Lack of consistency in school mask use presents challenges

In his recent directive implementing Executive Order 2-2021, Governor Gianforte highlighted that “access to school is essential to the developmental, social, mental and  educational needs of school-age children.” We cannot agree more that access to school is  essential to the health and well-being of our children and adolescents. 

Across our state and nation many K-12 schools have remained open during the COVID-19 pandemic by following a multi-layered approach to protecting students, teachers and staff.  There is growing evidence that when K-12 schools follow mitigation strategies, such as those outlined by the Center for Disease Control and Prevention and American  Academy of Pediatrics, there is generally not a significant increase in rates of  community transmission or in-school virus transmission. This evidence should encourage educators and school systems to continue these best practices to keep their students, staff, and communities safe while the COVID-19 pandemic is ongoing.  

In line with these best practices, Governor Gianforte’s Directive states “schools  should make reasonable efforts to follow school guidelines and best practices  recommended by the CDC…”. The CDC strongly recommends universal cloth face coverings (masks) as one of the critical mitigation strategies to keep schools open and  safe. However, we are concerned that some school leaders and parents have interpreted this Directive as a statement that masks are not an important mitigation tool for keeping  schools safe. 

COVID-19 still remains a significant threat to our vulnerable children and schools which is  why experts in public health, education, and pediatric health recommend universal masking in schools as best practice. The CDC’s school guidance recommends universal masking in schools and school-related extracurricular events, regardless of the level of community transmission. Masks protect both the wearer and others they come in close contact with and the vast majority of students have been able to wear a mask safely and effectively without any evidence of harm. Evidence for the importance of masks in reducing  COVID-19 transmission in school settings continues to grow.

For example, a recent CDC  study of 397 children in Mississippi found that in-person attendance at school was not  associated with COVID-19 infection, unless masks were not consistently worn by students  and staff. Also, a recent CDC study involving nine clusters of COVID-19 in a Georgia school  district described an increased risk to teachers, who are more likely to experience severe disease, when there was inadequate mask use. Furthermore, although vaccination will eventually improve the COVID-19 burden in our community, universal masking remains essential as we do not understand how vaccination affects transmission and children are unable to receive the vaccine at this time. Lastly, it is uncertain what effect newly recognized SARS-CoV-2 variants will have on our communities, children, and schools but  caution is warranted.

This lack of statewide consistency in school mask use presents a challenge for parents,  teachers, educators and school leaders trying to provide access to in-person education. It also presents a challenge for inter-school activities where schools from different communities have differing requirements resulting in significant conflict and potentially unsafe environments for participants. 

For all the above reasons, we strongly recommend continued universal mask use by all students and staff in schools and school-related activities which is in line with  Governor Gianforte’s Directive to follow best practices recommended by the CDC. 

Montana Chapter American Academy of Pediatrics, Montana Association of School Nurses, Association of Montana Public Health Officials, Montana Academy of Family Physicians, Montana Public Health Association