August 11, 2021
To: Central New York School Superintendents
In a few weeks, children all over Central New York will return to school. As pediatricians,
infectious disease physicians, and public health experts from Upstate Medical University and the
community, our goal is to ensure that all children can safely return to school in person, full time,
and participate in after school activities and sports. We advocate to minimize the risk for
COVID-19 infection and exposure at school which requires lengthy isolation or quarantine,
respectively. A safe in-person school attendance is predicated on a universal masking policy for
all children and staff. Our recommendations are based on the best medical advice and scientific
research available.
What We know:
Delta is the predominant SARS-CoV-2 variant. Delta is more transmissible and possibly causes
more serious disease compared to the original virus and its new variants. Data indicate that the
Delta variant is 40 to 60 percent more transmissible than Alpha and almost twice as transmissible
as the original SARS-CoV-2 virus. As an example, Delta variant is more contagious than other
viruses like Ebola, common cold, flu, and smallpox.
Delta led to a surge in hospitalization and death among unvaccinated. Currently, more than 97
percent of COVID-19 patients in intensive care units or patients dying from COVID-19 are
infected with the Delta variant. To make things worse, younger adults and now children are
being hospitalized in greater numbers. Many children are not eligible for vaccination given their
age. They are particularly susceptible to infection unless they are protected by mask. In addition,
control and prevention protocol are important: hand washing, not attending school when sick,
keeping physical distance, and staying in well ventilated areas whenever possible.
The Delta variant puts everyone at increased risk. Those who have been vaccinated are still
protected against moderate and serious illness and death. However, protection is not 100 percent.
Vaccinated people can still get infected and be contagious to others, particularly if they are
unmasked and in poorly ventilated and crowded settings. Unvaccinated people are at risk for
severe disease, hospitalization, and death. They also remain the main driver of COVID-19 in
the communities around them. Vaccination with COVID vaccine is the best way to prevent
serious COVID-19 and stop the spread of the virus. Unfortunately, children under the age of 12
years are not eligible for vaccination, making universal masking crucial to control the spread of
SARS-CoV-2 infection.
What we recommend to stay safe:
Masking is a proven way to keep children safe from COVID-19, especially when children are
indoors at school. There is abundant evidence that shows masking protects children and adults
from COVID-19, including the Delta variant. It is recommended by the CDC, the American
Academy of Pediatrics, the American Academy of Family Physicians, the American Public
Health Association, as well as most respected medical organizations.
We all are part of this community and we care deeply about the health of our neighbors, our
patients, and all children. We recognize the importance of in person education and social
interactions for children. Safe return to school must be coupled with universal masking to avoid
school closures, and exclusion of exposed or infected children. The cost of COVID-19 infection
and stress associated with testing of children cannot be underestimated, and should be carefully
considered as schools are finalizing their masking policies. Masked children are less likely to
be exposed, and less likely to require testing. They are also less likely to be infected, and
require isolation and exclusion from school. Our unequivocal recommendation is for every
school district to institute universal mask wearing requirement for children and staff. Masking in
schools will help keep our children and our community safe.
Kathryn Anderson, MD, PhD, Assistant Professor of Medicine, Hospitalist/Epidemiologist,
Upstate Medical University
Winter Berry, DO, Associate Professor General Pediatrics Upstate Medical University;
President, American Academy of Pediatrics New York Chapter 1
Steven Blatt, MD, Professor of Pediatrics, General Pediatrics, Upstate Medical University; Co-
President, Pediatric Society of Central New York
Gregory Conners, MD MPH MBA, Chair, Department of Pediatrics, & Executive Director,
Golisano Children’s Hospital, Upstate Medical University
Barbara Anne Morisseau, MD, Brighton Hill Pediatrics; Co-President, Pediatric Society of
Central New York
Christopher Morley PhD, Professor & Chair, Public Health & Preventive Medicine, Upstate
Medical University
Jana Shaw, MD, MPH, Professor, Pediatric Infectious Disease, Golisano Children’s Hospital
Epidemiologist, Upstate Medical University
Telisa Stewart, DrPH, Associate Professor, Public Health & Preventive Medicine, Upstate
Medical University
Stephen Thomas, MD, Professor of Medicine & Interim Chair, Microbiology & Immunology
and Infectious Disease Physician, Upstate Medical University
