Journal
PEDIATRICS
Volume 149, Issue 6, Pages -Publisher
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2022-056687
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Funding
- Rapid Acceleration of Diagnostics Underserved Populations (RADx-UP) (National Institutes of Health) [U24 MD016258, 1 OT2 HD107543-01, 1 OT2 HD107544-01, 1 OT2 HD107553-01, 1 OT2 HD107555-01, 1 OT2 HD107556-01, 1 OT2 HD107557-01, 1 OT2 HD107558-01, 1 OT2 HD107559-01]
- Trial Innovation Network
- National Institute of Child Health and Human Development [HHSN275201000003I]
- National Institutes of Health (NIH)
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This study aimed to estimate the impact of different masking practices on secondary transmission in K-12 schools. The study found that universal masking in school districts was associated with reduced secondary transmission compared to optional masking.
OBJECTIVES: Throughout the COVID-19 pandemic, masking has been a widely used mitigation practice in kindergarten through 12(th) 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 estimated the impact of various masking practices on secondary transmission in a cohort of K-12 schools. METHODS: We performed a multistate, prospective, observational, open cohort study from July 26, 2021 to December 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: A total of 1 112 899 students and 157069 staff attended 61 K-12 districts across 9 states that met inclusion criteria. The districts reported 40601 primary and 3085 secondary infections. Six districts had optional masking policies, 9 had partial masking policies, and 46 had universal masking. In unadjusted analysis, districts that optionally masked throughout the study period had 3.6 times the rate of secondary transmission as universally masked districts; and for every 100 community-acquired cases, universally masked districts had 7.3 predicted secondary infections, whereas 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 with optional masking.
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