Back to school: can we really say that the return of the mask to school does not make sense?

Back to school this Monday morning for nearly 7 million primary school children… and a return of the mask to the face for a good part of them.

Schoolchildren aged at least 6 are concerned in 61 departments, or 39 more than before the holidays.

And the list could grow over the next few weeks, given that the health situation is deteriorating (the threshold set is an incidence rate of 50).

But to impose the mask on children under 12 "does not make sense", said Wednesday the president of the French Pediatric Society, Christèle Gras-Le-Guen.

We take stock of this subject.

What you may have read or heard

"Children under 12 are little affected by the Covid infection and are not contagious" and "wearing a mask at school for children under 12 does not make sense", thunders Christèle Gras-Le-Guen , also head of the emergency department and general pediatrics at Nantes University Hospital, in an interview published in Ouest-France.

The same day, in La Dépêche, the doctor was a little less clear-cut.

She assured that the children were "less contagious than their elders and are infected less often", while insisting on the fact that "the wearing of the mask at school does not appear to be neither an urgent measure, nor scientifically rational".

Are children contagious?

Undoubtedly, and as the World Health Organization indicates in black and white in a brochure published at the end of September, children can not only be infected but also "transmit [the virus] to other people".

“Children of all ages are susceptible and can transmit SARS-CoV-2,” adds the European Center for Disease Prevention and Control.

This is evidenced, for example, by several clusters identified in primary school.

“Even before the arrival of the Delta variant, several studies had, for example, shown that the viral load excreted was the same regardless of age,” adds medical biologist Claude-Alexandre Gustave.

One of them, conducted on a panel of 29,578 positive cases in Wuhan (China) between December 2019 and April 2020, appeared in The Lancet Infectious Diseases in January 2021. “Children are potentially important in the chain of transmission », Then indicated Ramanan Laxminarayan, principal researcher in charge of the study.

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However, and even if all scientific work does not agree on this point, some data suggests that children are less contagious than adolescents and adults. An equivalent viral load does not necessarily equate to an equivalent risk of transmission, especially because of the level of neutralizing antibodies in the body and the symptoms. Children generally have fewer symptomatic forms than adults. They cough and sneeze less, so they may spread the virus less.

“The contagiousness [of children] may be a little less than in adults, but the viral load is the same and they are actively involved in the spread of the virus.

Especially since the cases are more difficult to detect in them, because they are often asymptomatic ”, summarizes the epidemiologist Mahmoud Zureik, quoted by Le Monde.

Why is the mask at school relevant?

In this context, scientists are mostly at odds with the president of the French Pediatric Society and they believe that wearing a mask in children has "meaning".

In any case, on an epidemiological level and to curb the circulation of the virus.

“Yes, without hesitation, because the main mode of transmission is the aerosol respiratory route.

Wearing the mask will reduce the emission of particles and therefore the enrichment of the ambient air in potentially contaminated aerosols, ”explains Claude-Alexandre Gustave.

In the absence of masks, the risk is even greater if the classroom is not well ventilated or ventilated.

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Two American studies, carried out by the Centers for Disease Control and Prevention (CDC) and published at the end of September, point in the same direction. The first of these was carried out on a thousand schools in Arizona, divided into three groups: those who imposed the mask on their students and staff at the start of the school year, those who did so at any time. what time afterwards, and those who do not impose the mask. The authors found a risk of "cluster" (at least two positive cases) 3.5 times greater in schools that do not require students and staff to wear masks than in those that decided to do so as soon as possible. departure. Note, however, that we speak of “schools” in the broad sense, including colleges and high schools.

Wearing a mask is also one of the measures which "are of major importance in minors, a fortiori in unvaccinated under 12s", listed by the Scientific Council.

In a previous opinion published at the end of August, the group of experts nevertheless considered "important that the wearing of the mask recommended for the smallest be the subject of an evaluation and a follow-up to assess its possible impact on learning by compared to its poorly evaluated potential benefit on transmission ”.

What about vaccination?

Christèle Gras-Le-Guen - who did not respond to our request this Sunday - also judged that there was "no urgency to vaccinate those under 12".

The European Medicines Agency should say in December whether it approves the Pfizer vaccine in 5-11 year olds, as the American authorities have just done.

The chairman of the Vaccine Strategy Orientation Council, Alain Fischer, also said on France Info that France "can afford to wait a bit".

The time, in particular, to assess possible side effects in the United States.

But also because children are much less at risk of severe form.

Only 40 of the 6,667 patients infected with SARS-CoV-2 and currently hospitalized are under the age of 10.

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But this does not take into account the risk of symptoms over time (the "long Covid").

According to a study published on August 3 in The Lancet Child & Adolescent Health, 3.1% of children aged 5 to 11 still reported at least one symptom after 28 days.

In summary :

• Children can be infected with the virus, although they are less likely to get a severe form of Covid-19.

• If infected, children can obviously transmit the virus (but perhaps less than adults).

• Wearing a mask for children limits the risk of contamination, but it can also impact the follow-up of the class and learning.