Guidance for K-12 School Administrators on the Use of Masks in Schools

Summary of Recent Changes

Revisions were made on December 18, 2020 to update information including describing the protection offered to individuals wearing masks and to make the webpage easier to use and understand.

We are learning more about COVID-19 every day. This guidance may be updated at any time and is subject to potentially rapid change as the science evolves.

CDC suggests that all school operation considerations provide guidance on behaviors that prevent the spread of COVID-19. When used consistently and correctly, along with other important mitigation strategies, masks may help slow the spread of COVID-19. Other important mitigation strategies include social distancing, washing hands, and regular cleaning and disinfecting frequently touched surfaces in schools and buses. CDC provides  considerations for wearing masks and recommends that people wear masks in public settings and when around people who live outside of their household. The use of masks is especially important when social distancing is difficult to maintain.

SARS-CoV-2, the virus that causes COVID-19, is primarily transmitted  by respiratory droplets generated when people cough, sneeze, sing, talk, or breathe. CDC recommends community use of masks, specifically non-valved, multi-layer cloth masks to prevent transmission of SARS-CoV-2. Masks are primarily intended to reduce the spread of SARS-CoV-2 by reducing emission of virus-laden droplets, or “source control”. Source control refers to use of well-fitting cloth face masks or facemasks to cover a person’s mouth and nose to prevent spread of respiratory secretions when they are talking, sneezing, or coughing. Several studies^1-4 have documented asymptomatic and pre-symptomatic SARS-CoV-2 transmission; meaning that people with COVID-19 who never develop symptoms (asymptomatic) and those who are not yet showing symptoms (presymptomatic) can still transmit the virus to other people. Masks can protect other people in case the wearer is unknowingly infected. There is also evidence that masks offer some protection to the wearer by preventing the wearer from breathing in small, or fine droplets and particles.   

The use of masks in educational settings may present challenges, particularly for younger students and students with special healthcare or educational needs. This document provides guidance to help school administrators decide how to best implement the wearing of masks ― in their school settings and facilities, including but not limited to buses and other shared transportation. 

Education and promotion of positive and supportive relationships between teachers, students and staff should remain the primary focus of school administrators, teachers, and staff. This guidance provides K-12 school administrators with strategies to encourage students to wear masks, consistent with CDC guidance, while maintaining a positive learning environment. 

General Considerations

COVID-19 can be spread to others even if you do not feel sick. A mask helps prevent a person who is sick from spreading the virus to others, and offers some protection to the wearer as well. Appropriate and consistent use of masks is most important when students, teachers, and staff are indoors and when social distancing of at least 6 feet is difficult to implement or maintain.

Masks should not be placed on:

• Children younger than 2 years old.
• Anyone who has trouble breathing or is unconscious.
• Anyone who is incapacitated or otherwise unable to remove the mask without assistance.

Appropriate and consistent use of masks may be challenging for some students, teachers, and staff, including:

• Younger students, such as those in early elementary school.
• Students, teachers, and staff with severe asthma or other breathing difficulties.
• Students, teachers, and staff with special educational or healthcare needs, including intellectual and developmental disabilities, mental health conditions, and sensory concerns or tactile sensitivity.

While masks are strongly encouraged to reduce the spread of COVID-19, CDC recognizes there are specific instances when wearing a mask may not be feasible. In these instances, parents, guardians, caregivers, teachers, and school administrators should consider adaptations and alternatives whenever possible. They may need to consult with healthcare providers for advice about wearing masks.

Some teachers and staff may want to consider use of clear masks that cover the nose and wrap securely around the face . Clear masks should be determined not to cause any breathing difficulties or over heating for the wearer. Teachers and staff who may consider using clear masks include:

• Teachers who interact with students or staff with special educational or healthcare needs, including intellectual and developmental disabilities, mental health conditions, and sensory concerns or tactile sensitivity as defined by the Individuals with Disabilities Education Act.external icon
• Teachers of young students learning to read
• Teachers of students in English as a second language classes
• Teachers of students with disabilities

Clear masks are not face shields. CDC does not recommend use of face shields for normal everyday activities or as a substitute for masks because of a lack of evidence of their effectiveness for source control.

Unintended Consequences

• Stigma, discrimination, or bullying may arise due to wearing or not wearing a mask. Schools should have a plan to prevent and address harmful or inappropriate behavior.
• Not all families will agree with school policies about masks. Schools should have a plan to address challenges that may arise and refer parents, caregivers, and guardians to CDC’s guidance on masks.

Practical Recommendations

• Include masks on school supply lists and provide masks as needed to students, teachers, staff, or visitors who do not have them available.
• Include clear masks on school supply lists for teachers and staff who regularly interact with students who are deaf or hard of hearing, students learning to read, students with disabilities, and those who rely on lip reading as a part of learning, such as students who are English Language Learners.
• Ensure that students, teachers and staff are aware of the correct use of masks, including wearing masks over the nose and mouth and securely around the face.
• Ensure that students, teachers and staff are aware that they should wash or sanitize their hands (using a hand sanitizer that contains at least 60% alcohol) before putting on a mask.
• Ensure that students, teachers and staff are aware that they should not touch their masks while wearing them and, if they do, they should wash their hands before and after with soap and water or sanitize hands (using a hand sanitizer that contains at least 60% alcohol).
• Ensure teachers and staff are aware that they should wash or sanitize hands (using a hand sanitizer that contains at least 60% alcohol) before and after helping a student put on or adjust a mask.
• Ensure that students, teachers and staff are aware that masks should not be worn if they are dirty or wet. A wet mask may make it difficult to breathe.
• Ensure that all students and staff are aware that they should never share or swap masks.
• Students’ masks should be clearly identified with their names or initials, to avoid confusion or swapping. Students’ masks may also be labeled to indicate top/bottom and front/back.
• Masks should be stored in a space designated for each student that is separate from others when not being worn (e.g., in individually labeled containers or bags, personal lockers, or cubbies).
• Masks should be washed after every day of use and/or before being used again, or if visibly soiled.
• Students and schools should consider having additional masks available for students, teachers, and staff in case a mask becomes wet or damaged due to inclement weather or because a back-up mask is needed during the day.

Strategies to Support Students’ Wearing Masks in Schools

All Students

• Encourage parents, caregivers, and guardians to practice wearing masks with students at home before the first day of school. If parents, caregivers, and guardians model appropriate use of masks and help students get used to wearing them, students may be more comfortable using them.
• Introduce students with sensory concerns/tactile sensitivities to masks with a variety of materials, prints, and textures, and allow them to choose which mask is most comfortable.
• Use behavioral techniques such as positive reinforcement to increase the likelihood that students will comply with mask guidance and other prevention practices.
• Encourage parents, caregivers, and guardians to include students in the selection of their mask and/or the material that is used to make it. This might increase a child’s acceptance of wearing the mask.
• Display age appropriate posters and materials with visual cues that show the proper way to wear a mask in classrooms and hallways. Consider incorporating images of popular influencers promoting or modeling use of masks.
• Include reminders about masks in daily announcements, school newspapers, and other materials. All communication should be in an appropriate format, literacy level, and language. Consider including how to properly use, take off, and wash masks in back-to-school communications educational materials. 

Elementary School Settings

• Ensure that teachers and school staff are available to help students put on and adjust masks as needed and that teachers and staff wash or sanitize their hands with hand sanitizer that includes at least 60% alcohol before and after doing so.
• Play games or engage in other fun activities that teach students how to wear a mask.
• Consider using some art materials or other creative outlets to help students understand why masks help reduce the spread of COVID-19.
• Share social stories about masks with students so they know what to expect at school. A social story is similar to a simple picture book that teaches students what to expect in social settings.
• Use behavioral techniques, such as positive reinforcement, to increase the likelihood that students will comply with mask guidance.
• Show short videos or incorporate short lessons (less than 10 minutes) that teach students how to wear a mask. Consider including videos with celebrities, musicians, athletes or other influencers popular among this age group.

Middle School Settings

• Show short videos or incorporate short lessons (less than 10 minutes) that teach students how to wear a mask. Consider including videos with celebrities, musicians, athletes or other influencers popular among this age group.
• Follow videos with verbal instructions that demonstrate the correct ways to wear a mask.
• Engage the class in discussions about why masks help reduce the spread of COVID-19.
• Incorporate a lesson into the science curriculum on how respiratory droplets spread infectious disease.
• Create a school competition for the best health communication strategy to highlight the importance of wearing a mask to middle school students.

High School Settings

• Show videos or incorporate lessons that teach students how to wear a mask, including the correct and incorrect ways to wear a mask. Consider including videos with celebrities, musicians, athletes, or other influencers popular among this age group.
• Ask students to write a short paper on the science behind the use of masks.
• Create a school competition for the best health communication strategy to highlight the importance of wearing masks to high school students.

Students with Special Healthcare Needs

• Ask parents, caregivers, and guardians to practice wearing masks at home before the student returns to school.
• Share social stories about masks with students so they know what to expect at school. A social story is similar to a simple picture book that teaches students about what to expect in social settings.
• Introduce students with sensory concerns or tactile sensitivities to masks with a variety of materials, prints, and textures, and allow them to choose which mask is most comfortable.
• Use behavioral techniques such as positive reinforcement to increase the likelihood that students will comply with mask guidance and other prevention practices.

Additional Considerations for the Use of Masks among K-12 Students

CDC recommends that people, including teachers, staff, and students, wear masks in public settings as able when around people who live outside of their household, especially when other social distancing measures are difficult to maintain.

The following table contains examples of some, but not all, situations schools might encounter.

Masks in schools pdf icon[PDF – 3 Pages]

Additional Considerations for the Use of Masks among K-12 Students

* CDC recognizes that wearing masks may not be possible in every situation or for some people. In some situations, wearing a mask may exacerbate a physical or mental health condition, lead to a medical emergency, or introduce significant safety concerns. Adaptations and alternatives should be considered whenever possible to increase the feasibility of wearing a mask or to reduce the risk of COVID-19 spreading if it is not possible to wear one. Learn more.

References

1. Lu X, Zhang L, Du H, et al. SARS-CoV-2 Infection in Students. N Engl J Med2020;382:1663-5.
2. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet2020;395:514-23.
3. Wang Y, Liu Y, Liu L, Wang X, Luo N, Ling L. Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China. J Infect Dis
4. Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility – King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep2020;69:377-81.