With Masks On, Three Feet Is Just as Safe as Six Feet Apart for COVID-19

A statewide study in Massachusetts showed no significant differences in COVID-19 cases between K-12 counties implementing a physical distance of 3 feet versus 6 feet.

As COVID-19 infections continue to decline, Massachusetts officials indicate that it is almost time to stop remote learning and send all school-aged children back to class. While new data indicates that young children and schools have not been the main drivers of the COVID-19 pandemic, evidence for best practices to prevent the spread of the virus in the school environment is limited, and as a result, there are national and international recommendations. inconsistent.

A study led by physician researchers Beth Israel Deaconess Medical Center (BIDMC) provides new, much-needed data on the optimal physical distance between students for the prevention of COVID-19 in the school environment. In a statewide retrospective cohort study, the researchers compared the rates of COVID-19 cases among students and staff in Massachusetts public schools between districts with universal mask mandates but different physical distance requirements. The team found no substantial difference in the incidence of COVID-19 among students or staff in school districts implementing a three-foot versus six-foot distance policy between students. The findings, published in the journal Clinical Infectious Diseases, suggest that lower physical distance management can be applied in school settings with masking mandates without negatively impacting student or staff safety.

“Previous studies have not directly compared the impact of different physical distance policies between students attending school in person,” said lead author Polly van den Berg, MD, a fellow in the Division of Infectious Diseases at BIDMC. “This study, which found no substantial difference in the number of cases among students or staff in school districts pursuing a distance policy of 1 meter versus 1.80 meters between pupils, is important because many school buildings have physical infrastructure unsuitable for 1 , Take 80 meters away and bring all (or most) students back to class. “

Van den Berg and colleagues looked at publicly available data from 251 Massachusetts school districts, including 537,336 students and 99,390 staff who received personal instruction during a 16-week study period from September 2020 to January 2021. Using a combination of information – including individual district plans for infection control, the number of infections reported by districts to the Commonwealth and the community figures of COVID-19 through a non-partisan, non-profit data dashboard – the scientists found no significant difference in the rate of COVID-19 cases among college students and staff in districts requiring six feet distance versus districts requiring three feet distance. The scientists note that physical distance was just one of many infection prevention measures taken by school districts.

“This data can be used to inform and update how infection control plans are being implemented in school settings,” added corresponding author Westyn Branch-Elliman, MD, MMSc, ​​an infectious disease specialist at BIDMC and a clinical investigator at VA Boston Healthcare System. . “It is important to remember that distancing was just one of many interventions in the districts included in our analysis. In the districts included in our study, there was an almost universal masking mandate, so our study addresses the question of whether a distance between students and staff wearing masks is effective between 1 and 6 feet. “

The team’s findings also showed that schools generally had lower infection rates than their surrounding communities, supporting the notion that personal learning is not a major cause of the pandemic; However, the number of cases in the district was closely linked to that of the community, especially among the staff.

“Early in the pandemic, infection control plans for schools and other institutions were developed based on the best available evidence at the time – which was limited in the beginning,” said Branch-Elliman, also an assistant professor of medicine. at Harvard Medical School. . “We hope our findings can be used to update current distance policy recommendations and ultimately drive more students back into class.”

Reference: “Effectiveness of 3 vs 6 ft Physical Distance for Controlling Spread of Coronavirus Disease 2019 Among Primary and Secondary Students and Staff: A Retrospective Country Cohort Study” by Polly van den Berg, Elissa M Schechter-Perkins, Rebecca S Jack, Isabella Epshtein, Richard Nelson, Emily Oster, and Westyn Branch-Elliman, Mar 10, 2021, Clinical Infectious Diseases.
DOI: 10.1093 / cid / ciab230

Co-authors include Elissa M. Schechter-Perkins, MD, MPH, of Boston University School of Medicine and Boston Medical Center; Rebecca S. Jack, MPP of COVID-19 School Response Dashboard; Isabella Epshtein, MPP, of VA Boston Center for Healthcare Organization and Implementation Research; Richard Nelson, PhD, Veterans Affairs Salt Lake City Healthcare System and University of Utah School of Medicine; and Emily Oster, PhD, from COVID-19 School Response Dashboard and Brown University Watson Institute for International and Public Affairs.

The authors received no financial support for the research, authorship and / or publication of this article. WBE is the PI site for a grant funded by Gilead Pharmaceuticals (funds to institution). EO and RJ are affiliated with the COVID-19 School Dashboard, which is co-funded by the Chan Zuckerberg Foundation and the Arnold Foundation. All other authors have no conflicts to report.