CDC chief: We'll keep recommending masks for kids even after they're eligible for vaccination

Boy, I dunno. Seems to me if you’re looking to encourage parents to get their kids immunized against COVID at a moment when many have misgivings about it, one obvious incentive is to present them with a vax-or-mask option. If their children get the shot, they’re done with masks in school. If not, not.

The CDC doesn’t seem inclined towards an either/or approach — yet.

The key phrase here from Rochelle Walensky is “it will take some time,” I believe. Given the administrative burden of vaccinating millions of children and the current reluctance of many parents, it’ll be many months before a meaningful number of children in the average classroom have had their shots. Certainly it won’t happen before the expected national winter surge begins. So schools will be urged to keep up precautions for now.

Again, though, why not exempt kids who get the jab from masking? Maybe the CDC is calculating that a policy in which 20 percent of kids in a given classroom are mask-free due to vaccination and 80 percent are masked up because they’re unvaxxed will lead to dissension in schools and enforcement difficulties. Imagine trying to explain to a six-year-old why he has to keep his mask on eight hours a day while his best friend goes barefaced. And imagine the anger among vax-reluctant parents when that six-year-old comes home crying, demanding that he be vaccinated too like his pal so that he won’t need to wear a mask anymore.

Joseph Allen, a professor at Harvard, has a thoughtful op-ed in WaPo today arguing that the beginning of vaccination for young children should mean the end of masking in schools. Yes, it’s true that unvaxxed kids in class will remain at higher risk of getting infected and infecting others. But the risk of a young child experiencing severe illness from COVID is microscopic, on the order of one hospitalization per million kids. As for the risk of kids infecting adults…

…every adult in America has been eligible for vaccination for months and all senior citizens are already eligible for boosters. Why should kids bear the burden of protecting adults by having to wear masks all day long when adults are capable of protecting themselves, asks Allen? Let’s do what we can instead to make class as safe as possible without masks by using rapid testing, ventilation, and vaccine drives at school for kids whose parents are willing to get them jabbed. (Why Allen is gung ho to let kids get vaxxed isn’t clear to me since his arguments against masking children work just as well against vaccinating them for COVID.)

I assume Walensky and Fauci would answer him by pointing to the enormous number of cases and deaths the U.S. experienced last winter and arguing that anything we can do to limit transmission among the unvaccinated, including unvaccinated young children, is worth doing. Maybe the fact that so many Americans are immunized will mean fewer deaths and hospitalizations this year, but COVID keeps surprising us. We may get another wave that crashes down on the elderly and immunocompromised and claims thousands of lives despite them having had their shots. (See, e.g., Colin Powell.) If we can stop some chains of transmission from getting started by masking kids until spring, isn’t that worth doing?

A study from Michigan published last week found that local schools without mask mandates saw 62 percent more COVID than schools that had them. More notably, just one percent of COVID-related closures in American schools this fall have come from California despite the fact that the state accounts for 12 percent of all U.S. students. That’s shocking because many districts in California persisted in virtual learning last year after most other states had sent kids back to class. This year Cali is doing a great job keeping classrooms opens. School districts there are using multiple strategies — masking, testing, ventilation, physical space, better ventilation — to keep buildings open while they wait for kids to become eligible for the vaccine. The CDC is watching and probably figuring that, if nothing else, masking kids will help avert some school closures due to outbreaks, avoiding further disruption to children’s education.

Still, it remains unclear just how much kids, particularly young kids, are spreading the virus given how quickly they shake it off. The Michigan study implies that they’re spreading it to some degree. But a fascinating post from Kinsa over the weekend cited circumstantial evidence that transmission of the coronavirus appears to operate differently from standard respiratory viruses. Kinsa’s smart thermometers and their accompanying app are able to tell the company which member of a customer’s household was first to have a fever and then whether other family members developed fevers subsequently. Logically, the first person with the fever probably brought a contagious illness home and spread it to everyone else. Kinsa found that, before the pandemic, 55 percent of transmission in households was child-to-child, 25 percent was child-to-adult, 15 percent was adult-to-child, and five percent was adult-to-adult. But:

Once the COVID-19 pandemic hit, there was a distinct shift in these trends. The amount of transmission originating in children drastically decreased, with the amount of transmission originating in adults increasing to about 40-50%.

That could be a simple function of so many kids being kept home last year while at least one parent kept going to work. Since the working parent was around strangers and the children weren’t, it stands to reason that they’d be bringing the virus home more often than the kids would. But it could also be that, due to the vagaries of the coronavirus, because kids have so little trouble fending off COVID they’re also less likely to transmit it. Instead, they may be more apt to find themselves on the receiving end of transmission from mom or dad.

If that’s true then worrying about kids catching the virus in school and bringing it home seems backward. They may be more at risk at home from their parents than they are from catching it in class via a schoolmate. Where does that leave us with classroom masking?