A Look at DESE's Cited Sources: Footnote #33 - COVID-19: Prevention of infection spread

DESE Claim: "In addition to the WHO, several other countries including Denmark, France, China, and Hong Kong recommend one meter (approximately three feet) distance in schools."

Cited Source: Denmark National Board of Health, COVID-19: Prevention of infection spread. (2020, May 10). Available at https://www.sst.dk/da/Udgivelser/2020/COVID-19-Forebyggelse-af-smittespredning

Peer Reviewed?: No (government public health guidance)

Study Methodology: N/A (government document)

Notes: I used Google Translate on the page since I do not speak Danish. However, I could not translate the PDF document referenced. On this page on the English version of the site, there is mention of 1-2 meters of social distancing. 

Supports DESE Claim?: Yes, it seems Denmark recommends 1 meter distancing.

A Look at DESE's Cited Sources: Footnote #31 - Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China

DESE Claim: "There is no precise threshold for safety; indeed, studies suggest that physical distancing of three feet or more leads to reduced transmission, with additional distance providing additional protection"

Cited Source: Zhang, J., Litvinova, M., Liang, Y., Wang, Y., Wang, W., Zhao, S., ... & Ajelli, M. (2020). Changes in contact patterns shape the dynamics of the COVID-19 outbreak in China. Science. Available at https://science.sciencemag.org/content/early/2020/05/04/science.abb8001

Peer Reviewed?: Yes

Study Methodology: Mathematical modeling and contact tracing "we analyze contact survey data for Wuhan and Shanghai before and during the outbreak and contact-tracing information from Hunan province"

Notes: This study determined that during the outbreak, people in Wuhan and Shanghai had contact with fewer people than they did before the outbreak. Schools were closed during the study period in these cities, so most children were only in contact with members of their households. During the study, people "decreased daily contacts, essentially reducing them to household interactions. This led to a dramatic reduction of SARS-CoV-2 transmission." 

Supports DESE Claim?: Limited. The study says strict stay-home and physical distancing help reduce the spread of COVID-19. They do not address the specific parameters distancing.

A Look at DESE's Cited Sources: Footnotes #29 and #39 - Considerations for school-related public health measures in the context of COVID-19

DESE Claim 1 (footnote #29): "the World Health Organization’s guidance states approximately three feet" of physical distancing is advisable.

DESE Claim 2 (footnote #39): "Distancing requirements: As reviewed and advised by the Massachusetts COVID-19 Command Center Medical Advisory Group, schools should aim for a physical distance of six feet when feasible, and three feet is the minimum distance allowed"

Cited Source: WHO, Considerations for school-related public health measures in the context of COVID-19. (2020, May 10). Available at https://www.who.int/publications/i/item/considerations-for-school-related-public-health-measures-in-the-context-of-covid-19

Peer Reviewed?: No. Public health guidance.

Study Methodology: N/A. Public health guidance.

Notes: This report acknowledges that risk to all stakeholders must be considered in school reopening decisions. "Deciding to close, partially close or reopen schools should be guided by a risk-based approach to maximize the educational and health benefit for students, teachers, staff, and the wider community, and help prevent a new outbreak of COVID-19 in the community". DESE does not address this part of the article, however. The WHO article also indicates that physical distancing can be hard for younger students. This is especially concerning when coupled with the no mask requirement for kindergarten and first graders. "Younger children may find it more difficult to adhere to physical distancing of at least 1 metre." The report recommends at least 1 meter of space (about 3 feet) between individuals at school.

Supports DESE Claim 1?: Yes, WHO suggests about three feet of physical distancing.

Supports DESE Claim 2?: Yes

A Look at DESE's Cited Sources: Footnote #28 - Social Distancing, Quarantine, and Isolation

DESE Claim: "While the U.S. federal CDC has recommended maintaining a physical distance of six feet between individuals"

Cited Source: CDC, Social Distancing, Quarantine, and Isolation. (2020, May 6). Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html

Peer Reviewed?: No, government information site

Study Methodology: N/A - public health guidance

Notes: This page gives guidance for the public on how to social distance. It advises staying 6 feet apart, and limiting close contact with others.

Supports DESE Claim?: Yes. CDC guidance says 6 feet distancing.

A Look at DESE's Cited Sources: Footnote #26 - COVID-19: Recommendations for School Reopening

DESE Claim: "Students in grade 2 and above are required to wear a mask/face covering that covers their nose and mouth. Students in kindergarten and grade 1 should be encouraged to wear a mask/face covering."

Cited Source: http://www.sickkids.ca/PDFs/About-SickKids/81407-COVID19-Recommendations-for-School-Reopening-SickKids.pdf (if masks are worn incorrectly, they may increase infection risk). See also: https://www.publichealthontario.ca/-/media/documents/ncov/covid-wwksf/what-we-know-public-masks-apr-7-2020.pdf?la=en

Peer Reviewed?: No (hospital publication)

Study Methodology: N/A - public-aimed health information from a hospital.

Notes: This document is comprised of the medical guidance from one hospital in Canada for the return to school. " [...] it is anticipated that there will likely be an increase in cases of COVID-19 upon the resumption of school and as such, the appropriate measures should be proactively put in place to mitigate the effects of such an increase." In other words, all the recommended safeguards can mitigate but not eliminate an increase in cases from the return to school. The document recommends scheduling at least 5 hand hygiene times per day. This particular hospital is not recommending that children wear face masks in school. " It is recognized that some parents and children may choose to wear masks. This is a personal choice and should not be discouraged. To this end, equitable access to non-medical masks in the school setting is an important consideration." The document says staff should not be required wear masks either, contradicting many of the other DESE sources which state that masks are highly effective. 

Supports DESE Claim?: Evidence is not grade level specific and no sources are given for some of the medical claims in the source.

A Look at DESE's Cited Sources: Footnote #22, #27, and #30 - Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

DESE Claim 1 (footnote #22): "Masks/face coverings protect the general public against COVID-19 infection"

DESE Claim 2 (footnote #27): "Mask breaks should occur throughout the day."

DESE Claim 3 (footnote #30): "There is no precise threshold for safety; indeed, studies suggest that physical distancing of three feet or more leads to reduced transmission, with additional distance providing additional protection."

Cited Source: Chu, D.K., Akl, E.A., Duda S., Solo K., Yaacoub S., Schunemann H.J. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet

Note: no link is provided in the DESE citation. I used Google to find this link to the study. 

Peer Reviewed?: Yes

Study Methodology: "systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses"

Notes: The review of 172 studied indicated that physical distancing, face masks, and eye protection were all protective against COVID-19. Different types of masks offered different levels of protection. "[...]our findings continued to support the ideas not only that masks in general are associated with a large reduction in risk of infection from SARS-CoV-2, SARS-CoV, and MERS-CoV but also that N95 or similar respirators might be associated with a larger degree of protection from viral infection than disposable medical masks or reusable multilayer (12–16-layer) cotton masks." Mask efficacy is supported by the study. Physical distancing efficacy is also supported with moderate confidence.

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: No. There is no mention of mask breaks in the article. 

Supports DESE Claim 3?: Yes.

A Look at DESE's Cited Sources: Footnote #21 and #25 - The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2

DESE Claim 1: "masks or face coverings are among the most critical components of risk reduction"

DESE Claim 2: "community-wide mask/face covering usage contributed to control of COVID-19 in Hong Kong."

Cited Source: Cheng, V. C., Wong, S. C., Chuang, V. W., So, S. Y., Chen, J. H., Sridhar, S., ... & Yuen, K. Y. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. Available at https://www.journalofinfection.com/article/S0163-4453(20)30235-8/pdf

Peer Reviewed?: yes

Study Methodology: "Epidemiological analysis was performed for confirmed cases, especially persons acquiring COVID-19 during mask-off and mask-on settings. The incidence of COVID-19 per

million population in HKSAR with community-wide masking was compared to that of non-mask-wearing

countries which are comparable with HKSAR in terms of population density, healthcare system, BCG vaccination and social distancing measures but not community-wide masking."

Notes: This study looks at Hong Kong (where universal masking was required) compared to countries where masks were not worn community-wide. "Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19." Masks were effective in reducing the spread of COVID-19.

Supports DESE Claim 1?: Yes.

Supports DESE Claim 2?: Yes.