July 12, 2021 -- School may be out for summer, but the CDC is still in session. The agency recently released updated guidance that promotes in-person learning when K-12 students return in the fall, and relaxed mask recommendations for those fully vaccinated against COVID-19.
"Children and adolescents benefit from in-person learning, and safely returning to in-person school in the fall of 2021 is a priority," the CDC said in a July 9 statement.
Why now? The federal agency cites "widespread availability of safe and effective COVID-19 vaccine for people aged 12 and older [as well as] recent reductions in cases, hospitalizations, and deaths."
But some states are already saying they'll continue to require masks. Take California, for example, where health officials said masks will continue to be required in schools despite the CDC’s new guidance.
“Masking is a simple and effective intervention that does not interfere with offering full in-person instruction,” said California Health and Human Services Agency Secretary Mark Ghaly, according to the Los Angeles Times. “At the outset of the new year, students should be able to walk into school without worrying about whether they will feel different or singled out for being vaccinated or unvaccinated — treating all kids the same will support a calm and supportive school environment.”
That said, masks asks are still recommended for anyone aged 2 years or older, including students, who is not vaccinated, according to the CDC.
"While fewer children have been sick with COVID-19 compared with adults, children can be infected with the virus that causes COVID-19, can get sick from COVID-19, can spread the virus to others, and can have severe outcomes," the CDC statement notes.
"As a parent and ID physician, I am concerned. I had a feeling that this decision was coming soon. I have children under 12 years old who are not yet eligible for vaccine and it's unclear to me when the [FDA's emergency use authorization] will be expanded to the entire pediatric population. Adolescents rank among the lowest in terms of vaccine uptake," says Priya Nori, MD, an infectious disease physician at Montefiore Health System in the Bronx, New York.
"This group as well as other unvaccinated populations are driving the spread of the delta variant throughout the US. Based on low vaccine uptake, and increasing rates of the highly transmissible delta variant, how can we feel confident that lifting masking in schools is the right decision? It also puts our educators in an unfair position. These decisions also have not been backed up with mandates to ensure vaccination status in schools," she says.
Together but Apart
The federal agency still calls for at least three feet between student desks — down from the six feet recommended prior to March 2021.
"Using a distance of at least 3 feet between students in classrooms could provide a feasible definition of physical distancing so long as other prevention strategies are maximized," the agency notes on its updated Science Brief addressing transmission of SARS-CoV-2 in schools.
This guidance continues calls for a layered approach to COVID-19 prevention, including the familiar strategies such as proper ventilation, hand hygiene, and staying home if symptomatic or when exposed to someone who likely has COVID-19.
A Lesson in Controversy
Like previous moves the CDC has taken that relax their COVID-19 guidance, this one is not without controversy. On Twitter, reactions to the CDC's post about the new guidance ranged from outrage to applause.
"I'm somewhat disappointed by this decision and would hope the CDC would at least recommend a hybrid approach — masking during respiratory viral season between fall and spring," says Nori, who is also an associate professor of medicine and orthopedic surgery at Albert Einstein College of Medicine in the Bronx.
Becky Cunningham, a mother with two children, for example, questioned how the guidance for the unvaccinated to keep wearing masks in schools will be enforced. "Hard to trust that folks will just do the right thing & follow the rules/be honest!!" she tweeted.
Another tweet raised the issue of enforcing the honor system for mask wearing. Ana Mercedes appeared to back the new guidance: "That's great since my 17yr old is vaccinated."
Other parents of children with underlying medical conditions or below the 12-year-old minimum age for vaccination were more concerned.
For example, "Eve" tweeted that the CDC's new guidance "is ridiculously irresponsible."
The CDC is not calling for proof of vaccination for teachers or students. Nor does the agency specifically outline how schools can determine which students are vaccinated and which are not, or how to enforce mask wearing among the unvaccinated.
Instead, the CDC said it is providing enough flexibility for local districts and schools to adapt the guidance as needed based on local conditions.