Analysis & Comment

Opinion | We Need Clear Goals for Every Covid-19 Policy

By Joseph G. Allen and Helen Jenkins

Dr. Allen is director of the Healthy Buildings program at Harvard T.H. Chan School of Public Health and has studied how Covid-19 spreads in indoor spaces. Dr. Jenkins is an associate professor at Boston University School of Public Health and an infectious disease epidemiologist.

While the availability of vaccines refocused the U.S. response to the pandemic, many policy questions remain. Should vaccinated people get boosters? Does everyone need to wear a mask? Are unvaccinated children safe in schools?

We think much of the confusion and disagreement among scientists and nonexperts alike comes down to undefined and sometimes conflicting goals in responding to the pandemic. What are we actually trying to achieve in the United States?

If the goal is getting to zero infections and staying at that level before dropping restrictions, one set of policies apply. If the goal is to make this virus like the seasonal flu, a different set of policies follow.

Let’s use masking of children in schools as an example.

The Centers for Disease Control and Prevention pegged its masking recommendation for vaccinated adults to local transmission rates. If high, all people should mask indoors. If low, no need. But, it did not set similar metrics for children and masks in schools when it recommended universal masking. In failing to do so, it avoided not just the obvious tough question — When can kids stop masking in school? — but also an even tougher, fundamental one: What is the purpose of Covid-19 precautions now?

One often discussed timeline for ending masking in schools is the date that a vaccine is approved for children under 12. That seems reasonable, but it raises yet another question: What happens if vaccines for children younger than 12 are approved at the end of the year but only 35 percent of this age group get vaccinated? That is exactly what we see now for 12- to 15-year-olds, who have had access to vaccines for months.

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