The Delta variant of COVID-19 is “several-fold” more transmissible than the Alpha variant, making mask mandates in schools more important than ever, a Duke University professor of pediatrics said Wednesday.
Dr. Danny Benjamin’s advice comes as most of North Carolina’s 1.5 million school children prepare to return to classrooms, and school boards wrestle with whether to adopt mask mandates amid surging COVID infections.
“It [the Delta variant] will make secondary attack rates in the unmasked setting much higher,” Dr. Danny Benjamin said. “It will result in much more quarantine, and it will result in faster school closures as a result of multiple clusters.”
Benjamin is part of the ABC Science Collaborative at Duke that has partnered with UNC-Chapel Hill researchers to help school districts develop best practices to address the coronavirus pandemic. He made his comments as part of a panel assembled to discuss the best way for students to return to school safely.
Nearly 50 of the state’s 115 school districts have made face coverings optional to start the 2021-22 school year. The NC School Boards Association has begun maintaining a data base  to track whether districts require masks.
Benjamin said masks should be required in school settings to help staff members protect vulnerable family members and unvaccinated students from serious illness or death. Children under 12 are ineligible for the vaccine, which means most elementary school students cannot receive it.
A high school custodian, for example, can get the vaccine to protect himself but contract and spread the virus to his children who are too young for the vaccine or to vulnerable family members, Benjamin said.
“When school boards vote to not have masking in place with the Delta variant here, this is what they’re going to be asking of their staff every day as it relates to a work and learning environment,” Benjamin said.
State health officials reported 3,413 new cases of COVID-19 on Wednesday, for a daily percent positive rate of 12.2%. There were 1,580 people hospitalized due to COVID-19.
School employees in districts that don’t require masks can experience high levels of stress, said Robin Gurwitch, a professor in psychiatry and behavioral sciences at the Duke University School of Medicine.
School workers such as bus drivers and custodians must often go to work in unsafe environments despite their fears about getting sick or putting family members at risk of COVID-19.
“There are many families that don’t have the luxury of work from home,” Gurwitch said. “They are essential workers. [They] can’t work from home if janitorial staff or school bus driver.”
Gov. Roy Cooper lifted the statewide mask mandate and is encouraging everyone eligible to get the vaccine to do so. North Carolina also updated its StrongSchoolsNC Public Health Toolkit  to place it an alignment with guidance issued by the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics. The guidance urges districts to do everything possible to keep students in schools and emphasizes continued masking.
The Toolkit says schools with students in Kindergarten through eighth grade should require all children and staff to wear masks indoors, regardless of vaccination. That gives districts the option to require masks.
The Duke panel shared its wisdom a day after the Wake County Public School System, the state’s largest school district, adopted rules requiring all students and staff to wear masks to begin the school year regardless of vaccination status.
The school board said a mask mandate gives the district the best chance to keep students in school full-time for in-person learning.
“This decision for me, I’m making, is saying we have a best option of keeping, at the end of the day, our students in-person learning and remaining in-person learning and decreasing the time that these students are quarantined if we make the decision to mandate masks,” said school board member Monika Johnson-Hostler.
School board chairman Keith Sutton frequently reminded visitors to respect each other’s differences over masking during Tuesday’s raucous meeting, at which parents and others spoke in favor and against mask mandates.
“My request is simple; just be respectful of our speakers,” Sutton asked. “This goes for both our speakers and those in the audience.”
The Wake County school board meeting highlighted how deeply divided North Carolinians are over requiring students and teachers to wear masks.
Other school boards that adopted mask mandates such as those in Charlotte and Greensboro have faced stiff opposition from parents who contend face coverings are not needed in schools.
During the Wake County school board meeting, Julie Page hit all of the frequently voiced — and false — talking points of those opposed to face masks: children recover quickly from COVID infections, paper and cloth masks are not effective, the vaccines don’t prevent COVID, and the available vaccines are not approved by the Federal Drug Administration.
“As your constituents and your bosses, we are the parents and we demand our right to decide what is best for our kids,” said Page, who believes masks should be optional. “We have the right to freedom of choice in this country. It’s time to get our liberty to back.”
Among the 11 states reporting, children account for 19% of weekly cases from July 22-29 — more than 71,000 cases — according to the American Academy of Pediatrics . Those figures are an increase of 3% over the previous two weeks.
More than 4.1 million children have tested positive for the virus since the pandemic began in 2020; of that total North Carolina accounts for more than 100,000 cases in children.
Science has shown that masks, worn correctly, decrease  the spread of the virus. The science has also shown that vaccines are 90% to 95% effective against COVID;  if vaccinated people do contract the virus, their symptoms tend to be milder and the length of the disease is shorter. As for the Delta variant, the vaccines are still protective against severe disease that would require hospitalization, or worse — death.
The FDA has authorized three vaccines for emergency use : Pfizer, Moderna and Johnson & Johnson. Pfizer has since applied to the FDA for full approval.
While the academy’s report says “it appears that severe illness due to COVID-19 is uncommon among children … there is an urgent need to collect more data on longer-term impacts of the pandemic on children, including ways the virus may harm the long-term physical health of infected children, as well as its emotional and mental health effects.”
Meanwhile, supporters of a mask mandate countered that masks and vaccines are safe and effective and are the surest way to help students return to safely return to classrooms, full time for in-person instruction.
“There has been a lot of information as well as misinformation on the topic of masking along with some very strong opinions, but what it boils down to is masks are safe and effective and are our best defense against COVID infection, lengthy quarantines and school closures,” said Audey Veach, a pediatrician with four children in the Wake County school system.
Michele Benoit-Wilson, a Wake County physician and the mother of two teenagers, also spoke in favor of a mask mandate.
Her impatience with those opposed to it was evident even though her facial expressions were hidden under a mask. One could hear it in her voice.
“We stand before you as physicians knowing that masks work,” said Benoit-Wilson, who was flanked by nearly a dozen colleagues. “We know that masks work because we are here after taking care of hundreds and thousands of COVID patients in the hospitals.”