Gov. DeSantis questions science behind school masking. What do the experts say?

Gov. Ron DeSantis is carving a new battle line in the COVID-19 fight, fighting against mandatory masks in school now being called for by some of the nation’s leading scientists and health organizations.

DeSantis criticizes the face coverings as uncomfortable for students and unhealthy for breathing – while highlighting some medical professionals who say masks can cause psychological harm.

Among the governor’s most damning criticism, though, is that science doesn’t support making masks a requirement in schools.

“There’s not very much science behind it,” DeSantis said of universal school masking, just days before the Centers for Disease Control and Prevention issued recommendations urging that all teachers, staff and students of K-12 schools to mask up, even if they are vaccinated.

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Leading health experts are stunned by DeSantis’ attack on the science behind school masking, pointing to a host of studies indicating that masks effectively limit COVID-19 transmission in the school setting. They argue there is strong evidence to show masks can keep infected individuals from spreading the virus on campus.

“In the school environment masks definitively limit COVID transmission. Full stop,” said Dr. Daniel Benjamin, a Duke University professor who led a North Carolina research study on COVID-19 transmission in schools. “You may or may not want to have masks as a matter of policy, but do masks work? Yes.”

An expert on pediatric infectious diseases, Benjamin was part of a team tapped by the state of North Carolina to study COVID-19 in schools.

Looking at 100 different school districts encompassing more than 1 million students and staff doing in-person learning, all of whom were required to wear masks, Benjamin’s team found extremely low transmission within schools.

The so-called “secondary attack rate” of the virus was 1% in the North Carolina study, meaning an infected individual who comes into close proximity with 100 people will infect one of them on average.

Benjamin pointed to a study done in Israel that documented a much higher secondary attack rate when students didn’t wear masks.

“Masking works,” Benjamin said, noting studies of COVID-19 in Utah, Missouri and Georgia schools produced results similar to his North Carolina research.

Benjamin is a medical doctor who also has a PhD in epidemiology. He said among “well-trained physicians and epidemiologists it’s not disputed” that masks protect against COVID-19 in schools.

For Florida’s governor, the clash over mandatory masking in schools – something DeSantis said Friday he will prohibit by executive order – is his latest break with conventional health experts over combating COVID-19.

It’s an echo of the defiance he showed when turning back calls to close beaches during last year’s spring break, his brief shuttering of the state’s economy and refusal to order a statewide mask order, leaving it to local governments to decide.

With the state adding a most-in-the-nation 73,000 new COVID-19 cases in one week this month and test positivity rates now in double digits, DeSantis again is embracing a conservative voting base hostile to recommendations from President Joe Biden’s administration and the scientific consensus, which supports the effectiveness of masks in schools.

Strong science on the efficacy of masks

Dr. Aileen Marty, an expert on infectious diseases at Florida International University, said the science demonstrating the efficacy of masks in the school setting is strong.

“Multiple recent studies conducted during the COVID-19 pandemic have repeatedly demonstrated the value of masks/facial coverings for reducing transmission in the general population and schools specifically,” Marty said in an email.

Dr. Sonja Rasmussen, a professor who teaches pediatric medicine and epidemiology at the University of Florida, also said the evidence supports masks as an effective tool against the spread of COVID-19 in schools.

“The data that I have reviewed supports mask-wearing in schools to decrease transmission of coronavirus,” Rasmussen said. “Kids are at low risk but they’re not at no risk, and some kids are at high risk – kids with obesity, kids with heart conditions, kids with other underlying conditions – and we need to keep in mind those kids are in schools and they are at risk.”

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The COVID-19 vaccines have not been approved yet for children younger than 12.

DeSantis has pointed to Florida data to criticize the scientific justification for masks in schools, raising the issue during three different events over the last week.

“There’s some schools we had didn’t do masks, others did, the outcomes were not meaningfully different,” DeSantis said during a news conference at Indian River State College.

The governor repeated that assertion Monday during a roundtable discussion at the state Capitol of school masking that featured a number of medical professionals who were critical of masks. 

Again noting that many Florida school districts required masks last year while others did not, DeSantis said “There was no difference in outcomes in any of these places.”

DeSantis also held a press conference Friday at a Cape Coral restaurant to criticize school masking, justifying his position by highlighting a paper that looked at COVID-19 mitigation efforts and infections at schools in Florida, New York and Massachusetts. The paper – which DeSantis called “very credible” – concluded that in Florida: “We do not see a correlation between mask mandates and COVID-19 rates among students.” 

DeSantis said this paper is proof that “districts that did not require masks did not perform statistically different than those who did ... and so we have to look at the data.”

But Benjamin said the Florida data analysis – which was conducted by a Brown University economics professor and other researchers – is of limited value when it comes to evaluating masks in schools.

‘Substantial weaknesses’

The problem with the Florida analysis is that it doesn’t look at whether students acquired COVID-19 in the school or in the community, Benjamin said.

“The Florida data has substantial weaknesses and is open to criticism,” Benjamin said.

The authors of the paper highlighted by DeSantis acknowledge the limitation of their analysis, stating that “our data only represent cases among people associated with schools, not cases spread in schools. Careful contact tracing would be helpful in focusing on the latter, but is not widely available.”

Benjamin’s North Carolina research – and the other research he cited – relies on contact tracing by public health officials to classify infections as community-acquired or school-acquired.

Focusing in on the school-acquired infections is essential to understanding whether masks are effective, Benjamin said.

Benjamin called the research methods in the paper DeSantis highlighted “weak relative to the industry standard used in human subjects medical research.”

“This paper suffers from trying to take population data and applying population correlations to individual risk,” he said in an email. “This technique was shown be invalid over 100 years ago ... So if you are looking for 19th century medicine and 19th century research methods quality, this paper is for you. Personally, I prefer 21st century for my pandemic management.” 

But with DeSantis dug in against mask requirements, many school districts across Florida have announced that masks will be optional for the upcoming year, defying recommendations by the American Academy of Pediatrics and the CDC to make masks mandatory on K-12 campuses.

School boards have been under withering pressure from parents on both sides of the mask divide.

Outside the Broward County School Board headquarters near downtown Fort Lauderdale, some 16 protesters burned masks last Tuesday morning – in advance of a School Board meeting.

School officials postponed the hearing, but later approved a mask mandate for the upcoming school year, defying DeSantis and making Broward an outlier among Florida districts, although the school superintendent in Palm Beach County said he also is weighing whether to make masks mandatory and Miami-Dade County school officials are exploring the mask issue.

Lisa Silva, a Palm Beach County parent, recently testified before her county’s School Board, saying that mask options are not enough – that they should be required.

“Sending our children, unmasked, unprotected, unvaccinated to school, sitting next to other unmasked children is not fair, it’s not right. That’s not protection,” Silva said.

Anti-mask pressure

DeSantis, though, has been ratcheting up the pressure on school districts to back away from mask mandates.

The governor first said he would call lawmakers to Tallahassee for a special legislative session to ban any effort by local school districts to require masks.

Then on Friday DeSantis said he would seek to stop mask mandates through executive order.

“Very soon I’ll be signing an executive order which directs the Florida Department of Education and Department of Health to issue emergency rules protecting the rights of parents to make this decision about wearing masks for their children,” DeSantis said.

The mask issue has roiled school districts.

“School board members are hearing concerns from parents and stakeholders on both sides of this issue, and ultimately want all students and families to be able to return to happy and healthy learning environments this fall,” said BillieAnne Gay, director of legislative services at the Florida School Boards Association.

Now the governor appears poised to come down decisively on the side of those fighting against mask requirements.

The conservative Moms for Liberty, with chapters in more than a dozen Florida counties, has been pushing back against any mask mandates.

“We want parents to be able to decide,” said Tina Descowich, a co-founder of Moms for Liberty and a former Brevard County School Board member. “They should be the ones who choose to mask their children or not.”

School children and mask-wearing has become muddled in the broader issue of personal freedom, which so many allies of the governor cite as a defense for those reluctant to mask, get vaccinated or change their behavior in the face of a global pandemic.

Sarasota County School Board member Bridget Ziegler recently ridiculed the idea of linking mandatory vaccinations to ending mask requirements.

“I don’t know why we have to keep going down this path, but I will keep fighting it vigorously,” Ziegler said. “I just think it’s a complete abuse of power.”

Follow Herald-Tribune Political Editor Zac Anderson on Twitter at @zacjanderson. He can be reached at zac.anderson@heraldtribune.com