The following is an excerpt from the Initial Fall School Reopening Guidance released on June 25, 2020 by the Commonwealth of Massachusetts:
At this time, these are the health and safety practices that will enable the safe reopening of schools for in-person learning this fall. These requirements will be modified as needed during the summer and into the fall. In addition to required practices, we have also included guidance on best practices where applicable.
As general background, COVID-19 spreads when people are in relatively close proximity, through respiratory droplets generated through coughing, sneezing, or talking to an infected person. Among the most effective preventive measures – when used consistently and in combination – are masks/face coverings, physical distancing, handwashing, and cleaning frequently touched surfaces.[i]
Masks/face coverings: As the primary route of transmission for COVID-19 is respiratory,[ii] [iii] [iv] masks or face coverings are among the most critical components of risk reduction.[v] [vi] [vii] Masks/face coverings protect the general public against COVID-19 infection,[viii] with a recent retrospective study estimating near 80% effectiveness in reducing COVID-19 transmission, especially when worn prior to symptom onset.[ix] In the United States, states advising face masks/face coverings be worn in public saw a decline in their COVID-19 growth rates,[x] and community-wide mask/face covering usage contributed to control of COVID-19 in Hong Kong.[xi] At this time, our initial requirements and related guidance are as follows:
- Students in grade 2 and above are required to wear a mask/face covering that covers their nose and mouth. Students in kindergarten and grade 1 should be encouraged to wear a mask/face covering.[xii] Face shields may be an option for those students with medical, behavioral, or other challenges who are unable to wear masks/face coverings. Transparent masks may be the best option for both teachers and students in classes for deaf and hard of hearing students. They may also be useful for teachers and younger students who rely on visual / facial cues.
- Adults, including educators and staff, are required to wear masks/face coverings.
- Exceptions to mask/face covering requirements must be made for those for whom it is not possible due to medical conditions, disability impact, or other health or safety factors.
- Mask breaks should occur throughout the day.[xiii] Breaks should occur when students can be six feet apart and ideally outside or at least with the windows open. Further guidance on mask breaks including duration and frequency will be forthcoming, as well as more information about properly removing and putting on masks.
- Masks/face coverings should be provided by the student/family, but extra disposable face masks should be made available by the school for students who need them. Reusable masks/face coverings provided by families should be washed by families daily. Districts and schools with families experiencing financial hardship and unable to afford masks/face coverings should endeavor to provide masks for students through grant funds described earlier in this document.
- Masks/face coverings are required to be worn by everyone on the bus during school bus transportation.
- Transparent face coverings provide the opportunity for more visual cues and should be especially considered as an alternative for younger students, students who are deaf and hard of hearing, and their teachers.
Physical distancing: Physical distancing is another important practice that helps mitigate transmission of the virus. While the U.S. federal CDC has recommended maintaining a physical distance of six feet between individuals,[xiv] the World Health Organization’s guidance states approximately three feet.[xv] There is no precise threshold for safety; indeed, studies suggest that physical distancing of three feet or more leads to reduced transmission, with additional distance providing additional protection. [xvi] [xvii] For instance, in a study of household transmission in China, keeping at least three feet of distance was associated with one-fourth the number of transmissions.[xviii] It is important to note that six feet distancing is emphasized in public health advisories especially when no mask/face covering is worn.
We encourage districts and schools to aim for six feet of distance between individuals where feasible. At the same time, a minimum physical distance of three feet has been established when combined with the other measures outlined in this list of safety requirements. Because of the reduced susceptibility in children and lower apparent rates of transmission, establishing a minimum physical distance of three feet is informed by evidence and balances the lower risk of COVID-19 transmission and the overarching benefits of in-person school.
View full Initial Fall School Reopening Guidance (Mass.gov)
[i] CDC, How COVID-19 spreads. (2020, June 16). Available at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html
[ii] Zhang, Renyi, et al. "Identifying airborne transmission as the dominant route for the spread of COVID-19." Proceedings of the National Academy of Sciences (2020).
[iii] CDC., et al. "Coronavirus Disease 2019 in Children—United States, February 12–April 2, 2020." Morbidity and Mortality Weekly Report 69.14 (2020): 422.
[iv] World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific brief, 27 March 2020. No. WHO/2019-nCoV/Sci_Brief/Transmission_modes/2020.1. World Health Organization, 2020. Available at: https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
[v] Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., ... & Liu, B. (2020). Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Global Health, 5(5), e002794. Available at https://gh.bmj.com/content/bmjgh/5/5/e002794.full.pdf
[vi] Lyu, W. and Wehby, G. L. (2020). Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Affairs. Available at https://doi.org/10.1377/hlthaff.2020.00818
[vii] Cheng, V. C., Wong, S. C., Chuang, V. W., So, S. Y., Chen, J. H., Sridhar, S., ... & Yuen, K. Y. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. Available at https://www.journalofinfection.com/article/S0163-4453(20)30235-8/pdf
[viii] Chu, D.K., Akl, E.A., Duda S., Solo K., Yaacoub S., Schunemann H.J. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet
[ix] Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., ... & Liu, B. (2020). Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Global Health, 5(5), e002794. Available at https://gh.bmj.com/content/bmjgh/5/5/e002794.full.pdf
[x] Lyu, W. and Wehby, G. L. (2020). Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US. Health Affairs. Available at https://doi.org/10.1377/hlthaff.2020.00818
[xi] Cheng, V. C., Wong, S. C., Chuang, V. W., So, S. Y., Chen, J. H., Sridhar, S., ... & Yuen, K. Y. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. Available at https://www.journalofinfection.com/article/S0163-4453(20)30235-8/pdf
[xii] http://www.sickkids.ca/PDFs/About-SickKids/81407-COVID19-Recommendations-for-School-Reopening-SickKids.pdf (if masks are worn incorrectly, they may increase infection risk). See also: https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en
[xiii] Chu, D.K., Akl, E.A., Duda S., Solo K., Yaacoub S., Schunemann H.J. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet (the challenges of constant mask wearing include “frequent discomfort”)
[xiv] CDC, Social Distancing, Quarantine, and Isolation. (2020, May 6). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
[xv] WHO, Considerations for school-related public health measures in the context of COVID-19. (2020, May 10). Available at https://www.who.int/publications/i/item/considerations-for-school-related-public-health-measures-in-the-context-of-covid-19
[xvi] Chu, D.K., Akl, E.A., Duda S., Solo K., Yaacoub S., Schunemann H.J. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet
[xvii] Zhang, J., Litvinova, M., Liang, Y., Wang, Y., Wang, W., Zhao, S., ... & Ajelli, M. (2020). Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China. Science. Available at https://science.sciencemag.org/content/early/2020/05/04/science.abb8001
[xviii] Wang, Y., Tian, H., Zhang, L., Zhang, M., Guo, D., Wu, W., ... & Liu, B. (2020). Reduction of secondary transmission of SARS-CoV-2 in households by face mask use, disinfection and social distancing: a cohort study in Beijing, China. BMJ Global Health, 5(5), e002794. Available at https://gh.bmj.com/content/bmjgh/5/5/e002794.full.pdf