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The science on masking in schools

ELISSA NADWORNY, HOST:

Across the country, calls for lifting mask mandates in schools have gotten louder, from protests in Oregon to walkouts in upstate New York to court cases in Iowa. It's clear many are frustrated that their children are still being asked or required to wear masks throughout the school day.

We've asked NPR's health correspondent Maria Godoy to join us now because we wondered, just how effective are masks in schools? Thanks for being with us, Maria.

MARIA GODOY, BYLINE: Of course.

NADWORNY: So what does the science tell us about how well masks work to protect kids in school?

GODOY: I'm actually going to tackle this in two parts. First, do masks work? The science is pretty compelling that a high-quality mask - so a respirator like an N95 or a KN94 - they can really protect an individual from infection when worn properly. So if a kid is wearing a good mask, it fits them well and they wear it properly and consistently, there's no reason to think it's not protecting them.

Two - if you're wearing a cloth mask, on the other hand, and, you know, the kid's nose is hanging out of it, that's probably not doing much against a variant as highly transmissible as omicron. But when you ask the question, do studies show that when children wear masks in schools, it helps lower transmission in schools, that's much harder to answer.

NADWORNY: Why is that? Why is it harder to show masks are effective in that sort of, like, real-world setting?

GODOY: Because the kind of study you'd have to conduct to really prove a cause and effect - you know, that it is the masking and nothing else, not community vaccination rates or behaviors, not opening windows, that it is the masking alone that is lowering transmission - that kind of study is extremely difficult to carry out in the real world. I spoke to Noah Haber about this. He's an expert in study design.

NOAH HABER: So we have good evidence that masks help lower transmission in general populations. When we start getting into specifics about children, we don't have as much evidence because we can't have as much evidence.

GODOY: He says to get really strong evidence that masking mandates slow transmission in schools, you'd need to have a large number of schools, you'd have to control for those other factors I mentioned, plus lots of other things. He says the bottom line is that the totality of evidence suggests high-quality masks do help slow transmission in schools, but we may never be able to pin down exactly how much they help.

NADWORNY: OK. So if masks work, then why is masking in schools being so hotly debated?

GODOY: Well, for several reasons. One - there's no good evidence that cloth masks, which many kids wear, do much against omicron, so you could argue, why make kids wear them? And while high-quality respirators do work, they cost more, and not everyone can afford to buy and replace them regularly, especially when you consider that at least younger kids can be pretty messy. So there's a real equity issue there, but there's also question of fairness.

Dr. Monica Gandhi is an infectious disease specialist at UCSF. She says, look, evidence shows kids are a lot less susceptible to severe disease from COVID than adults. So, she says, how can states drop mandates for adults and keep them for kids? Instead, she says, communities need a metric for when it's time to drop masking mandates for everyone.

MONICA GANDHI: We need to think about releasing mask mandates on what matters the most, which is our hospitals having good capacity and a vaccination rate in the community.

GODOY: She says high vaccination rates among adults can protect kids, too.

NADWORNY: Well, what about vaccination rates in children?

GODOY: Well, right now, only about a quarter of 5- to 11-year-olds are vaccinated. But researchers at Massachusetts General Hospital say if vaccination rates in an elementary school were at, say, 90% instead of 25%, you could comfortably drop mask mandates even if there was a lot more virus in the community.

NADWORNY: All right. That's NPR health correspondent Maria Godoy. Thank you so much for your knowledge tonight.

GODOY: My pleasure. Transcript provided by NPR, Copyright NPR.