Oregon’s health department and the governors of Connecticut, Delaware and New Jersey have announced when their states will end the school mask mandate. Leaders in other states, cities and counties are also considering when to end required masking as well.
The White House is also reported to be discussing an off-ramp for pandemic restrictions, although the US Centers for Disease Control and Prevention has not yet updated its guidance on masking in schools.
Should parents and caregivers be worried if their child’s school is no longer going to require masks? What steps can they take if they want to continue reducing their children’s risk of contracting Covid-19? How can families weigh the risk of going to school and extracurricular activities? What about kids younger than 5, who are not yet eligible to be vaccinated?
To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen. Wen is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health,” and the mother of two young kids.
CNN: A lot of parents and families are concerned — is the decision to drop mask requirements premature?
Dr. Leana Wen: First, I want to clarify something — the end of a statewide mask mandate doesn’t mean that a particular school will no longer require masks. And even if the school is no longer requiring masks, that doesn’t mean the end of masks and that everyone should walk around maskless.
To me, ending mask mandates means that masking is no longer a government-imposed requirement. It’s still the choice of parents and families whether their child should be masked.
The reason why I don’t think it’s premature to have an off-ramp for school mask requirements is because unlike before, prior to vaccines, parents who want to take additional precautions can still do so. Vaccines are widely available for children ages 5 and older, and they protect very well against severe illness due to Covid-19. In addition, one-way masking protects the wearer, in particular, with a high-quality mask (N95, KN95 or KF94). Even if people around your child are not wearing masks, you could still choose for your child to mask, and that would offer some protection.
CNN: For months, you’ve been supporting the idea of having more high-quality masks available to people. How does it make sense to drop mask mandates, while you want to upgrade the quality of masks?
Wen: It’s precisely because high-quality masks exist that we can move to mask-optional policies. For months, high-quality masks weren’t widely available. When most people are wearing single-layer cloth masks, source control becomes very important, meaning that we wear masks to protect others as much as the mask also protects us. Now that high-quality masks are available, it allows people the choice to protect themselves. Plus, we have highly effective vaccines.
CNN: Are there other tools that can help make the school environment safer, if masks are no longer required?
Wen: Yes. All along I’ve talked about layers of protection, in the same way that we talk about layers to shield you and your kids when it’s cold outside. When there is a lot of virus around — or when it’s very cold — we need more layers. Layers can also replace one another.
The vaccine is a very powerful layer of protection because people who are vaccinated are less likely to contract Covid-19 and therefore less likely to transmit it, too. Those who want to can choose to wear a mask, which is another very powerful layer. Other layers include improved ventilation and regular testing. These are also tools that can reduce risk, in the classroom and in other situations.
CNN: How should parents decide whether to keep their children masked in schools?
Wen: There are three factors to consider. First, what is the medical circumstance of your child and your household? If everyone in your household is fully vaccinated and boosted if eligible, and everyone is generally healthy, the chance of severe illness from Covid-19 is very low. That’s a different calculation than if your child or someone else in your home is moderately or severely immunocompromised.
Second, what is your family’s tolerance of risk? Some families are trying very hard to avoid contracting Covid-19, while others are not.
Third, how onerous is masking for your child? Many children have adapted very well to masking. However, it has been problematic for some. Some experts have speculated that prolonged masking may particularly impact younger children, kids with learning disabilities, and English-as-a-second-language learners. The possible effects of continued masking should be weighed against the possible benefit in your specific family’s situation.
CNN: My child has asthma. Is that considered a high-risk condition to keep masking?
Wen: Every family has to make the right decision for them. Asthma is not a condition that predisposes to particularly severe outcomes from Covid-19. Many families with kids who have asthma will not choose to continue having their child mask, especially if they are vaccinated. Conditions that are high risk in children would primarily be being moderately or severely immunocompromised — for example, someone receiving chemotherapy for cancer.
There are other conditions that are more commonly associated with hospitalization in children who contract Covid-19, including obesity and diabetes. Again, families have to make individualized decisions. Many will decide that vaccination is sufficient for protection, while others may want to continue masking.
CNN: What if my child doesn’t want to stand out as the only kid who’s wearing a mask?
Wen: Consider speaking to other parents in the class. There may be other children who are still wearing masks, too. Perhaps arrangements can be made for these kids who want to be extra cautious to have certain options, for example, eating lunch in an area separate from others.
CNN: What about extracurriculars? Should my child still participate in these activities?
Wen: Again, it will be up to you. So many kids have lost a lot and made great sacrifices during the pandemic. As long as it makes sense for your family, I think it makes sense to prioritize returning them to as much normalcy as possible.
CNN: What about kids younger than 5 years old who aren’t yet eligible to be vaccinated? Should they keep masking? What if they have older siblings who now don’t need to mask in schools?
Wen: I’m hopeful that vaccines will soon be available for children under the age of 5. As a mom of two little kids under 5, I cannot wait until vaccines are authorized for this age group.
In the meantime, I think it’s reasonable to have masks still be required for children under 5 and the school and daycare staff taking care of them. After all, these kids don’t have the option of getting vaccinated just yet. If masks are not required, I’d recommend keeping children masked at least until they are able to be vaccinated. The exception is if they recently contracted Covid-19. Those with recent infection probably have immune protection for a couple of months.
Whether older siblings continue masking in schools will depend on the risk tolerance of the family. If the goal of the family is to avoid infection for the unvaccinated younger child, then I’d recommend that the older sibling wear a mask in school.
At the end of the day, masks have to be seen just like any other intervention. There are clear benefits and some potential drawbacks. Mask mandates being lifted is out of recognition of this risk-benefit analysis. Masks aren’t ending, though, and parents will be able to make an individualized decision that’s best for their circumstance.