August 25, 2020

expert reaction to the debate over face masks in schools

There has been debate about whether face masks should be required in schools to help limit the spread of COVID-19 as they re open across the UK. 

Dr David Strain, Clinical Senior Lecturer, University of Exeter and chair of the British Medical Association’s Medical Academic Staff Committee, said:

“The use of face masks in schools is a controversial subject, centred in the first instance around the role of children in the transmission of COVID. There is clear evidence that younger children do not suffer significant disease and therefore are less likely to have significant viral load in order to pass on coronavirus. In older children and young adults however, there is little general consensus about the role they have in driving transmission; indeed there a number of studies that maintain that children – predominantly older children – can and do transmit the virus in a comparable way to adults.

“In the absence of clarity, given the known detrimental impact of school closures, we must err on the side of caution in order to ensure that when schools re-open they remain open. 

“In order to accomplish this, the World Health Organisation (WHO) guidance is now that children aged 12 or over should wear masks where they are less than one metre from others; the same WHO guidance also says children aged 6-11 should wear masks based on risk (such as their ability to use a mask, transmission rates and adequate adult supervision) – the guidance clarifies that those aged 5 and under should not be required to wear a mask. 

“Since schools in Scotland reopened just over a week ago, there has already been one school that has had to close due to a COVID outbreak, where 27 new cases have been traced back to this cohort. As a result, Scotland is now reviewing its policy on face masks.  Several other countries have already implemented this, ahead of the WHO guidance. 

“It is also important to consider that last week the CMO, Prof Chris Whitty, said we have ‘probably reached near the limit or the limits’ of what can be done to reopen society, suggesting trade-offs may be required. In order to minimise the need to re-implement lockdown measures any step, no matter how small, would be of benefit to ensure children and young adults are enabled to resume their education. In view of this, it becomes more important for the Prime Minister to explain why the government is choosing to ignore WHO guidance, rather than for anybody else to justify why masks should be used in situations where pupils cannot maintain physical distance, such as in school corridors.”

Prof Rowland Kao, Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:

“Recent outbreaks in Scotland (where there is evidence of teenagers becoming infected in clusters, as opposed to younger children where the risk appears lower) reinforce the idea that COVID-19 transmission in schools is potentially substantial.

“An important consideration here is for the risks to teachers, especially those who may be in more vulnerable categories due to age or health. The positive effects of face masks in protection against aerosol and droplet transmission, however, must be balanced against the potential for increased fomite transmission, such as may occur if the masks become traps for the virus themselves.  For younger children who are likely to have less discipline in regards to hygiene (and are also believed in any case to be at inherently lower risk of transmission) face masks continue not to be recommended, but recent WHO guidance is for face masks to be worn by young persons from the age of 12 where social distancing cannot be maintained – and this would include many school settings.

“Should masks be adopted, their use must be accompanied by awareness of the need for good mask hygiene and regular handwashing.”

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

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