Is it fair to ask children to wear face masks in schools?

Preventive measures such as masking, social distancing and lockdowns are designed to slow down the rate of infection. They are justified by the danger that hospitals will be overwhelmed with severely sick people, leading to the collapse of the health system. Stretching the pandemic in time may also be a wise thing to do if there is a prospect of developing a vaccine. This has been the case since the onset of COVID-19.

What should be the protective measures in the age of the vaccines and COVID-19 variants? When it comes to children, whose physical and mental abilities are forming during that age, answering this question through tries and failures would be unacceptable. Summer onslaught from the delta variant of COVID-19 and the emergence of the lambda variant right before the beginning of the school year requires careful thinking.

For a deadly virus that jumps from a wild (or a lab) animal to humans, successful mutations are those that make it more transmissible and less deadly so that it can coexist with the new host. The high transmission rate of the delta variant and the fact that half of the U.S. population has not been fully vaccinated raised concerns that it may overwhelm our health system. It prompted the Centers for Disease Control and Prevention (CDC) to issue a new recommendation regarding wearing face masks. 

Following that recommendation, a number of U.S. states have required students to wear face masks in schools during the upcoming school year. However, reading the statistics of recent hospitalizations and deaths among different age groups, and comparing it with the statistics or recent flu epidemics, one begins to think about the fairness of protective measures that have not been mandated in similar situations in the past and which negative effects may outweigh their benefits. 

To put it on a quantitative footing, consider for example the recent data from Florida where the delta variant has been raging. The fatality rate for children under the age of 16 has been less than 0.003 percent as compared to 0.006 percent during the severe flu epidemic of 2017-2018. Children were not required to wear face masks in schools back then, so why would they be required to do it now? 

The probability of catching a virus by a child in a school setting is difficult to evaluate. This is especially true for emerging variants of COVID-19, but it is also true for the flu. One must anticipate that clusters of infection are going to happen as they occur during flu epidemics. There should be no doubt that some of the infected children will pass the virus to adults.

One should worry about that because the mortality rate from COVID-19 steeply increases with age, becoming as large as 9 percent for people over the age 65, as compared to 0.9 percent from the flu. Unvaccinated adults will be better off wearing face masks during both COVID-19 flare-ups and the flu seasons. Among vaccinated people, the mortality from breakthrough COVID-19 infections has been so small that it is virtually impossible to establish with confidence whether the few reported deaths, if any, were caused by COVID-19 or by some other unrelated conditions. 

So how fair is it to ask children to wear face masks in schools all year round? If a child lives with an immunocompromised family member, it would be a reasonable thing to do. However, given the extremely low mortality rate from COVID-19 among school-age children, it seems clear that universal mask mandates issued by some states to the schools are not so much about protecting children as they are about protecting unvaccinated adults from infected children.

If one has any doubts about the fairness of such a mandate, recall yourself waiting for the end of a long school day filled with classes you liked and those you hated. Now imagine yourself wearing a face mask that is rubbing your face for the entire day; do you want to mask up? Or, if you have school-age children, grandchildren, little sisters and brothers, do you want them to wear face masks in school? If you don’t, get vaccinated.

Eugene M. Chudnovsky is a distinguished professor of physics at the Graduate School and Lehman College of the City University of New York. He has done research and published articles on the spread of COVID-19