Heading back to school often means the reemergence of illnesses ranging from the cold and flu to strep and RSV, and in recent years, greater odds of COVID-19 being spread among school children. Just weeks into the 2023-24 school year, the United States is seeing an increase in COVID-19 cases, which has already caused a few school districts (in Texas and Kentucky) to temporarily close, while others have been forced cancel football games.
To make things more confusing, while some school districts are still adhering to the Centers for Disease Control and Prevention’s COVID-19 recommendations (five days at home, then five days of masking at school), others (like Connecticut's Greenwich Public School District) are opting to do away with their previous COVID-specific health protocols. With the latest Omicron variants making the rounds, some families are beginning to wonder if it’s time to bring back masking. But what do the experts think?
What the experts say
While some families never stopped masking, a recent Yahoo News/YouGov survey of 1,665 adults in the U.S. found that just 12% had practiced regular mask-wearing outside of the home over the previous week.
According to Dr. Colleen Nash, a pediatric infectious disease specialist with Rush University in Chicago, it’s good for families to do what they can to “remain vigilant as we embark on respiratory virus season, because there are many viruses that will circulate that can cause significant illness as we get into fall and winter, including COVID-19, influenza, RSV and others.” That means practicing “thorough handwashing” and following other sensible sick etiquette — though not everyone necessarily needs to mask up.
“Certainly when adults or children are sick and are unable to stay home, wearing a mask is very reasonable,” she says. “Every situation is different. Sometimes you’re around others who are more prone to severe infection, and in such situations, you may want to consider wearing a mask.”
Dr. Zachary Hoy, a pediatric infectious disease specialist at Pediatrix in Nashville, says he doesn’t believe that families should overreact to the uptick in COVID-19 cases just yet, though it is worth monitoring.
“At this time, masking should be based on COVID illness, COVID hospital admissions in the local area and risk of COVID disease, so most school-age children would not be at increased risk unless they have an underlying immune system deficiency or are on immune-compromising medications,” he tells Yahoo Life.
“If a person is in a high-risk group for COVID or there is significant transmission in the local area, specific patients could return to masking, but I would not recommend masking as a blanket recommendation for larger groups at this time,” he adds.
As far as who is most susceptible to the new variants, “it appears similar groups are most at risk, including the elderly and kids with compromised immune systems, such as those with cancer or on chemotherapy-type medications,” Hoy says.
Nash agrees that at-risk individuals — or those who spend time around them — should at least consider wearing a mask.
“COVID is not gone, but we have found a way to live with it while still being vigilant,” she says. “Be thoughtful of your neighbor: Don’t make assumptions about what is and isn’t risky for them.”
Nash also recommends that all eligible adults and children receive any recommended vaccines and boosters when available. This week the CDC recommended the updated COVID-19 vaccine for Americans ages 6 months and up, and it is expected to hit pharmacies and doctors’ offices within days.
Are masks effective?
Research cited by the CDC found that consistent masking — particularly when wearing well-fitted N95s and KN95s offering higher filtration capacity — in indoor public spaces was associated with a lower likelihood of having a positive COVID-19 result. In conjunction with other mitigation measures like vaccines and proper air filtration, they work even better to slow the spread of COVID-19.
What else should parents know?
According to the CDC, masks and respirators can be worn by children who are at least 2 years old. A child’s mask or respirator should fit snuggly and comfortably to ensure they won’t be tempted to take it off or wear it incorrectly, which would make it less effective. Masks should fit over the nose but not be worn so high up that it impairs vision.
The CDC also advises parents to consult their child’s doctor if the child has a medical condition and there are concerns about masking. And while cloth masks offer less protection than a surgical mask or respirator (the latter of which may be difficult to size for a child’s small face), they are still an acceptable option if a child struggles with the alternative.
How to discuss masking with kids
Jillian Amodio, a licensed social worker and founder of Moms for Mental Health, notes that some kids who wore masks early on in the pandemic struggled with it, for a variety of reasons: sensory struggles, anxiety, trouble communicating effectively, conflicting views on masks in the home and other spaces, and so on. And for younger kids who had yet to turn 2 during previous waves, mask-wearing will be a new concept and will likely require some age-appropriate explainers.
If your family decides to return to masking, Amodio suggests including kids in any discussions. “Help them to understand the reasons behind the choice, and be sure to validate their emotions even if those emotions are anger, frustration or annoyance,” she says.
Now that community mask-wearing is less common, it’s important for kids to learn ways to advocate for themselves around peers and feel more empowered. Some phrases Amodio suggests to help kids communicate their return to masking include: “This is how I feel most comfortable,” “I prefer to wear a mask for personal reasons,” “I have a compromised immune system” or “I have a loved one with a compromised immune system.”
“If a child is wearing a mask at school and others inquire or make fun, the best thing to say is, ‘I need to protect a family member,’” she says. “Hopefully we are teaching our children to be empathetic and nonjudgmental regarding these health choices.”
Fox says that while kids may be worried or resistant if they have to wear masks again, it’s also best to remind them it’s only temporary and that it helps keep people who are compromised safe.
“A matter-of-fact, calm approach is most helpful,” she says. “Kids really shouldn’t be too concerned if we don’t present it with alarm.”