COVID-19 cases spiked in schools that lifted mask mandates, study finds
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Boston-area school districts that lifted mask mandates earlier this year experienced nearly 45 more cases of COVID-19 per 1,000 students and staff than school districts that kept their mandates in place, a study found.
According to the authors of the study, which was published in The New England Journal of Medicine, after Massachusetts rescinded a statewide mask mandate for public schools in late February 2022, all but two school districts in the Boston area lifted their mask requirements, giving the researchers “an opportunity to examine the potential effect of universal masking policies in schools” over the remainder of the school year.
The study included 72 public, noncharter schools in the Boston area with 294,084 students and 46,530 staff members. The study period encompassed the 40 weeks of the 2021-2022 school year, which ended in June.
According to the researchers, the Massachusetts Department of Elementary and Secondary Education required standardized weekly reporting of all positive COVID-19 tests among students and staff, which were used in the study.
The authors found that the lifting of masking requirements was associated with an additional 44.9 COVID-19 cases per 1,000 students or staff members in the 15 weeks following the mask policy being rescinded, which corresponded to an estimated 11,901 additional cases and 29.4% of all cases in all districts during that time.
They also found that the districts that chose to sustain masking requirements for longer periods tended to have school buildings that were “older and in worse condition,” and had more students per classroom than districts that chose to lift masking requirements earlier. Such districts also had higher percentages of low-income students, students with disabilities and students who were English-language learners, and higher percentages of Black and Latinx students and staff.
“Our results support universal masking as an important strategy for reducing COVID-19 incidence in schools and loss of in-person school days,” they wrote. “As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities.”
The study was accompanied by an editorial cowritten by Julia Raifman, ScD, a professor in the department of health law, policy and management at Boston University School of Public Health, and Tiffany Green, PhD, a professor in the departments of population health sciences and obstetrics and gynecology at the University of Wisconsin-Madison.
Raifman and Green noted that the findings exposed a “fundamental logic flaw of individual masking”: the assumption that “individual persons will fully absorb the costs of their own masking decisions, rather than assuming that such costs will be shifted onto others and society.”
“Universal masking policies distribute a small cost across society, rather than shifting the highest burdens of COVID-19 onto populations that have already been made vulnerable by structural racism and other inequities,” Raifman and Green wrote. “Strategic use of universal masking policies could include community-level implementation early in surges of new COVID-19 variants and throughout the year in select classrooms to protect higher risk children and staff.”
References:
- Cowger TK, et al. N Engl J Med. 2022;doi:10.1056/NEJMoa2211029.
- Raifman J, et al. N Engl J Med. 2022;doi:10.1056/NEJMoa2213556.
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