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PolicyLab school guidance: Mask-optional policies OK, but caution, flexibility needed



School leaders preparing for the 2021-22 academic year should build flexibility into their Covid-19 health and safety plans, and should understand the critical importance of effective communication with students and their families, according to newly released guidance from PolicyLab, the public health research center at Children's Hospital of Philadelphia.

"A more normal school year is on the horizon, but sensible school health and safety plans are essential to ensure that schools are operating safely," it said.

The guidance is the latest update from PolicyLab, which has generally advocated a middle-ground approach to Covid-19 mitigation strategies.

School districts are facing a vastly different environment than they did in 2020. On the one hand, Covid-19 vaccines for ages 12 and up are abundant, safe and effective; on the other hand, vaccination rates are lower than many health officials had hoped, and the Delta variant is spreading rapidly.

Absent a government mandate, many districts are likely to adopt a "masks-optional" strategy, PolicyLab said. For that to be effective, high local vaccination rates, robust testing and low Covid-19 community transmission rates are prerequisites, PolicyLab said.

Universal vaccination is "the most reliable intervention" for assuring safety, it said.

Schools may choose to require masks in certain contexts, such as school buses, or during periods of high transmission. Moreover, schools will need to make sure that students and staff who wear masks aren't stigmatized. They may be at higher risk from Covid-19 or live in households with higher-risk individuals.

At most schools, full occupancy will limit the potential for social distancing. That's not necessarily a concern, PolicyLab said, although opportunities that are available should be made use of. The center strongly encouraged schools to maintain a robust Covid-19 testing capability and continue enhanced cleaning of high-contact surfaces.

PolicyLab advises parents to evaluate the risks to their children in deciding on masking: "Even among elementary school-age children who have not been vaccinated, some families might decide that the benefit of not using a mask for their child outweighs the risk from infection." Parents of children with medical conditions should talk with their pediatricians, it recommends.

The guidance notes that while most of the 4 million documented cases of Covid-19 among U.S. children and adolescents have been mild, there have been nearly 17,000 hospitalizations and 300 deaths.

Three takeaways

In a separate post, PolicyLab interns Radhika Purandare and Corinne Filograna offer three "lessons learned from a year of school surveillance." They are:

  • Schools should be leveraged to help with vaccine accessibility: Doing so could help boost rates among minority and hard-to-reach communities.
  • It's important for schools to communicate about their reopening policies: Robust communication and transparency are vital to building confidence and trust.
  • There is no returning to 'normal': Innovations adopted last year can continue to protect students and staff from Covid-19 and other vectors. A case in point: There was just one pediatric influenza death last year, versus an average of about 200 in previous flu seasons.