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As U.S. schools begin opening for another year of learning, the controversy over whether students should be required to wear masks is anything but settled in many states. While hospitalization and death from COVID-19 is uncommon in children, cases have been increasing steadily. Dr. Danny Benjamin, a distinguished professor of pediatrics at Duke University, joins Stephanie Sy to discuss.
Around the country, K-12 schools are opening for another year of learning. But in many states, the controversy over whether students should be required to wear masks is anything but settled.
Stephanie Sy has the story.
As of last week, children represented more than 14 percent of all COVID-19 cases, according to the American Academy of Pediatrics. And, while hospitalization and death from COVID is uncommon in children, cases have been increasing steadily in recent weeks.
One means of protection? Wearing a mask. The Centers for Disease Control and prevention recommend any children age two and up — as well as all school staff– wear masks indoors.
But in states like Texas, Florida, and Arizona, governors are banning mask mandates, including in schools, forcing school districts to make some difficult choices.
Dr. Danny Benjamin is a distinguished professor of pediatrics at Duke University. He says, for students who can't get vaccinated — which is currently children under 12 — masking is the next best protection.
Dr. Benjamin, thank you so much for joining us.
You were involved in a study looking at 1 million students and you concluded that masks are the most effective and efficient way to prevent COVID transmission in schools.
What proof do — do you have?
Absolutely. So the thing that schools need to do in the midst of a pandemic is that COVID cases will come into school property via children and adults. What we did was we looked at in the fall and the spring and the winter how much within school transmission there is, how many children infect other children, how many children infect adults, et cetera.
What we found was despite having extremely widespread COVID in the communities in North Carolina, if universals masking is in place, the chances of one child infecting another is less than 1 percent.
So are you advocating, based on this research, for universal masking, from K-12 including older students that are vaccinated?
Well, remember that for older students that are vaccinated, only 20 to 40 percent of the population in high school is vaccinated right now. We know that from nationally.
So that that will contribute to community spread and spread within the schools based on data from the other countries and from the U.S. Right now, in the U.S., vaccination is running, say, 50, 60, 70 percent and that's clearly not sufficient. So why would 20 percent in schools be sufficient?
For children pre-K-8, really the only preventative measure or the protection measure available to parents is universal masking, because just telling a parent to, hey, mask your own child, I'm sorry, but respiratory physiology does not work that way. That's not protective. You're not protecting that one child by giving that one child a mask. So, clearly, unless you want a bunch of COVID in your schools, then, yes, you want to mask, universally.
Some schools are making masks optional. Some don't have a choice based on states' governors' mandates against mandates. What evidence have you seen, Dr. Benjamin, that makes you feel voluntary mask policies are not enough?
Sure. So having a voluntary mask policy is like having a no-peeing section of a pool or a no-smoking section on an airplane. That's absurd.
Now, as far as what evidence there is, clearly, there's the North Carolina, the Wisconsin, the Los Angeles, the California, the Nebraska, Georgia, Missouri, repeated studies that have shown extremely low transmission, about a second, 1 percent secondary tack rate in the United States with universal masking.
And what we've seen in the unmasked setting, is that 13 to 16 percent secondary attack rate as evidenced by Israel. And it's also now one or two school districts that have opened up unmasked and have within four or five days gone back to a mask policy universally.
You cite in your article specifically schools in Missouri and North Carolina with voluntary policies on masking that did see increases in COVID 19 cases. The other thing your study looks at is the COVID risks of participating in school-sponsored sports.
What is important for us to know about that?
Absolutely. So transmission's going to be higher in the sports setting than anyplace else on school property. It's responsible for approximately 50 to 75 percent of the within-school transmission for high school and middle school. What that's going to mean is that that's where all your transmission's occurring, or a lot of it, and that's an area where you can put in policies to incentivize vaccinating. For example, vaccinate as a condition of participation or vaccinate or undergo frequent testing and masking.
Schools can really do a good public service for their children if they will incentivize good behavior via voluntarily extracurricular activities.
Dr. Benjamin, some parents may still be nervous about sending their children to in-person school especially in those schools where masks are optional. What would you say to those parents and, if their child wears a mask, are they sufficiently protected?
Sure. For children 12 and up, it's easy. Just have your own child vaccinated and that should be sufficient.
For children under 12, it's a tougher question. If you've got a lot of resources at home, if you've got the ability to do education at home easily, that's a consideration to do education at home, but we know that most children, remote education was a disaster last year, not only learning lost but mental health, physical health, the ability for social connectivity.
And so, in those circumstances, families should ask for transparent reporting of COVID infections, to ask for quarantining when children are exposed across the school district, and for school districts to monitor their own data as they did in school districts in North Carolina and go back to masking, if, indeed, it does not work.
Dr. Danny Benjamin with Duke University, thank you so much for joining the NewsHour with your expertise.
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