With schools nationwide soon to return to classrooms and COVID-19 cases on the upswing, top infectious disease doctors Tuesday reiterated a call for universal mask-wearing in schools to protect young children who aren’t yet eligible for vaccines.
In step with cities like New York and agencies like the Department of Veterans Affairs, the doctors supported the prospect of more widespread vaccine mandates, while acknowledging the political difficulty.
“Mask mandates or universal masking in the school setting should be enforced,” said Tina Tan, a pediatrics professor at Northwestern University, in a conference call with reporters.
On Sunday, Dr. Anthony Fauci, the nation’s leading infectious disease expert, hinted at the possibility of reinstating broad mask mandates in public places, even for vaccinated people. CNN reported a decision on the revised guidelines could come as soon as Tuesday. The Centers for Disease Control and Prevention scheduled a COVID-related press conference for 3 p.m. Eastern Time.
Many districts have been grappling with how to plan for in-school protocols, as COVID-19 cases are once again increasing. Other districts in states such as Florida, Tennessee, Mississippi and Arizona are planning to return thousands of unvaccinated children to classrooms with no masks or social distancing requirements.
On a call Tuesday hosted by the Infectious Diseases Society of America, Tan supported tougher measures to slow the spread of COVID-19 in classrooms because children under the age of 12 aren’t yet eligible for vaccination. Plus, she said, “only 30% of kids ages 12 to 17 have been vaccinated.”
Tan said increased vaccinations for eligible children and adults are the best way to control outbreaks in school settings. But until those rates increase, she recommended schools return to masking and other mitigation protocols used before the vaccine was available, such as social distancing, good hygiene and improved building ventilation.
The surge in infections is driven by the highly transmissible delta variant, mainly among people who are not vaccinated. While high school and many middle school students are eligible to be vaccinated, younger students in elementary schools are not. The doctors reiterated that a vaccine for children under 12 likely won’t be available until the end of this year or early 2022.
Although young children rarely get very sick from COVID-19, infections have been climbing with the spread of the delta variant this summer. About 4.1 million children have had a diagnosed case, resulting in around 18,000 hospitalizations and more than 350 deaths.
“It’s pretty clear that the cases that are occurring all around the country are not being driven by the fully vaccinated,” said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
“It’s not a coincidence where cases are high, vaccination rates are also low.”
Conflicting national guidance on masks
Conflicting advice on masks from the CDC and American Academy of Pediatrics has added to the confusion for schools.
Both medical organizations want schools to reopen fully because of the academic and social benefits for students. But the pediatrics group this month recommended anyone over the age of 2 be required to wear a mask in school — directly contradicting the CDC’s advice that vaccinated students and staff don’t need to wear a mask.
District leaders have made their own decisions in the meantime.
Public schools in Springfield, Missouri – where COVID infections exploded this summer, largely because of low vaccination rates – reinstated a mask mandate for July summer school. Masks had been optional in June.
The first districts to head back to school in California and Arizona featured dramatically different protocols. Arizona’s governor specifically forbade districts from mandating vaccines for teachers or students, and from requiring face coverings in buildings.
In California, the state health department still requires masks indoors in K-12 schools when children are present, regardless of vaccination status.
Los Angeles, where the nation’s second-largest district reopens Aug. 16, is under a countywide face mask mandate for all indoor public spaces — a measure reinstated July 17 because of a rise in infections.
In Mississippi, most districts are planning to make masks optional when students and staff return, because there’s no state guidance requiring them.
“The era of statewide mask mandates is over,” said Mississippi State Health Officer Thomas Dobbs.
In Tennessee, only Memphis schools are requiring masks so far. Masks in schools are a “local decision,” the state’s education commissioner reiterated Monday.
Other districts are in limbo. In Florida, which is again leading the nation in COVID-19 infections, the Alachua County School District in Gainesville made masks optional in April but is reconsidering that move. The school board plans to make a final call on Aug. 3.
Meanwhile, Florida’s governor has threatened to call the Legislature back in session to ban school systems from requiring masks.
“There’s been talk about potentially people advocating at the federal level, imposing compulsory masks on kids,” DeSantis said. “We’re not doing that in Florida, OK? We need our kids to breathe.”
Vaccine mandates get mixed response
Even health experts are split to some degree on mask mandates. While Tan recommended universal masking in schools, Adalja said said face-covering requirements could be relaxed for vaccinated students and staff in communities where virus transmission is low.
However, he said, it’s time to make vaccines mandatory for teachers and other staffers who don’t have a medical exemption.
“The teachers unions are saying, ‘We want to have access to the vaccines but, no, we don’t want to be forced to take them,'” Adalja said. “That doesn’t make sense to me. Either the vaccines are of value to the teachers or they’re not.”
Public school teachers in New York City and the state of California will be some of the first educators subject to vaccine mandates, unless they prefer to submit to regular COVID-19 screening.
Vaccine or testing:California, NYC unveil plans; VA makes shots mandatory for medical workers
A spokeswoman for New York’s United Federation of Teachers union stopped short of fully endorsing the vaccine requirement in a conversation with a USA TODAY reporter Monday. In a statement, the union said the new approach “puts the emphasis on vaccination but still allows for personal choice.”
Only about 60% of New York City’s Department of Education employees have had at least one dose of the vaccine, according to Chalkbeat, an education news site. The figure does not include education workers who were vaccinated outside the city, however.
New York City has required masks for summer school but hasn’t made a final ruling on mask requirements for fall, according to the UFT.
Preeti Malani, a professor and chief health officer at the University of Michigan, cited a “big contrast” between schools and college campuses, where most students are eligible to be vaccinated.
Last week, a federal judge upheld the University of Indiana’s mandate that students, faculty and staff must be vaccinated against COVID-19 by mid-August.
And on Tuesday, citing the spread of the delta variant, the California State University system announced it would mandate vaccines for students, faculty and staff who come to campus. The university system had already planned to require COVID-19 shots, but the mandate was contingent on the Food and Drug Administration fully approving one of the available vaccines.
Now, members of the Cal State community have until September 30 to prove their vaccination status. The California State University system is one of the largest in the country, with 23 campuses and 486,000 students.
Most colleges have been encouraging their students to get vaccinated, but only 600 campuses have mandated vaccines, according to the Chronicle of Higher Education.
“The campuses that are highly vaccinated are going to be in the best position to avoid major disruptions this fall,” Malani said. “Even with some unknowns, getting vaccinated is far safer than getting COVID.”
Contributing: Chris Quintana of USA TODAY, Keisha Rowe of the Mississippi Clarion-Ledger, Meghan Mangrum of the Nashville Tennessean, Gershon Harrell of the Gainesville Sun, Laura Testino of the Memphis Commercial Appeal.