The recent article by Boutzoukas et al analyzed the association of universal vs partial vs optional school masking policies with secondary in-school infection and found an unexpectedly strong association between masking policies and secondary infections given recent studies.2,3  Unfortunately, it appears the authors have failed to consider at least 1 critically important confounding variable. The Centers for Disease Control and Prevention (CDC) state that “the close contact definition excludes students who were between 3 to 6 feet of an infected student if both the infected student and the exposed student(s) correctly and consistently wore well-fitting masks the entire time.” We are aware of numerous districts across the country where contact tracing during the period of the study would not have correctly identified coronavirus disease 2019 cases truly transmitted in the school to have come from the school because a masked student transmitting to another...

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