Journal Article

Unravelling the role of the mandatory use of face covering masks for the control of SARS-CoV-2 in schools: a quasi-experimental study nested in a population-based cohort in Catalonia (Spain)

Fina Avilés, Francesc, Coma, Ermengol, Medina, Manuel, Català, Martí, Alonso, Sergio, Soriano-Arandes, Antoni, Bassat, Quique, Alvarez-Lacalle, Enric, Mas, Ariadna, Asso, Laia, Gatell, Anna, Méndez-Boo, Leonardo, Pino, David, Hermosilla, Eduardo, Prats, Clara

2023

Overview

ObjectiveTo assess the effectiveness of mandatory use of face covering masks (FCMs) in schools during the first term of the 2021–2022 academic year.DesignA retrospective population-based study.SettingSchools in Catalonia (Spain).Population599 314 children aged 3–11 years attending preschool (3–5 years, without FCM mandate) and primary education (6–11 years, with FCM mandate).Study periodFrom 13 September to 22 December 2021 (before Omicron variant).InterventionsA quasi-experimental comparison between children in the last grade of preschool (5 years old), as a control group, and children in year 1 of primary education (6 years old), as an interventional group.Main outcome measuresIncidence of SARS-CoV-2, secondary attack rates (SARs) and effective reproductive number (R*).ResultsSARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an increasing trend with age was observed. Six-year-old children showed higher incidence than 5 year olds (3.54% vs 3.1%; OR 1.15 (95% CI 1.08 to 1.22)) and slightly lower but not statistically significant SAR (4.36% vs 4.59%; incidence risk ratio 0.96 (95% CI 0.82 to 1.11)) and R* (0.9 vs 0.93; OR 0.96 (95% CI 0.87 to 1.09)). Results remained consistent using a regression discontinuity design and linear regression extrapolation approaches.ConclusionsWe found no significant differences in SARS-CoV-2 transmission due to FCM mandates in Catalonian schools. Instead, age was the most important factor in explaining the transmission risk for children attending school.

• Publisher: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health,BMJ Publishing Group LTD
• Subject: Age / Child / child health / Child, Preschool / Children / Childrens health / Clinical Diagnosis / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / COVID-19 vaccines / Disease control / Disease transmission / Education / Educational Testing / Elementary Education / Elementary school students / epidemiology / Face / Humans / Infections / Masks / Observational studies / Original research / paediatrics / Pediatrics / Politics of Education / Population / Population studies / Population-based studies / Preschool children / Preschool education / Primary Education / Quarantine / Quasi-experimental methods / Quasiexperimental Design / Regression (Statistics) / Research Design / Retrospective Studies / SARS-CoV-2 / School Buildings / Schools / Severe acute respiratory syndrome coronavirus 2 / Spain - epidemiology / Statistical analysis / Students / Teaching Methods / Test Results