'We need off-ramps': When will kids take off their masks in schools?

WASHINGTON — Last week, NPR host Steve Inskeep tweeted a photograph that should have made federal health officials swoon: a line of parents and children camped out on a Washington, D.C., sidewalk, as if waiting for Billie Eilish tickets. They were, in fact, waiting for something even more precious: a dose of coronavirus vaccine.

For anxious parents, the approval (on an emergency use basis) of the Pfizer vaccine for children between the ages of 5 and 11 amounted to an early holiday gift. As their children finally get inoculated — with shots shown to be safe and more than 90 percent effective, no less — millions of families are preparing to take a long-awaited step back into pre-pandemic normalcy.

But now that kids can shield themselves and others, many of those same parents are asking a question that closely tracks with the vaccine rollout: When can kids shed their masks?

A child receives the Pfizer vaccine.
A 5-year-old receives the Pfizer vaccine at Capitol Hill Day School in Washington, D.C., on Monday. (Tom Williams/CQ Roll Call via Getty Images)

“One of the main arguments to getting kids ages 5 to 11 vaccinated is to help them move closer to normal,” Dr. Lucy McBride, an internal medicine physician in Washington, D.C., told Yahoo News. “We need to start thinking about off-ramps for pandemic restrictions. Kids and adults cannot mask forever, nor should they. Once we have been vaccinated, we have taken the best step towards protecting ourselves, our families and our communities. And at that point we should really talk about unmasking.”

Across much of the nation, one of the most obvious — and contentious — signs of pandemic-era upheaval remains firmly in place: school mask mandates, which decree that all students, teachers and staff members cover their faces regardless of vaccination status or virus transmission rates in the surrounding community.

Those mandates went into effect throughout late summer, as worries about a Delta surge intensified; for the most part they haven’t gone away, even as the Delta wave shows signs of having peaked nationally. Despite objections from conservatives — objections that often took the form of screaming matches at school board meetings, death threats hurled at educators and political grandstanding by elected leaders — nearly 70 percent of the 500 largest districts in the country still require students and staff to cover their face indoors, according to the data analytics firm Burbio.

Yet as millions of children get vaccinated in the coming weeks, even some parents who have dutifully been masking their children since the beginning of the pandemic say the time is now for public health officials, elected leaders and educators to begin discussing the end of school masking.

A medical staffer prepares a dose of the coronavirus vaccine.
A medical staffer prepares a dose of coronavirus vaccine on Monday at a vaccination pop-up site in Manhattan. (Michael M. Santiago/Getty Images)

They know the end may not come tomorrow. For the most part, they simply want to know that an end will come, and that masking will not become a staple of the American classroom.

“I think we do need off-ramps, yes,” Brown University economist Emily Oster, who has written extensively about the pandemic, told Yahoo News. But, she added, “I am not sure what they should be. Vaccination rates? Case rates? Hospitalization rates?”

On the national level, at least, no one appears eager to answer the questions Oster and others are starting to ask with increasing urgency, now that it looks like masks will stay on, in many school districts, into 2022.

Though kids are much less likely than adults to suffer severe illness from COVID-19 — and though vaccination effectively eliminates that risk — federal officials and teachers’ unions wary of another winter wave are reluctant to address unmasking in schools while cooler weather and holiday celebrations are luring people indoors and Delta is still lingering.

A spokesperson for the CDC told Yahoo News that the agency has no plans to update current federal guidance, which “recommends universal indoor masking” for students, teachers and staff regardless of vaccination status. Likewise, in California — where some districts go so far as to require masks outdoors, even though the virus rarely spreads in the open air — state officials answered the San Francisco Chronicle’s recent questions about off-ramps by referring to an Oct. 20 statement affirming that the current rules will stay in effect for now.

“It’s certainly a possibility that we could update our recommendation,” the CDC spokesperson told Yahoo News. “I don’t think we’re going to do it in the next month or so.”

A child wearing a face mask.
A child on the first day of school in Brooklyn in September. (Brendan McDermid/Reuters)

Yet few Americans want or expect kids to cover their faces in class forever, and many experts agree that while it may still be too early for students to ditch their masks entirely, it’s not too early to start mapping out a coherent exit strategy and setting clear expectations for the months ahead.

“All of this comes to seem rather absurd,” Dr. Jeanne Noble, director of the COVID response at the University of California, San Francisco’s emergency department, told the Chronicle. “Kids will be the last ones to have their restrictions lifted even though they are least at risk.”

As a result, states and local municipalities are now taking the lead and starting to experiment with the kinds of timelines and metrics that could help American schools safely transition to a maskless future.

Some conservative states rushed to unmask students before they were eligible for vaccination, and while Delta was still on the rise. The results were not encouraging. In August, Florida Gov. Ron DeSantis, a Republican with presidential ambitions, declared that local school districts couldn’t mandate masking even if they wanted to, though polls unambiguously showed that most parents favored masks in schools.

As the hypercontagious Delta variant surged in the low-restriction state where millions remained unvaccinated, thousands of kids were sent into quarantine, disrupting school and work. The daily number of pediatric hospitalizations increased tenfold; ultimately, more Florida children died of COVID this summer than during the previous 16 months combined.

While masks could not have stopped Florida’s tragic Delta wave, multiple studies have demonstrated that universal masking — in schools and other places — can help slow the spread of the virus and lessen its toll, especially in combination with other safety measures. Eight other states tried to ban mask mandates, like Florida; none fared well over the summer.

But as younger kids get vaccinated, and as deaths and hospitalizations hopefully continue to decline due to rising immunity, the question will be where to draw the line — responsibly — between crisis mode and whatever kind of less disruptive coexistence with COVID comes next.

Children wear masks at school.
Children at East End Elementary School in North Plainfield, N.J. (Jonathan Ernst/Reuters)

School mask mandates will be central to that shift. In just the past few weeks, more than 80 districts in 19 states have ended or eased mask requirements for students or staff members; others have explained how and when they might follow suit.

Three main models of school unmasking are now gaining momentum on the state or local level. The first, and most cautious, is what could be called a vaccination threshold.

“Think of layers of protection [against COVID] as we do layers of clothing,” says Dr. Leana Wen, an emergency physician and public health professor who previously served as Baltimore’s health commissioner. “The colder it is, the more layers we will need. Some layers are better than others. For example, one really good winter coat can replace a few long-sleeve tops or sweaters. I think it would be very reasonable, then, to say that if an entire class is fully vaccinated, the students and teachers in the class do not need to mask in that classroom.”

Massachusetts is the most prominent jurisdiction charting this course. Like 16 other states, which together serve about 41 percent of U.S. students, Massachusetts currently requires all students and staff to mask up in the classroom. But because teens have been eligible for vaccination for months, the state also lets individual middle and high schools ask for permission to make masks optional if at least 80 percent of staff and students are fully inoculated.

So far, at least 18 Massachusetts schools have applied for a mask waiver, and at least 11 have been approved — including Hopkinton High School, where more than 95 percent of students are fully vaccinated.

People demonstrate with placards at a school board meeting.
Protesters at a school board meeting in Tavares, Fla., to discuss whether face masks should be mandatory in local schools. (Paul Hennessy/SOPA Images/LightRocket via Getty Images)

On Oct. 21, the Hopkinton School Committee voted 3-2 to approve a three-week trial that will run Nov. 1 through Nov. 19, even after the local health department lobbied for keeping the mask mandate in place until at least late fall. Students will be asked to return to universal masking on Nov. 22, the Monday before Thanksgiving — after which the school will decide whether to lift its mask requirement for good.

“I’m not necessarily sure that I think that there’s an ideal time,” said Superintendent Carol Cavanaugh after the vote. “But I do like the [trial] period.”

On Nov. 1, about half of the Hopkinton student body submitted proof of vaccination and arrived at school without masks. (Unvaccinated students are still required to cover their faces.)

Statewide, officials have extended the school mask mandate through Jan. 15 in part to “allow time for the elementary school population to receive the COVID-19 vaccine,” according to Massachusetts Education Secretary James Peyser — a signal that similar vaccination-threshold policies may soon apply to younger kids as well.

Elsewhere, districts are acknowledging the importance of vaccinating students without tying unmasking to vaccination rates, which tend to vary across demographic groups and income levels. Instead, they are providing enough time for newly eligible kids to receive two shots and develop full immunity before ending their mask mandates — and then letting parents decide how they want to proceed.

Think of it as a grace period. At least three counties in Michigan — Kalamazoo, Kent and Ottawa — declared in August that their school mask orders would “remain in effect” until either “six weeks” or “60 days past the date the COVID-19 vaccine is authorized and available to persons aged five years through age eleven.”

A box of face masks on a table outside of a school.
Face masks on a table outside Schoolcraft Elementary in Michigan on the first day of classes in August. (Matthew Hatcher/Getty Images)

Now that’s finally happened, the Kalamazoo Health Department has announced it will no longer require the use of face masks by students in kindergarten through sixth grade starting at 5 p.m. on Dec. 17 — exactly six weeks after CDC authorization of childhood vaccines. Kent and Ottawa counties have both said they will follow suit after winter break. Individual schools in all three counties will still have the option to require masks.

This represents a middle ground of sorts, one that gives some parents the advance notice they need to vaccinate their kids before masks come off, without alienating others by making vaccination a precondition for unmasking.

The third and final unmasking model doesn’t impose vaccination thresholds either, but it does rely on other data to determine when the local risk is low enough to lift mask mandates (or, conversely, high enough to reimpose them).

Georgia is a good example of such an on-off switch. In Fulton County, home to Atlanta, district officials now say schools can “return to mask optional status” if the “rate of infection has dropped below 100 per 100,000 for two consecutive weeks” in the surrounding community, or if the “ratio of cases in a [particular] school remains less than .01 of enrollment.”

But “if a school, grade level, class or team experiences an increase in COVID-19 positive cases,” officials added, “they may move to mask-required status.”

In recent weeks, falling COVID rates have enabled Fayette County, Camden County and Laurens County to do the same. Similarly, North Carolina has issued statewide guidance that allows districts in the CDC’s “yellow zone” for seven consecutive days — with total new cases below 50 per 100,000 residents and fewer than 8 percent of COVID tests coming back positive — to lift their school mask mandates. Other possible approaches could focus more on local hospitalization or death rates as increasing vaccination coverage and newly available therapeutics further reduce the risk of severe outcomes.

Student wear masks in a classroom.
Students at St. Lawrence Catholic School, north of Miami, when schools reopened in August. (Chandan Khanna/AFP via Getty Images)

For now, though, any movement on masks in schools will likely be contradictory and confusing. It’s simply the nature of American government that states can defy Washington (as Florida has done) and local governments can defy the state (as pro-masking districts in Florida have done), which means kids living just blocks away from each other may be subject to radically different masking policies.

Adults, for their part, are already embracing a new normal. In eight weeks, adult residents of California’s Bay Area, home to some of the strictest mask mandates in America, will finally be able to remove their masks indoors. Why? Because kids ages 5 to 11 are finally eligible for vaccination.

No one has said, however, whether those same kids — the ones actually getting vaccinated — will also be allowed to remove their masks in class, where the virus tends to spread at lower rates than in the surrounding community.

All this leaves parents and children doing what they have been doing for the last 20 months: waiting. The difference is that now, they’re waiting for an end that is actually in sight.

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