tetano
Editor, Senior Moderator
Pediatrics
. 2022 Mar 9.
doi: 10.1542/peds.2022-056687. Online ahead of print.
School Masking Policies and Secondary SARS-CoV-2 Transmission
Angelique E Boutzoukas[SUP] 1 2 [/SUP], Kanecia O Zimmerman[SUP] 1 2 3 [/SUP], Moira Inkelas[SUP] 4 5 [/SUP], M Alan Brookhart[SUP] 6 [/SUP], Daniel K Benjamin Sr[SUP] 7 [/SUP], Sabrina Butteris[SUP] 8 [/SUP], Shawn Koval[SUP] 9 [/SUP], Gregory P DeMuri[SUP] 8 [/SUP], Vladimir G Manuel[SUP] 5 10 [/SUP], Michael J Smith[SUP] 2 [/SUP], Kathleen A McGann[SUP] 2 [/SUP], Ibukunoluwa C Kalu[SUP] 2 [/SUP], David J Weber[SUP] 11 [/SUP], Amy Falk[SUP] 12 [/SUP], Andi L Shane[SUP] 13 14 [/SUP], Jennifer E Schuster[SUP] 15 [/SUP], Jennifer L Goldman[SUP] 15 [/SUP], Jesse Hickerson[SUP] 1 [/SUP], Vroselyn Benjamin[SUP] 1 [/SUP], Laura Edwards[SUP] 1 [/SUP], Tyler R Erickson[SUP] 1 [/SUP], Daniel K Benjamin Jr[SUP] 1 2 3 [/SUP]
Affiliations
Abstract
Objectives: Throughout the coronavirus disease 2019 (COVID-19) pandemic, masking has been a widely used mitigation practice in kindergarten through 12th grade (K-12) school districts to limit within-school transmission. Prior studies attempting to quantify the impact of masking have assessed total cases within schools; however, the metric that more optimally defines effectiveness of mitigation practices is within-school transmission, or secondary cases. We aimed to estimate the impact of various masking practices on secondary transmission in a cohort of K-12 schools.
Methods: We performed a multi-state, prospective, observational, open cohort study from 7/26/2021 to 12/13/2021. Districts reported mitigation practices and weekly infection data. Districts that were able to perform contact tracing and adjudicate primary and secondary infections were eligible for inclusion. To estimate the impact of masking on secondary transmission, we used a quasi-Poisson regression model.
Results: 1,112,899 students and 157,069 staff attended 61 K-12 districts across 9 states that met inclusion criteria. The districts reported 40,601 primary and 3,085 secondary infections. Six districts had optional masking policies, 9 had partial masking policies, and 46 had universal masking. Districts that optionally masked throughout the study period had 3.6 times the rate of secondary transmission as universally masked districts. For every 100 community-acquired cases, universally masked districts had 7.3 predicted secondary infections, while optionally masked districts had 26.4.
Conclusions: Secondary transmission across the cohort was modest (<10% of total infections) and universal masking was associated with reduced secondary transmission compared to optional masking.
. 2022 Mar 9.
doi: 10.1542/peds.2022-056687. Online ahead of print.
School Masking Policies and Secondary SARS-CoV-2 Transmission
Angelique E Boutzoukas[SUP] 1 2 [/SUP], Kanecia O Zimmerman[SUP] 1 2 3 [/SUP], Moira Inkelas[SUP] 4 5 [/SUP], M Alan Brookhart[SUP] 6 [/SUP], Daniel K Benjamin Sr[SUP] 7 [/SUP], Sabrina Butteris[SUP] 8 [/SUP], Shawn Koval[SUP] 9 [/SUP], Gregory P DeMuri[SUP] 8 [/SUP], Vladimir G Manuel[SUP] 5 10 [/SUP], Michael J Smith[SUP] 2 [/SUP], Kathleen A McGann[SUP] 2 [/SUP], Ibukunoluwa C Kalu[SUP] 2 [/SUP], David J Weber[SUP] 11 [/SUP], Amy Falk[SUP] 12 [/SUP], Andi L Shane[SUP] 13 14 [/SUP], Jennifer E Schuster[SUP] 15 [/SUP], Jennifer L Goldman[SUP] 15 [/SUP], Jesse Hickerson[SUP] 1 [/SUP], Vroselyn Benjamin[SUP] 1 [/SUP], Laura Edwards[SUP] 1 [/SUP], Tyler R Erickson[SUP] 1 [/SUP], Daniel K Benjamin Jr[SUP] 1 2 3 [/SUP]
Affiliations
- PMID: 35260896
- DOI: 10.1542/peds.2022-056687
Abstract
Objectives: Throughout the coronavirus disease 2019 (COVID-19) pandemic, masking has been a widely used mitigation practice in kindergarten through 12th grade (K-12) school districts to limit within-school transmission. Prior studies attempting to quantify the impact of masking have assessed total cases within schools; however, the metric that more optimally defines effectiveness of mitigation practices is within-school transmission, or secondary cases. We aimed to estimate the impact of various masking practices on secondary transmission in a cohort of K-12 schools.
Methods: We performed a multi-state, prospective, observational, open cohort study from 7/26/2021 to 12/13/2021. Districts reported mitigation practices and weekly infection data. Districts that were able to perform contact tracing and adjudicate primary and secondary infections were eligible for inclusion. To estimate the impact of masking on secondary transmission, we used a quasi-Poisson regression model.
Results: 1,112,899 students and 157,069 staff attended 61 K-12 districts across 9 states that met inclusion criteria. The districts reported 40,601 primary and 3,085 secondary infections. Six districts had optional masking policies, 9 had partial masking policies, and 46 had universal masking. Districts that optionally masked throughout the study period had 3.6 times the rate of secondary transmission as universally masked districts. For every 100 community-acquired cases, universally masked districts had 7.3 predicted secondary infections, while optionally masked districts had 26.4.
Conclusions: Secondary transmission across the cohort was modest (<10% of total infections) and universal masking was associated with reduced secondary transmission compared to optional masking.