District-Level Universal Masking Policies and COVID-19 Incidence During the First 8 Weeks of School in Texas

Published in: American Journal of Public Health, Volume 112, No. 6, pages 871–875 (June 2022). doi: 10.2105/AJPH.2022.306769

Posted on RAND.org on September 15, 2022

by Amy E. Hughes, Richard J. Medford, Trish M. Perl, Mujeeb A. Basit, Kandice A. Kapinos

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Texas discontinued state-sponsored business restrictions and mask mandates on March 10, 2021, and mandated that no government officials, including public school officials, may implement mask requirements even in areas where COVID-19 hospitalizations comprised more than 15% of hospitalizations. Nonetheless, some public school districts began the 2021–2022 school year with mask mandates in place. We used quasi-experimental methods to analyze the impact of school mask mandates, which appear to have resulted in approximately 40 fewer student cases per week in the first eight weeks of school.

Strategies to limit COVID-19 transmission have evolved as scientific knowledge increased, vaccines were developed, and new variants emerged. Prior to the 2021–2022 school year, COVID-19 vaccines were not approved by the Food and Drug Administration for children younger than 12 years and the incidence of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2, the virus that causes COVID-19) was increasing, in part because of the circulation of the Delta variant. As a result, the Centers for Disease Control and Prevention and the American Academy of Pediatrics recommended that schools return to in-person instruction with universal indoor masking policies in place.

The governor of Texas clarified a "mask mandate ban" via executive order on July 29, 2021, stating that "No governmental entity including a . . . school district . . . may require . . . or mandate that [a] person wear a face covering [but] that does not prevent individuals from wearing one if they choose." Despite this, several Texas school districts implemented mask mandates at the start of the school year.

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