By Kanecia Zimmerman and Danny Benjamin Jr.
Dr. Zimmerman is an associate professor of pediatrics at the Duke University School of Medicine. Dr. Benjamin is a pediatric-infectious-disease specialist at Duke Health.
Big questions loom over the upcoming back-to-school season: Should children be required to wear masks? Should children go to in-person classes at all?
If we send children to school without masks, we increase their risk of acquiring Covid-19. Some could suffer illness or die. If we close schools, millions of children will suffer learning loss, and many of them may suffer lifelong effects on their physical and mental health.
For more than a year, we’ve worked with North Carolina school districts and charter schools, studying the rate of new Covid cases, the efficacy of mitigation measures such as masking and the increased risks of participating in school-sponsored sports. We have learned a few things for certain: Although vaccination is the best way to prevent Covid-19, universal masking is a close second, and with masking in place, in-school learning is safe and more effective than remote instruction, regardless of community rates of infection.
Vaccination is the strongest method for preventing the ill effects of Covid, but students under 12 years of age are ineligible for the vaccines. Masking, then, is one of the best, most readily available methods to protect them from the disease, with universal masking being one of the most effective and efficient strategies for preventing SARS-CoV-2 transmission in schools.
Universal masking in schools can save lives. Voluntary masking in schools will likely be much less effective and could lead to school closures and community transmission. This summer, we’ve seen that voluntary masking has failed in some schools in Missouri and North Carolina, which saw increases in Covid-19 cases and days missed because of quarantines, prompting several districts to reinstate mask mandates.
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