LA County now requires youth sports participants in indoor sports to mask and test weekly. Outdoor “high or moderate risk” sports participants must test within 48 hours of games. Logistics are still being worked out, but it includes rec and club teams as well as school teams. Looks like I’ll be testing my 7 year old weekly. My high schooler doesn’t play a sport on the list.
I know there have been a lot of discussions here about youth sports and their role in spread and if they are necessary right now, so I thought this news was interesting.
My girls are staring today & we are begging them to wear masks….we will see how it goes, but I’m expecting schools to be the super spreader Evers we were so worried about lasf fall since there ar no precautions being taken at all….
neverfstop, good luck. I hope it all goes okay! I, too, expect school to be crazy spreader events this year. Sure, sure. A more contagious variant with zero precautions. Makes sense.
It's been 3 days for us. I know of several people that have tested positive already. It's just a waiting game at this point.
Post by timorousbeastie on Aug 23, 2021 8:36:51 GMT -5
Parents in my district have been posting all over Facebook about their plans for the school year - never test for COVID even if symptomatic, refuse to quarantine and send kids to school if the school says they need to quarantine, send kids to school even if they know they are sick. One of the people posting this is even a teacher in another district. And yet the superintendent is still saying he has no interest in requiring masks unless mandated by the state or county (the county never will, so all my hopes fall on the state at this point, which isn’t lookin good right now).
School starts next week. I don’t know how we are going to make it to DD’s age group being approved for shots without her getting sick first.
melmaria, Covid is obviously not going anywhere. I think we will see periods where masks might be needed in school and periods where they won't. I think last Spring we mostly didn't need them. Right now in the south they are needed but it's also the one place where they aren't mandated. From my understanding most countries have a much better testing system which makes masks not as much of a necessity. We don't have that either. From what I can see with my own two eyes though the districts here that imposed masks against Abbott's will have much lower cases. The schools that don't are exploding. Is it the masks that are making a difference or other things? I honestly don't know. It will be interesting to continue studying.
Anyways. Full FDA approval for Pfizer! My question...will that open it up for off label use in kids?
Post by Velar Fricative on Aug 23, 2021 9:01:03 GMT -5
NYC is going to require all school staff to be vaccinated with at least one dose by September 27th. School starts on September 13th but I'll take it. Previously, it was either get vaccinated or get tested weekly.
[Inserting my standard caveat that while I don't oppose mask mandates in schools atm, I think many people are way too confident in how much of a difference they might make given the lack of data we have.]
At the end of May, the Centers for Disease Control and Prevention published a notable, yet mostly ignored, large-scale study of COVID transmission in American schools. A few major news outlets covered its release by briefly reiterating the study’s summary: that masking then-unvaccinated teachers and improving ventilation with more fresh air were associated with a lower incidence of the virus in schools. Those are common-sense measures, and the fact that they seem to work is reassuring but not surprising. Other findings of equal importance in the study, however, were absent from the summary and not widely reported. These findings cast doubt on the impact of many of the most common mitigation measures in American schools. Distancing, hybrid models, classroom barriers, HEPA filters, and, most notably, requiring student masking were each found to not have a statistically significant benefit. In other words, these measures could not be said to be effective.
In the realm of science and public-health policy outside the U.S., the implications of these particular findings are not exactly controversial. Many of America’s peer nations around the world — including the U.K., Ireland, all of Scandinavia, France, the Netherlands, Switzerland, and Italy — have exempted kids, with varying age cutoffs, from wearing masks in classrooms. Conspicuously, there’s no evidence of more outbreaks in schools in those countries relative to schools in the U.S., where the solid majority of kids wore masks for an entire academic year and will continue to do so for the foreseeable future. These countries, along with the World Health Organization, whose child-masking guidance differs substantially from the CDC’s recommendations, have explicitly recognized that the decision to mask students carries with it potential academic and social harms for children and may lack a clear benefit. To date, the highly transmissible Delta variant has not led them to change this calculus. (Many experts I spoke with told me that while the Delta variant represents a major and concerning new development in the Covid pandemic, it probably shouldn’t change our thinking on a mask requirement for schools.)
Here in the United States, the message looks different. On July 9, a little more than a month after the study was published, the CDC released updated guidance for schools, including the recommendation that masks should be worn indoors by all individuals (age 2 and older) who are not fully vaccinated. Ten days later, the American Academy of Pediatrics took the guidance a step further and said that everyone in school over age 2 should wear masks, regardless of vaccination status. (The CDC later matched the AAP’s guidance.)
The extreme political heat around the issue of masks in schools is making it hard to have a coherent conversation about the science. At the risk of generalizing, much of blue-state America is strongly in favor of masks in schools, while much of red-state America is opposed. In Florida, Tennessee, and elsewhere, local school-board meetings are verging on violence as parents and officials fight over the question. But with tens of millions of American kids headed back to school in the fall, their parents and political leaders owe it to them to have a clear-sighted, scientifically rigorous discussion about which anti-COVID measures actually work and which might put an extra burden on vulnerable young people without meaningfully or demonstrably slowing the spread of the virus. In that context, the best practices for mask use in schools — elementary schools in particular — are much less obvious than CDC guidance and news headlines about keeping schools safe might have you believe.
...
Many people may surmise that even if there’s not conclusive evidence, it’s still likely that masking kids in schools helps. But not all masks are created equal. A list of public-health notables, including Michael Osterholm, an epidemiologist and former COVID-19 adviser to Joe Biden, and Scott Gottlieb, the former commissioner of the FDA, have publicly noted the limited effectiveness of cloth masks. Celine Gounder, an infectious-disease epidemiologist at NYU, who also advised Biden’s transition team on COVID-19 policy, recently tweeted a chart that showed when cloth masks are worn by both the source and receiver they provide just an estimated 27 minutes of protection from an infectious dose of the SARS-CoV-2 virus. Higher-grade N95s, or KN95s, the Chinese equivalent, offer more protection, but are also much harder to tolerate over extended periods of time. Three physicians I talked with considered the idea of children wearing them all day at school — suggested recently by an aerosol scientist in the Times — “laughable,” “cruel,” and “unrealistic, because most adults can barely handle an N95 for even short durations,” since they are so uncomfortable.
While the protective value of a mask mandate for children in school seems, at best, uncertain, experts have concerns about the potential downsides of them in a learning environment.
“Mask-wearing among children is generally considered a low-risk mitigation strategy; however, the negatives are not zero, especially for young children,” said Lloyd Fisher, the president of the Massachusetts chapter of the American Academy of Pediatrics. “It is important for children to see facial expressions of their peers and the adults around them in order to learn social cues and understand how to read emotions.” Some children with special needs, for example those with articulation delays, may be most affected, he suggested. Fisher stressed his opinions are not to be perceived as contradicting AAP’s stance for universal masking of students but said he wanted to discuss some of the potential harms and the importance of using evidence and data to drive decisions on when to eliminate mask usage.
“There are very good reasons that the World Health Organization has repeatedly affirmed their guidance for children under 6 to not wear masks,” said a pediatrician who has both state and national leadership roles in the AAP but who wished to remain anonymous because they did not want to jeopardize their roles in the organization. “Reading faces is critical for social emotional learning. And all children are actively learning language the first five years of life, for which seeing faces is foundational,” the pediatrician said.
One troubling aspect of the CDC and AAP’s guidance for masking children in school, nearly every expert I interviewed said, is that it has no endpoint or specific metrics. When asked when kids can remove masks in school, CDC director Rochelle Walensky said, “If our children are vaccinated, we have full vaccination in schools, we have full vaccination in teachers, we have disease rates that are low — I think then we can start thinking about how we can loosen up.” In practical terms, this seems to translate to the distant future. Likely a percentage of teachers will not get vaccinated. And estimates are that the vaccine for kids ages 5 to 11 may not be approved for emergency use until the winter or later. When an EUA does come, a significant percentage of parents won’t vaccinate their kids. By Walensky’s criteria, children may be in masks for years at school.
Well, my city is part of 3 different school districts. 2 are requiring masks, 1 isn't ("strongly recommended"). It'll be interesting to see how mine and the other masked district compares to the unmasked district in terms of covid cases and spread.
I want to be clear that I am pro-mask. I am extremely happy my district requires them.
timorousbeastie I am sorry. I don't understand how people are just okay with any sickness, not just covid? Clearly there are going to be other viruses/bacteria circulating. So just don't worry about strep? Or something worse?
abs, An off-label use wouldn't allow it to be used for kids. It would be more like they're also going to see if the vax can also be used for another virus.
melmaria, One thing that our local pediatricians are saying is that while masking effectiveness for Covid may not be in super solid science right now, the numbers for flu, RSV, and other illnesses from last year suggest that they definitely protect from the spread of other things. Right now, our hospitals have zero pediatric beds. We need to be doing absolutely everything in our power to prevent *any* illness right now so when accidents happen and other childhood illnesses occur, there’s space for them to get the care that they need.
I sent my kids to school today. I feel like I’ve thrown them to the wolves. At open house, less than 50% were wearing masks. No contact tracing. No distancing. The only quarantines are for those who test positive and the school is notified. (But like PP above, many parents are being vocal about planning not to test and not being honest with the school about symptoms when kids are home.) No quarantines for kids who have a Covid+ family member at home. If my kids don’t get Covid before the vaccine, I’ll consider it nothing short of a miracle.
My kids were SUPER excited this morning, and I’m trying really hard to feed off of their energy…but this really, really sucks.
Post by Velar Fricative on Aug 23, 2021 9:10:01 GMT -5
I'm fine with masking younger children during local surges, but there should be off-ramps. My 4yo's inconsistent mask-wearing through the last school year was pretty reassuring, because I don't think most kids kept them on for very long, if at all. But, Delta is more contagious so I'm a little more concerned and want her to magically love masks on September 13th.
I feel like I’m being baited by the mask opinion pieces at this point. There’s a new one every week that all say the same exact thing with limited / no / low quality historical evidence and zero data on Delta. They’re being published *because* they’re contrary to current medical guidelines in the US.
In other news, full FDA approval is exciting! Wish I had a kid closer in age to 12 where off label use could be a serious consideration now.
Post by Velar Fricative on Aug 23, 2021 9:11:38 GMT -5
lilac05, I liked the part about masks preventing other illnesses, which is critical where hospitals are overrun, not the concerns about your kids. And all last year I did feed off my kids' excitement being in school despite my concerns. Hell, DD1 knows she caught the virus at school and was still so excited when she was finally able to go back.
Yes I want off ramps. I wish we weren't so distracted by just fighting about fucking masking in general. If we weren't we could have intelligent conversations like "When infections rates are at X, masks are not needed."
Again it would also be a carrot. I really really think we have underestimated how many people need motivation to do the right thing. As I said last week, I am annoyed my vaccinated son has the same quarantine policy as unvaccinated. Where is the fucking carrot to vaccinate your kid? Or even acknowledge that vaccinations work. It is just so non-sensical.
If we did this with masking, maybe people would be more motivated to say mask up for a month so we could get infection rates down. If we promised there could be an end in sight. Heck, I need that right now and I am a 40 year old adult!
melmaria, Covid is obviously not going anywhere. I think we will see periods where masks might be needed in school and periods where they won't. I think last Spring we mostly didn't need them. Right now in the south they are needed but it's also the one place where they aren't mandated. From my understanding most countries have a much better testing system which makes masks not as much of a necessity. We don't have that either. From what I can see with my own two eyes though the districts here that imposed masks against Abbott's will have much lower cases. The schools that don't are exploding. Is it the masks that are making a difference or other things? I honestly don't know. It will be interesting to continue studying.
Anyways. Full FDA approval for Pfizer! My question...will that open it up for off label use in kids?
From what I hear, most reputable pediatricians will not do off-label use for this. They are typically more comfortable with doing off-label uses for a drug that already is approved to be used in kids.
I also wonder if the federal coverage of the vaccines impact how it can be administered to children right now.
melmaria, Covid is obviously not going anywhere. I think we will see periods where masks might be needed in school and periods where they won't. I think last Spring we mostly didn't need them. Right now in the south they are needed but it's also the one place where they aren't mandated. From my understanding most countries have a much better testing system which makes masks not as much of a necessity. We don't have that either. From what I can see with my own two eyes though the districts here that imposed masks against Abbott's will have much lower cases. The schools that don't are exploding. Is it the masks that are making a difference or other things? I honestly don't know. It will be interesting to continue studying.
Anyways. Full FDA approval for Pfizer! My question...will that open it up for off label use in kids?
From what I hear, most reputable pediatricians will not do off-label use for this. They are typically more comfortable with doing off-label uses for a drug that already is approved to be used in kids.
I also wonder if the federal coverage of the vaccines impact how it can be administered to children right now.
12-18 year olds are kids.
It gets dicey when you move into much younger ages (and a hard pass for toddlers and infants who are at risk for run of the mill febrile seizures and will likely require much lower doses)
But why wouldn’t a reputable pediatrician consider off label use for, say, a high risk 11 year old?
ETA I see it’s only fully approved for 16+. 12-15 remains EUA. That’s a little less exciting but I do wonder if there could be some room for off label use in kids right below the cutoff.
My kid has lost out on so much. So if masks make ANY kind of difference and lower her/others risk AT ALL, then I will do it. Very thankful that our county (and state) have mask mandates. She goes back on Thursday and my stomach is in knots. Am I throwing her to the wolves???
From what I hear, most reputable pediatricians will not do off-label use for this. They are typically more comfortable with doing off-label uses for a drug that already is approved to be used in kids.
I also wonder if the federal coverage of the vaccines impact how it can be administered to children right now.
12-18 year olds are kids.
It gets dicey when you move into much younger ages (and a hard pass for toddlers and infants who are at risk for run of the mill febrile seizures and will likely require much lower doses)
But why wouldn’t a reputable pediatrician consider off label use for, say, a high risk 11 year old?
ETA I see it’s only fully approved for 16+. 12-15 remains EUA. That’s a little less exciting but I do wonder if there could be some room for off label use in kids right below the cutoff.
Obviously, by kids I meant under 12 in this situation.
From what I hear, the biggest issue is that they don't have confirmation of the correct dose and they are concerned with how to balance efficacy of the vaccine, myocarditis risk with the vaccine, and doing nothing risk in under 12s. Until there's better understanding I think most pediatricians will be very hesitant to take the risk in getting shots in younger kids arms.
This is not my opinion, it is what I have heard from medical professionals. I asked every single question you are asking last night.
Our district just updated the Covid dashboard (they are only updating weekly this year) 1.5 weeks of school and my son’s elementary school went from 0 cases the first 3 days to 8 cases last week.
Post by bookqueen15 on Aug 23, 2021 9:43:21 GMT -5
Nine days into the school year for us and dealing with our first ever quarantine from school for my DS (never had any all last year). He started getting a runny nose this weekend so I had already planned to keep him home today and get him tested. But found out yesterday another student in his class tested positive.
And of course got a text this morning that there are 5 more positive cases at my DD's elementary school. It's definitely going to be a rough month here.
Once the vaccine is widely available to all school aged children, I think it would be reasonable for there to be a baseline positivity rate that would automatically trigger a mask mandate. But local health departments could decide on the number as opposed to politicians.
Post by Patsy Baloney on Aug 23, 2021 9:55:56 GMT -5
I work in higher ed and masking on campus is tied to county transmission. We’re putting pressure on local leaders to step up the pressure on getting people vaccinated. You want students here spending their money? Get your shit together, county.
As far as school masking in general - until quarantine measures change for our school district/state, those masks keep my kid in school. We avoid exclusions from symptoms of other illnesses and won’t get pegged for quarantine because of “close contact” - the mask breaks that. It would be great if pre-k - 12 could be given county metrics to follow with masking. But everyone is too busy screaming about “my rights” to give a fucking shit about the subtlety of response and mitigations.
There's a protest planned for the school board meeting tomorrow night because of the mask mandate. There's a "poster" circulating on Facebook to get more people to show up. Half of it is misspelled. Really lends a lot of credibility to your cause...
To be clear - our mandate is not even an all day thing. If you're outside, or more than 3 feet apart, or sitting behind a plexi shield, you don't have to mask. All desks and cafeteria tables have shields. It's very similar to the policy we had last year and resulted in no quarantine issues at all within the schools. The only time we had major "outbreaks" was at the high school level when sports and parties messed everything up. I'm fairly confident our school board will laugh them out of the room and keep on keeping on with the policies they've put in place.
My kid has lost out on so much. So if masks make ANY kind of difference and lower her/others risk AT ALL, then I will do it.
The issue is the data shows it makes no difference.
Maybe. Because it is early days.
I am ok with a better safe than sorry approach, but that should be communicated! I am a broken record but all communication about this has just been total shit.
And the flip side is harm reduction.... If we have data that masks do nothing to reduce spread in schools, is it ethical to require them when they may cause harm in development? Does anyone know if we have data on speech or social communication?
My kids's school requires masks and I am happy about that but I ballpark that it is 90% emotional and not data driven at this point.
My understanding is that cloth masks only really work if everyone is wearing one. If not you need something more like a medical grade mask but those are expensive and not really practical for use in kids. I do send DD to school with her ON masks but honestly Delta is a whole new game. Who knows if it’s effective. If (when) DD gets Covid at least I will know I did everything I could.
The Daily podcast today is about questions regarding COVID and kids. The best thing I took out of it is the expert on the show said you need to decide what your #1 priority with your kids is right now and make decisions around that. So if your #1 priority is that they absolutely not get COVID (because of at risk family members etc), you make decisions around that (virtual learning etc). If your #1 priority is that they not fall further behind in school, you make decisions around that (accept some risk, send to in person but have them mask etc). It's the only perspective that really makes sense because there are risks, issues with any decision made.