Addressing the uncertainties in schools caused by the delta variant

In the early summer of 2021, the upcoming school year seemed to be radically different from the one it just ended. Vaccination coverage in adults remained relatively high. A vaccine was available for children as young as 12 years old and proved to be highly effective against variants. After that, the highly contagious delta variant, together with a sharp drop in vaccination coverage, changed the landscape again. The Infectious Diseases Society of America (IDSA) held a press conference to discuss what all this means for the 2021-2022 school year.

Jason Newland, MD, Med, professor of pediatrics and infectious diseases at Washington University School of Medicine in St. Louis, Missouri, stated that many more children are being diagnosed with COVID-19. The American Academy of Pediatrics weekly report from August 19, 2021 to August 26, 2021 found 203,962 pediatric cases for the period and that children accounted for nearly a quarter of the total number of weekly reported cases. Newland emphasized that the layered approach of masking, social distancing, vaccination if possible, ventilation and doing outdoor activities if possible is the best approach to prevent transmission. He noted that in several schools that had face-to-face lessons during the winter wave and also used those techniques, the transfer rate was only 1%, compared to the 50% transfer rate seen in previous variants when no mitigation strategies were used.

Noelle Ellerson Ng, associate executive director of policy and advocacy for AASA, the School Superintendents Association in Alexandria, Virginia, said the school’s launch was a mixture of the usual excitement with concerns about the highly contagious nature of the delta variant and what schools do to keep children safe. She said combining the know-how of education and public health experts could lead to effective mitigation policies for districts. Creating local mitigation strategies is the solution that would work best. Ng noted that some state-level officials took a heavy-handed approach that was unnecessary.

Discussing the vaccine, Newland said the vaccination coverage needed for herd immunity is unknown, but the current rate of 52% is certainly not close enough. He recommended that clinicians and other health officials continue to promote and recommend the vaccine for the currently eligible population, and that health care providers should begin conversations about the vaccine with families who have children under the age of 12 to ensure high levels of administration when authorized.

The briefing concluded with a look at the lack of uniformity in masks in schools. Newland pointed to the large number of children who negatively impacted distance learning and that a lack of mask mandate could mean that a significant proportion of children have to return to a learning environment that did not work. Ng said that many children have been wearing masks comfortably and correctly for over a year and that it is not the children who have difficulty wearing masks. She noted that there are thousands of school districts with a variety of dress codes that have no problem with enforcement, and that mask mandates can be seen as a face dress code. Newland said any mask that meets the recommendations of the Centers for Disease Control and Prevention should work for mitigation strategies, as long as the mask is worn properly over the chin and nose.


1. Newland J, Ng N. Back to school + delta variant = uncertainty. Infectious Diseases Society of America Press Briefing. September 2, 2021; Online.

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