Since the CDC issued its guidelines for summer camps, numerous experts have criticized them as overly cautious, particularly the suggestion that campers wear masks outdoors. Dimitri Christakis, the editor-in-chief of JAMA Pediatrics, the leading journal for pediatric medicine, described the combination of mask-wearing and social distancing for children “unfairly draconian.” Dr. Walensky, the Director of the CDC defended the guidelines as being an effort to prevent the outbreaks that camps saw last summer. Medical doctors responded that last summer's outbreaks were almost uniformly due to indoor transmission, not outdoor.
Federal officials are set to approve a vaccine for 12- to 15-year-olds, and Dr. Walenksy said recently that vaccinated campers need not wear masks outdoors. A vaccine for younger children is still several months away.
Other guidelines are less stringent than the CDC's recommendations. The World Health Organization recommends masks for children in most situations, but specifically advises against masks during physical activity: "Children should not wear a mask when playing sports or doing physical activities, such as running, jumping or playing on the playground, so that it doesn’t compromise their breathing."
Likewise, the American Academy of Pediatrics notes in its guidance for sports leagues that "[m]ost transmission associated with outdoor sports has been related to off-field activities, such as sharing meals and during transportation in private vehicles where individuals were unmasked or partially masked." The AAP recommends masks during activities that pose a high risk of transmission, but not when the masks might become a choking hazard, impair vision, or might increase heat-related illnesses. North Carolina recently issued guidelines for schools allowing students to forego masks in outdoor classes.
Dr. Fauci predicts that the CDC will evaluate and change its guidance "in real time." Perhaps the bureaucracy will change its usual procedure and change its guidance quickly to follow recent science. Until then, camps are stuck with conflicting signals and difficult-to-enforce standards of care.
"We know that the risk of outdoor infection is very low. We know risks of children becoming seriously ill or even ill at all is vanishingly small. . . . Children cannot be running around outside in 90-degree weather wearing a mask."