As the schools are slowly opening across the globe and Indian states are set to allow schools to reopen in a phased manner, there is a lot of confusion and debate happening around the importance of masking the school kids.
The experts are divided over the fact that initially, the masking measures looking promising, it is hard to assess what kind of effect would mandatory masking have among schools kids with no definite end-date. However, Centres for Disease Control (CDC) had published a study on Covid transmission in US Schools in May that suggested masking unvaccinated teachers and improved ventilation lowered down the incidences of virus spread in the schools.
However, in the month of July, CDC issued another set of guidelines in which they recommended that masks should be worn indoors by everyone above the age of 2 who are not vaccinated. The American Academy of Paediatrics echoed the guidelines and further added that everyone (both vaccinated and non-vaccinated) should wear a mask in schools. CDC later modified the guidelines in July to match AAP’s recommendations.
Notably, in the May study, stats showed that most common measures taken by the schools, including hybrid models, classroom barriers, HEPA filters, distancing, and student masking, did not show any significant benefit, and CDC was unclear if they had any impact on the spread of the virus.
The study covered over 90,000 elementary students in approximately 170 schools in Georgia from November 16, 2020, to December 11, 2020. It was a first-of-its-kind study by the CDC to see if the mitigation measures in schools had any effect on the spread of the virus.
Vinay Prasad, associate professor at the University of California, San Francisco’s Department of Epidemiology and Biostatistics, said in a statement that in the final conclusion, CDC should have included the summary of all measures taken by the schools. He further added that it should have mentioned, “That a masking requirement of students failed to show independent benefit is a finding of consequence and great interest.”
According to Tracy Hoeg, epidemiologist and senior author of a separate CDC study on COVID-19 transmission in schools, the study gives the impression that only masking among the staff was studied, but in reality, it included the student masking. The issue has become political for the United States. While the red and blue states hold different opinions on if the students should be masked or not, the leaders owe it to the children to have better information on the fact if the masks help in reducing the spread or not.
The problem with imposing the same guidelines for children and adults
Masking is believed to provide protection for adults from Covid-19. However, treating children like little adults may not be scientifically correct. For example, for many years, doctors kept prescribing a certain migraine medication to children based on studies done on adults. In 2017, scientists realised that the medicine did not make a significant difference compared to the placebo group in children, after which the doctors stopped prescribing the medicine.
In case of Covid-19, more studies are required to be done on the children to see if masks help them or not. Studies show that children are less likely to get severe Covid-19 infection. There were rumours that the third wave would affect children more, but that too has been denied by the majority of the experts. Masking among children is seen as a low-risk mitigation strategy. Experts believe that better ventilation in classrooms will have more benefit in controlling the disease.
Lack of exchange of expressions
With masks on all the time in school, the children can’t see and react to the facial expressions of the adults. Children under the age of five and children with special needs can only understand how to read emotions if they are able to see the expressions on the faces of peers and adults around them. Studies show that the understanding of expressions is not limited to early years but extends to teenage and further. Even World Health Organization suggests that children under the age of six are not required to wear masks.
In June this year, the Directorate general of health services (DGHS) under the Union ministry of health and family welfare also issued guidelines in which they said children between the ages of six to 11 may wear a mask but only under the supervision of the adults and after consulting with doctors. Children under the age of five years do not need to wear a mask.
As per the Directorate General of Health Services (DGHS) guidelines, mask is not recommended for children of 5 years of age or below; children aged 6-11 years may wear a mask under supervision of parents and doctor. #COVID19— ANI (@ANI) June 10, 2021
Precautions, vaccination and ventilation
Experts believe that in the lack of evidence-based study to support masking among children, it is essential to protect people with multiple layers of mitigations. Both adults and children should follow protocols and take precautions. Schools should work on improving ventilation in the classrooms. Adults should follow masking mandates. Children between the ages of six to 11 should follow masking mandates if and when required, and everyone who is eligible for the vaccine should get it at the earliest so that the world, especially the children, can survive the pandemic.