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)

28 Pages Posted: 7 Mar 2022

See all articles by Ermengol Coma

Ermengol Coma

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Martí Català

University of Oxford

Leonardo Méndez-Boo

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Sergio Alonso

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

Eduardo Hermosilla

Universitat Autonoma de Barcelona - Idiap Jordi Gol

Enric Alvarez-Lacalle

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

David Pino

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

Manuel Medina-Peralta

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Laia Asso

Generalitat de Catalunya

Anna Gatell

Alt Penedès-Garraf Territorial Pediatric Team

Quique Bassat

University of Barcelona - Institut de Salut Global de Barcelona (ISGlobal)

Ariadna Mas

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Antoni Soriano-Arandes

Autonomous University of Barcelona - Paediatric Infectious Diseases and Immunodeficiencies Unit

Francesc Fina-Aviles

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Clara Prats

Polytechnic University of Catalonia (UPC) - Computational Biology and Complex Systems (BIOCOM-SC)

Date Written: March 1, 2022

Abstract

Background: Mandatory use of face covering masks (FCM) had been established for children aged six and above in Catalonia (Spain), as one of the non-pharmaceutical interventions aimed at mitigating SARS-CoV-2 transmission within schools. To date, the effectiveness of this mandate has not been well established. The quasi-experimental comparison between 5 year-old children, as a control group, and 6 year-old children, as an interventional group, provides us with the appropriate research conditions for addressing this issue.

Methods: We performed a retrospective population-based study among 599,314 children aged 3 to 11 years attending preschool (3-5 years, without FCM mandate) and primary education (6-11 years, with FCM mandate) with the aim of calculating the incidence of SARS-CoV-2, secondary attack rates (SAR) and the effective reproductive number (R*) for each grade during the first trimester of the 2021-2022 academic year, and analysing the differences between 5-year-old, without FCM, and 6 year-old children, with FCM.

Findings: SARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an age-dependent trend was observed. Children aged 3 and 4 showed lower outcomes for all the analysed epidemiological variables, while children aged 11 had the higher values. Six-year-old children showed higher incidence than 5 year-olds (3•54% vs 3•1%; OR: 1•15 [95%CI: 1•08-1•22]) and slightly lower but not statistically significant SAR and R*: SAR were 4•36% in 6 year-old children, and 4•59% in 5 year-old (IRR: 0•96 [95%CI: 0•82-1•11]); and R* was 0•9 and 0•93 (OR: 0•96 [95%CI: 0•87-1•09]), respectively.

Interpretation: FCM mandates in schools were not associated with lower SARS-CoV-2 incidence or transmission, suggesting that this intervention was not effective. Instead, age-dependency was the most important factor in explaining the transmission risk for children attending school.

Note:
Funding Information: CP and SA received funding from Ministerio de Ciencia, Innovación y Universidades and FEDER, with the project PGC2018-095456-B-I00.

Conflict of Interests: The authors declare that they have no conflict of interests.

Ethical Approval: The study was evaluated and approved by the Clinical Research Ethics Committee of the IDIAP Jordi Gol, Reference 21/018-PCV. This research was based on the agreement established in Regulation 2016/679 of the European Parliament and the Council of Europe of 27 April 2016 on Data Protection, and Organic Law 3/2018 of December 5 on the protection of personal data and the guarantee of digital rights.

Keywords: SARS-CoV-2, COVID-19, schools, masks, epidemiology, child

Suggested Citation

Coma, Ermengol and Català, Martí and Méndez-Boo, Leonardo and Alonso, Sergio and Hermosilla, Eduardo and Alvarez-Lacalle, Enric and Pino, David and Medina-Peralta, Manuel and Asso, Laia and Gatell, Anna and Bassat, Quique and Mas, Ariadna and Soriano-Arandes, Antoni and Fina-Aviles, Francesc and Prats, Clara, 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) (March 1, 2022). Available at SSRN: https://ssrn.com/abstract=4046809 or http://dx.doi.org/10.2139/ssrn.4046809

Ermengol Coma

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Barcelona
Spain

Martí Català

University of Oxford

Mansfield Road
Oxford, Oxfordshire OX1 4AU
United Kingdom

Leonardo Méndez-Boo

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Barcelona
Spain

Sergio Alonso

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

Eduardo Hermosilla

Universitat Autonoma de Barcelona - Idiap Jordi Gol

Enric Alvarez-Lacalle

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

David Pino

Universitat Politècnica de Catalunya (UPC Barcelona Tech)

Manuel Medina-Peralta

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP)

Barcelona
Spain

Laia Asso

Generalitat de Catalunya

Spain

Anna Gatell

Alt Penedès-Garraf Territorial Pediatric Team

Spain

Quique Bassat

University of Barcelona - Institut de Salut Global de Barcelona (ISGlobal) ( email )

Barcelona
Spain

Ariadna Mas

Institut Català de la Salut - Institut Català de la Salut (ICS), Barcelona

Barcelona
Spain

Antoni Soriano-Arandes (Contact Author)

Autonomous University of Barcelona - Paediatric Infectious Diseases and Immunodeficiencies Unit ( email )

Barcelona
Spain
+34639712438 (Phone)

Francesc Fina-Aviles

Institut Català de la Salut - Sistemes d’Informació dels Serveis d’Atenció Primària (SISAP) ( email )

Barcelona
Spain

Clara Prats

Polytechnic University of Catalonia (UPC) - Computational Biology and Complex Systems (BIOCOM-SC) ( email )

Castelldefels
Spain

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