 

In the real world, the efficacy can be affected by many factors such as the type of mask, how the mask is worn, and how often the mask is washed, but there are no studies that prove that masking lacks benefit and many that show the opposite. 

Masking is an important part of the layers of protection, notes Sonja O’Leary, M.D., chair of the American Academy of Pediatrics Council on School Health: “Combining layers of protection that include vaccinations, masking and clean hands hygiene will make in-person learning safe and possible for everyone.”

Additionally, there is no substantial research that shows that masks cause any physical or emotional harm to the wearer. There is no evidence of increased carbon dioxide levels, decreased oxygen levels, interference with lung development or other true physiologic changes during mask wearing for anyone above 2 years of age. Wearing masks also does not weaken the immune system. These claims are simply scientifically false. 

Universal masking in schools for all students and staff ages 2 and older is recommended by the American Academy of Pediatrics, which is a professional group of pediatricians committed to promoting the health and well-being of children. Its goal in this recommendation is to protect those who are too young or unable to be vaccinated from Covid infection and allow children to be in-person for schooling. 

There are many unknowns with the newer Delta variant but it is believed that it is more easily transmissible and there can be breakthrough cases even in those who are vaccinated, so masking for all provides an extra layer of protection. 

With the new Delta variant at play, Tim Lahey, M.D., an infectious disease specialist at the University of Vermont, stated to VTDigger recently, “We should plan for everyone in school above age 2 to wear masks if they can. With case counts and hospitalizations clearly rising now, I would be surprised if masking in school only lasts a few weeks.”

Universal masking in schools should not be a debate. Masking is imperative to the safety and well-being of the children in our community in order to prevent the spread of Covid and to allow them to attend in-person school safely, which we imagine we all collectively want for our children. 

Becca Bell, M.D., president of the Vermont chapter of American Academy of Pediatrics and a pediatric ICU physician, recently said, “Having everyone mask is the best, most practical way to add a really strong layer of protection when school starts again.” Healthy children can not only get sick from Covid but can spread it, end up hospitalized, have serious long-term effects and even die from Covid infection. This was previously less of a concern but is more common now with the Delta variant of Covid-19. 

We stand by the recommendation of the American Academy of Pediatrics and the Centers for Disease Control and support area schools in requiring universal masking for all students and staff ages 2 and above in K-12 schools. 

We encourage you as parents and community members to acknowledge the science and medicine behind mask-wearing in order to keep the children of this community safe and in in-person schooling for as long as possible. 

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