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Association between K–12 school mask policies and school-associated COVID-19 outbreaks — Maricopa and Pima Counties, Arizona, July–August 2021
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September 24, 2021
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Series: MMWR; v. 70, ER, 9/21/21
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Description:CDC recommends universal indoor masking by students, staff members, faculty, and visitors in kindergarten through grade 12 (K–12) schools, regardless of vaccination status, to reduce Transmission of SARS-CoV-2, the Virus that causes COVID-19 (1). Schools in Maricopa and Pima Counties, which account for >75% of Arizona’s population (2), resumed in-person learning for the 2021–22 academic year during late July through early August 2021. In mid-July, county-wide 7-day case rates were 161 and 105 per 100,000 persons in Maricopa and Pima Counties, respectively, and 47.6% of Maricopa County residents and 59.2% of Pima County residents had received at least 1 dose of a COVID-19 vaccine. School districts in both counties implemented variable mask policies at the start of the 2021–22 academic year (Table). The association between school mask policies and school-associated COVID-19 outbreaks in K–12 public noncharter schools open for in-person learning in Maricopa and Pima Counties during July 15–August 31, 2021, was evaluated.
A school was considered to have a mask requirement if all persons, regardless of vaccination status, were required to wear a mask indoors in School An early mask requirement was one that was in place when the school year began, and a late mask requirement was one that was implemented any time after school began. Mask policies were abstracted from publicly available school COVID-19 mitigation plans, which must be posted online per Executive Order 2020–51. A school-associated outbreak was defined as the occurrence of two or more laboratory-confirmed COVID-19 cases§ among students or staff members at the school within a 14-day period and at least 7 calendar days after school started, and that was otherwise consistent with the Council for State and Territorial Epidemiologists 2020 outbreak definition and Arizona’s school-associated outbreak definition. In Arizona, school-associated outbreaks are required to be reported to the local public health agency within 24 hours; data are stored in Arizona’s Medical Electronic Disease Surveillance Intelligence System. School characteristics, including county of location, grade levels present, enrollment, and Title I status (a measure of a school population’s socioeconomic status) were obtained from the Arizona Department of Education Crude and adjusted logistic regression analyses with 95% confidence intervals (CIs) were performed in Stata (version 15; StataCorp) and adjusted for school county, enrollment size, grade levels present, Title I status, and 7-day COVID-19 case rate in the school’s zip code during the week school commenced. Schools with late mask requirements were excluded from these analyses because of their mixed exposure status during the sampling time frame (e.g., schools might have enacted mask requirements after an outbreak). Vaccination coverage for staff members and students was not available at the school level.
Suggested citation for this article: Jehn M, McCullough JM, Dale AP, et al. Association Between K–12 School Mask Policies and School-Associated COVID-19 Outbreaks — Maricopa and Pima Counties, Arizona, July–August 2021. MMWR Morb Mortal Wkly Rep. ePub: 24 September 2021.
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