A German study suggests that adults wearing masks may help decrease COVID-19 outbreaks in schools and preschools. The study discovered that while children were the most common index cases in schools, adult infections caused more severe outbreaks. Without masks, index adults caused 4.5 new cases, while children caused 0.3. When masks were required, these figures fell to 0.5 and 0.3.
As of December 2021, 270 million Covid-19 infections have been reported worldwide.
Although the involvement of children and adolescents in the spread of Covid-19 is unknown, school and preschool closures have become a popular strategy for preventing outbreaks.
But shutting schools harms children and teenagers. It can cause social isolation, hinder their growth and development, and cost parents and guardians money.
The study’s co-author, Dr Anika Kästner of University Medicine Greifswald, Germany, said: “To avoid school closures at high incidence levels, it is important to identify factors contributing to the spread of Covid-19 infections in schools and preschools.”
Dr. Martine Sombetzki of the University Hospital Rostock in Germany and her colleagues analyzed the dynamics of Covid-19 infections in schools and preschools in relation to changes in hygiene measures, as well as the impact of these measures on the magnitude of outbreaks.
“Our study was designed to provide further insight into the effectiveness of specific hygiene measures in schools and preschools.”
The source of infections at schools
The authors investigated routine surveillance data from Mecklenburg-Western Pomerania, Germany, between August 2020 and May 2021 in relation to Covid-19 infection cases in schools and preschools. They looked at outbreaks in the context of changing infection control strategies. To accomplish so, they identified four temporal phases: ‘phase one’ (no mask obligation), ‘phase two’ (lockdown in Germany), ‘phase three’ (with mask obligation in schools), and ‘phase four’ (only emergency treatment) (lockdown in Germany).
While children were frequently the index cases in schools, outbreaks were more severe when an adult served as the index case. In phase one, adult index cases induced 4.5 secondary cases and child index cases 0.3. In phase three, adults caused 0.5 secondary cases and kids 0.3.
In preschools where only adults were recommended to wear masks, index adults were responsible for an average of 0.6 secondary cases in phase one and 2.8 secondary cases in phase three. In phases one and three, kids triggered 0.5 secondary cases.
“The reason for this difference between phases could be the increasing prevalence of the delta variant, which causes more frequent infections in children,” added Sombetzki.
Obligatory masking to prevent outbreaks
Masks in schools and preschools are difficult for young children to wear. It appears that masks help prevent illness outbreaks.
“Our results show that mandatory masking of teachers and caregivers and children at schools in the 2020 to 2021 school year each resulted in a significant reduction in the number of Covid-19 transmissions.”
However, there are certain limitations to the study. Vaccinations are not routinely recorded in Germany, so their influence cannot be calculated. The researchers also assume that the hygiene measures were properly implemented and followed in the schools investigated.
Nonetheless, the study showed that masks help fight coronavirus.
“In a model analysis, mask obligation, for adults in particular, was shown to be effective in reducing secondary cases. We can therefore recommend all-time mandatory masking in schools for both children and adults. In preschools, mask wearing could also reduce secondary cases,” concluded Kästner.
Source: 10.3389/fpubh.2021.780039/full
Image Credit: Getty
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