SACRAMENTO (CBS13) — Two groups of parents from across the state filed a lawsuit on Thursday, suing the governor and the California Department of Public Health over school mask mandates and other COVID protocols.
In light of the growing Delta variant, even some who once supported their fight are now recommending masks in schools to start the year.
However, a growing number of infectious disease experts from across the county are urging health officials to set a data-based threshold for school masking, with a clear endpoint based on low community transmission.
Northern California parents from the Re-open California Schools Facebook group filed a joint lawsuit with the Southern California-based Let Them Breathe group that successfully sued the state to reopen schools.
In addition to challenging the state’s quarantines and asymptomatic testing guidance, the complaint calls on the state to end school mask mandates.
It asks the court to find the state’s current school mask guidance, “invalid and unlawful to the extent (the state) treat(s) it as mandatory for all students and schools.”
The complaint also asks for “(a) declaration that the July 2021 guidance related to mandatory masking, quarantines and COVID-19 testing is invalid and unlawful to the extent (the state) treat(s) it as mandatory for all students and schools.”
The complaint cites data to support their argument that children are at low risk of severe symptoms or death from COVID-19.
The complaint also argues that children “rarely spread COVID 19,” citing studies that, the plaintiffs argue, indicate mask mandates “do not impact student or teacher infection rates”. It also points to CDC data and findings to support their argument.
“The CDC reports, ‘staff-to-student and student-to-student transmission are not the primary means of exposure to SARS-CoV-2 among infected children.’ Additionally, ‘students are not the primary sources of exposure to SARS-CoV-2 among adults in school setting.’”
“Based on a CDC report of data from November and December 2020 – prior to vaccine availability and during higher case prevalence – ‘lower incidence in schools that required mask use among students was not statistically significant compared with schools where mask use was optional.’20”
School Masking Data
Parents also point to a lack of school-specific evidence that masks prevent COVID spread in classrooms.
“That’s a fair point,” said UCSF infectious disease expert Dr. Monica Gandhi.
“(The school masking data) isn’t actually based necessarily on good studies in children. It’s based on the idea that there’s a physical science principle of blocking the mouth and nose. It has been shown in other studies and in adults. We just know that barrier methods work,” she said.
Some of the parents behind the lawsuit argue that many mask studies are predicated on properly-worn masks. They point to stories from teachers and administrators who acknowledge students often adjust or pull their masks down in class.
“If people say there’s no data in schools, that’s just not true,” adds Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital. He points to several studies that, he says, prove the benefits of masks in schools (linked here, here, here, and here).
The parents’ lawsuit also argues that “masks harm children”. The complaint cites data, studies and commentary related to negative health effects and impacts to learning.
“The vast majority of children that I see wear masks without a problem,” Blumberg said in response. “They wear them routinely. It doesn’t bother them. They’re resilient.”
“What’s changed is the Delta variant”
For her part, Dr. Gandhi initially supported the parents’ fight to reduce mandatory masking in schools. She was one of many advocating to remove some COVID-19 restrictions for students in light of increasing vaccination rates and decreasing COVID rates.
Last month, she pointed to data that indicates high vaccination rates among adults has a ripple effect and reduces transmission even among the unvaccinated, including kids.
She also cited studies that show little difference in transmission between masked and unmasked students. “Which actually speaks to the fact that children are less likely to transmit and also get, COVID-19,” Dr. Gandhi said in June.
But Gandhi has recently changed her recommendation for the start of the school year.
“What’s changed is the Delta variant,” she explained.
In light of increasing case rates from the highly transmissible variant, Gandhi believes masks in schools are needed right now to get all kids back safely — especially where physical distance in classrooms and vaccinations aren’t an option.
However, Gandhi is also among a growing number of infectious disease experts from across the county who are urging health officials to set a data-based threshold for school masking, with a clear endpoint based on low community transmission.
“This sort of appeases both sides,” Gandhi said. “The problem with this entire pandemic is no one has known when things end and when things start. We need a point at which there’s an off-ramp from masking in schools because of the implications for socialization.”
She, along with other infectious disease experts, recommend relaxing school mask mandates when vaccination rates are above 67 percent and COVID-19 hospitalizations are below five per 100,000 people.
“That is the metric at which community transmission is low enough to relieve masking mandates,” she said.
Notably, based on current vaccination rates and COVID hospitalizations, masks would be required in schools today based on that metric.
“It will be required right now,” she acknowledges, “but if you know something’s going to end, it’s easier to take that rule.”
Others question whether setting a mask threshold is possible with rapidly changing variants.
“I think that’s nice in theory, but I’m not sure you’re going to get everybody to agree what an appropriate threshold is, Dr. Blumberg said.
He says vaccination thresholds, for instance, “are a moving target.”
“I think we’ll see the end to masking guidelines when we have… a large portion of the population that’s immune from either vaccination or previous infection so that we don’t have widespread community transmission and outbreaks,” Blumberg clarified.
He added that some people may choose to indefinitely keep wearing masks — similar to some in Asian countries who mask seasonally to prevent the flu.
But Dr. Gandhi believes, in the meantime, a clear mask mandate metric will ease frustration for parents on both sides of the mask debate.
“It makes everyone feel better — knowing a clear metric of when (the masks) can come off.”
In response to the lawsuit, CDPH provided the following statement:
“CDPH doesn’t comment on litigation, but the data and science is unequivocal – there’s no substitute for in-person instruction, and California’s COVID-19 prevention strategies are the best way to fully open our schools while protecting students and staff. The state’s guidance, which aligns with the CDC and the American Academy of Pediatrics, is how we keep our kids safe and start the school year fully in-person.”