The superintendent quickly found herself on the phone with U.S. President Joe Biden, who asked some questions about community support. In response, the governor’s office considered taking away funding from the district, the Miami Herald reported, which would only hurt the kids they are trying to protect. The chaos in Broward County is not an isolated incident. This dilemma of mandatory masking (or not) is resulting in protests, petitions, and more happening all over the country as students return to schools during a major spike in infections due to the Delta variant. Ahead, doctors, parents, and experts weigh in on masking in schools.
What Experts and Parents Say About Mask Mandates
On Aug. 13, the American College of Physicians (ACP) released a statement saying that masks should be required in schools to reduce the spread of the COVID-19 Delta variant. Their statement, which aligned with that of the American Academy of Pediatrics (AAP), helped some school districts inform their decisions on masking. In the statement, ACP President George M. Abraham, MPH, FACP, FIDSA, said, “As a country, we have all been watching the number of COVID-19 cases rising precipitously over the past month. We need to ensure that we are availing ourselves of the public health measures available to us to combat this spread.” He clearly identified that teachers, students, and all staff should have mandatory masks at school. One of many reasons he gave is that a large segment of school populations are still not able to access the COVID-19 vaccine. However, not all doctors feel the same way about requiring children to mask in school. “I don’t believe that children should be required to wear masks in school," says Abe Malkin, MD, MBA, a family medicine specialist and medical director of ConciergeMD. “The majority of children who do catch the virus are either asymptomatic or have mild symptoms. That said, it is important for any unvaccinated adult coming into contact with children at school to wear a mask.” He says COVID-19 Delta is a disease that mostly affects unvaccinated adults. Instead, Dr. Malkin says that unvaccinated adults should be wearing masks at schools. “If adults are vaccinated the concern should be relatively low,” he says. He is also concerned with the mental toll of masking. Specifically, he worries about delayed linguistic skill development caused by having a teacher’s mouth covered, the misinterpretation of facial expressions because of masks, increased anxiety, and slower social skill development. Parents around the country have been strongly voicing their opinions, especially on social media, about whether all students or just those who choose to should wear a mask. Rachel Baker, a Cincinnati mom of three children and a nurse researcher, says that mandatory masking is a necessity. “It is critically important that students are able to attend in-person school safely and uninterrupted by frequent quarantines,” she says. She especially hopes that elementary schools, whose students can’t get vaccinated at this time, will enforce masks. In her students’ district, masks are mandatory in elementary schools but optional in middle school and high schools. “I am concerned that the same students who choose not to vaccinate will be the students who opt to not wear a mask, creating an environment conducive to potential viral spread and lots of quarantines,” she says. “It is critically important that students are able to attend in-person school safely and uninterrupted by frequent quarantines.” Her position is similar to the Centers for Disease Control and Prevention (CDC). “Inconsistent mask use may have contributed to school-based outbreaks,” the CDC says. They continue on to say that requiring masks is a successful prevention strategy for limiting spread. According to data from U.S. News and World Report, 16 states have imposed mask mandates in schools. Eight states have banned districts from being able to impose mandates, including Texas and Florida, where high numbers of cases are being reported.
Understanding the Risk for Kids
When the pandemic began, COVID-19 was not considered a major risk for children. The rise in the Delta variant and children’s inability to get vaccinated has changed that thinking in recent months. Purvi Parikh, MD, FACP, FACAAI, an immunologist with Allergy & Asthma Network and co-investigator with the COVID vaccine trials, says she is very concerned about unmasked children in schools, saying one in five cases are pediatric. Dr. Parikh says that the risk of Delta transmission is 70% lower with a mask and that Delta is highly contagious in kids. The AAP released updated numbers for the week ending on Sept. 9 stating that children made up almost 29% of reported weekly COVID-19 cases. “If families do not mask, they are putting their child and other children at risk of getting sick,” she says. “The COVID-19 Delta variant is making kids seriously ill, even causing deaths.”
Considering Those Who Cannot Mask
Preventing the transfer of COVID-19 for all children means thinking through situations for kids who cannot protect themselves, or cannot wear a mask at all. Christine Kron is a Milford, OH parent of a fourth- and first-grader. Her younger daughter has Down Syndrome and cannot wear a mask. “My daughter does not tolerate masks well due to her developmental delays as well as her physical features from Down syndrome: Small ears, no nose bridge, and she wears glasses to boot!" she says. “It is a struggle, as much as we would prefer her to wear a mask for herself and others.” She explains that she took an active role in advocating for mandatory masks for children at her school who cannot yet get vaccinated. “The Board of Education meeting was heated and standing room only,” she shares. “After four hours, they decided to mandate masks for [elementary schoolers].” She says now she feels relief that others around her daughter will be masked since her daughter cannot be. “My biggest concern has been her missing too much school,” Kron says. “She is already delayed by her peers, and constant quarantines would set her back even further.” Jenna Robertson, co-founder and board chair of the Nevada Alliance for Student Diversity, advocates for diverse families in Nevada. As a parent to a high school junior with ADHD, she feels students with ADHD need a face-to-face environment to thrive. Her child failed US History during distance learning but received a 98% when retaking it in person during the summer. “If wearing masks is what it takes to have our kids get the services and accommodations they need to succeed, I am thrilled to encourage wearing masks in school,” she says.
How to Make Calm and Meaningful Decisions About Masks
The pandemic has been mentally trying for almost everyone, and hearing that your school is or is not mandating masks can be emotionally draining. Caroline Fenkel, LCSW, co-founder and chief clinical officer at Charlie Health, suggests remembering that masks are the “side effect, not the cause” of our larger pandemic problem. This perspective can help you keep your cool in the face of this charged situation, which may impact your children and family’s mental and physical health. She also recommends doing your best to maintain open and honest communication with kids. Try saying things like, “I’m not sure what will happen, and it is overwhelming. But you can always talk to me about how you’re feeling and what’s going on, especially about all of these pandemic changes.” This demonstrates that vulnerability is a strength and that kids are not alone in their feelings. Fenkel also reminds parents that research showing a correlation between mask-wearing and negative mental health effects is thin. “Many students can feel triggered or retraumatized one way or another about mask mandates, which could then exacerbate underlying mental health issues,” she says. “Some kids feel anxious wearing a mask, while others have the same feelings of anxiety about people around them not wearing masks.” Focus on helping them develop coping skills, rather than controlling their anxiety.
