Pediatricians urge leaders to take strong stance on masks in schools

Local doctors urging masks in schools

BIRMINGHAM, Ala. (WBRC) - Governor Kay Ivey’s statewide mask order is set to expire before the school year starts in August, although it can be extended. Some doctors say it should be in place in the fall and students and teachers should be required to wear masks in schools.

“Our goal is to have our children back in school in the fall and the question now is how do we do that safely,” said Dr. Kelli Tapley, Pediatrician.

Pediatrician Dr. Kelli Tapley and well over 100 other physicians across Jefferson County and the state - believe safety starts with masks in schools.

Dr. Tapley penned a personal letter to county leaders and superintendents asking for the enhanced safety measure. She also helped write and send an additional letter, signed by over 100 doctors in the state, urging leaders to not treat masks in schools as a recommendation.

“COVID is keeping us humble, as it should. We don’t know everything yet. At the beginning of the pandemic, we didn’t think community spread was a big problem,” said Dr. Tapley.

Doctors have concerns as we prepare to bring thousands of students and teachers back into buildings.

Dr. Tapley says parents should talk with their child’s pediatrician as they make plans for the fall. She plans to send her children back to school, with masks. She says research has shown that it’ll help her children protect themselves and those around them.

“My children were taught to love others as we love ourselves,” said Dr. Tapley, “Which means regardless of what the school’s policy is, my children will wear masks.”

The letter from the doctors also urges districts to look into more outdoor learning options that would allow for more social distancing, hand washing schedules incorporated into the school day, and temperature screenings.

The mask issue is something state school leaders are also weighing. During Tuesday’s state school board meeting, board member Dr. Tommie Stewart said even though they can’t mandate face masks in schools, they should urge districts to make it mandatory.

The state has ordered face masks for students and teachers to wear if the district puts that measure in place.

Below is a copy of the letter sent by doctors:

Re: Best Practices regarding Re-Opening Schools

To Whom it May Concern,

We, the undersigned, are physician parents who work and live in the greater Birmingham area. We appreciate the countless hours you have spent responding to the COVID19 pandemic. As physicians serving on the frontlines with a vested interest in our patients and children, we wish to endorse the below evidence-based guidelines to re-open Alabama schools. As a group we agree with the American Academy of Pediatrics (AAP) that the goal of re-opening schools should focus on children returning to school physically and safely. While there are data showing children are less likely to spread COVID19 and less likely to have severe disease compared to adults, this is still a very serious illness. Among the 983 COVID deaths in Alabama to date, two have been children. We believe that schools can and should re-open in a meaningful and sustainable way. However, this is a novel virus and will require a novel response to control the spread in schools. These are our medical recommendations to aid in our common goal of safe schools for this upcoming school year:

· Face coverings must be mandated when indoors. These include medical masks, reusable fabric masks, gaiters or clear face shields. With very few medical exceptions, children over 2 can be taught to wear these for extended periods of time. Universal masking is crucial to controlling spread of COVID19 because the wearers’ mask protects others. If only a few wear them, they are not effective. A mandate is the best way to ensure universal face coverings. Parents will need time and resources to teach their children how to wear face coverings. Just like riding a bike or any other skill, children must be taught and encouraged to maintain their skills. We can partner with schools to develop tools for education, but the mandate needs to be step one. From a medical standpoint, face coverings are the best chance schools have to re-open and stay open.1

· Access to soap, water and paper towels with frequent hand-washing breaks coupled with sanitizer stations throughout the school will help decrease spread. Sanitizing spray and paper towels to wipe down frequently touched surfaces is an alternative to sanitizing wipes that are in short supply.1

· Educate parents on the critical importance of keeping children home when ill. While activities like daily on-site temperature screening make us feel safer, these screenings have not been shown to reduce risk of spread in a meaningful way. We have also found that some families will answer “no” when being screened for illness or exposure only to reveal a significant history of illness or exposure later in the visit. This observation does not mean these processes should not be used, but they are limited in efficacy and must be used in combination with other safe guards.

· Temperature screening must balance the practicality and resources of performing these screening procedures for large numbers of students and staff with the information known about how children manifest COVID-19 infection, the risk of transmission in schools, and the possible lost instructional time to conduct the screenings.”1

· Use all available outdoor spaces in creative ways to give kids more time outside. Gathering outdoors is inherently safer during a pandemic. Outdoor time will also give kids breaks from face coverings. Thinking creatively about outdoor spaces for lunch and snacks would enable more typical socialization while eating. Opening windows in classrooms and other spaces would also improve ventilation and reduce risk.1

· Offer varying hybrids of in person attendance and eLearning. Parents should be given flexibility to change at certain intervals (nine weeks or semester) to account for changing needs and special conditions such as family work constraints or illness. While we want all children to have an option to be in school, reduction in volume of students in the school on a daily basis will inherently make controlling and containing viral spread easier. 1,2

· Develop a COVID prevention plan for all school activities and modify or eliminate high-risk activities. Some of the high risk activities include assemblies, indoor singing, indoor use of wind instruments, spectators at sporting events, crowded locker rooms, parental visits. Some activities that are high risk are also necessary like eating lunch or snacks and pick-up/drop-off. Those activities will need staggered schedules, scrutiny, and creative planning to reduce risks.

· Develop and communicate a clear plan for classroom or school wide outbreaks. COVID outbreaks will be a part of the 2020-2021 school year. Local pediatricians are already seeing similar outbreaks in daycares, summer sports leagues, and camps. Because COVID19 symptoms can be very mild and often do not involve a fever in children, diagnosis and containment of outbreaks is especially complex. Adding to the difficulty of this task is the fact that our best test available has a 20-30% false negative rate.3

· Face Coverings will reduce the need for quarantine. We know that people infected with COVID19 can spread the virus for up to 14 days, with or without symptoms. The current recommendation by the Jefferson County Department of Public Health is that students return to school 14 days after a positive test was collected or 14 days from symptom start as long as symptom free for 3 days without any medications such as Tylenol or Motrin. If a student or staff has a close contact with someone who is infected (more than 15 min, less than 6 feet, indoors without a face covering), they will meet criteria for a 14 day quarantine. If that same interaction involved face coverings for both parties involved, the interaction is no longer considered a close contact.

· Flu vaccines will be especially important this season. We hope all schools will encourage students to vaccinate against influenza this season. We do not currently know what co-infection with influenza and COVID19 will look like. We hope families will reduce the risk of infection by choosing to vaccinate.

2. Cooks Children’s Hospital Recommendations for the Practical, Fair, and Safe Reopening of Public Schools K-12 in the State of Texas.

3. Ai Tang Xiao, Yi Xin Tong, Chun Gao, Li Zhu, Yu Jie Zhang, Sheng Zhang,Dynamic profile of RT-PCR findings from 301 COVID-19 patients in Wuhan, China: A descriptive study, Journal of Clinical Virology, Volume 127, 2020, 104346, ISSN 1386-6532

In closing, we wish to serve as a resource and want to work together to reach our common goal of ensuring a safe and sustainable return to school. We are especially passionate about this process as we will be the ones taking care of patients and families affected by COVID19. We are on the front lines of fighting this horrifying pandemic and see, firsthand, the fear, the pain and the devastation families experience. We greatly appreciate your consideration of our input. Please reach out to us for any further needs, including additional references.

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