School Kids and Faculty Should Mask Up — Will They?

Masks for children are a hot topic. But while some facts are clear (no, masks are not harmful to children; yes, masks do significantly reduce disease transmission), setting, communicating, and enforcing school and community policies around masks for children is more challenging. Amidst growing evidence of the medical and social impacts of COVID-19 on children, as well as the impacts of school closures on child and community well-being, many state and local education leaders are wondering how to reopen schools safely for the upcoming academic year.

Official Guidelines: Masks for All at School

At the beginning of July, the CDC recommended that all students age 2 and older wear masks at school if they are not fully vaccinated. This included the majority of primary and secondary students in the country: all children under 12 years, for whom a vaccine hasn’t yet been authorized, and over half of teenagers, who haven’t yet received vaccination against COVID-19.

Then, the American Academy of Pediatrics (AAP) recommended that at the start of the new school year, all students older than 2 years, and all school staff, wear masks in all situations except where medical or developmental conditions make masks inadvisable. This provided practical guidance for schools and educational leadership that helped apply the individual-level CDC recommendations to communities.

As of this week, CDC updated its guidance, recommending that everyone — teachers, staff, students, and visitors — wear masks in K-12 schools, regardless of vaccination status. This reflects new information about the Delta variant of COVID-19, which is spreading quickly in the U.S., and emerging evidence that while vaccinated people are unlikely to get seriously ill themselves, they could spread infection to others.

Why Should Everyone at School Wear Masks?

Some have wondered why the AAP’s recommendation initially seemed to go further than that of the CDC. While the recommendations were actually quite similar, the AAP took the CDC’s information and considered a few other factors: the challenge of keeping track of who in a school is vaccinated against COVID-19; the difficulty of enforcing rules for some but not all members of a school community; and issues of equity for students with disabilities or who come from under-resourced communities. When adding these factors into the equation, it’s easier and more equitable if everyone — regardless of vaccination status — is masking.

Let’s use a familiar school analogy: peanut allergies. Many primary schools with peanut-allergic students ban peanut products from the class, or the whole school, in order to protect the allergic children in the community. This may be a minor infringement on the freedom of non-allergic peanut-lovers, but they can enjoy their PB&J safely after school without endangering others in the class or school. Outside of school, it is a parent/guardian’s responsibility to monitor their child’s safety. At school, rules must be made for the safety of the whole community.

So, we now have guidance on the rules schools should be implementing, but what does that mean in practice?

Messaging Masks to Kids

Children, especially young ones, adapt to new rules relatively easily compared to adults. Adults often worry needlessly about how to explain complicated-seeming rules, or exceptions-to-rules, to children. But children are learning new and complex rules every day, and typically take this in stride. For example, perhaps at home the rule is to take off shoes at the door, but at a friend’s house the custom is to keep shoes on indoors. Academic lessons are full of rules with exceptions, such as “i before e, except after c.” If presented clearly and consistently, a mask-wearing rule in the classroom — even if masks are not required in many other settings — is no stranger for children than the requirement to raise a hand to speak at school.

To communicate effectively about a school or class rule that masks are required, it is important that the messages be consistent. There may be varying degrees of agreement with a mask policy among members of the school and surrounding community. However, as with other school rules, a mask rule will work best if staff, parents, and local leaders agree to follow and to kindly but firmly enforce the policy. Role modeling by the adults in the school community is part of this consistency and is essential for setting a tone of support for a school mask-wearing policy.

What if These Rules Change?

Let me save you the worry: these rules will almost certainly change. Case in point: CDC’s updated masking guidance in light of the Delta variant’s spread across the country. COVID-19 is still very new to us, and we are learning more every day about how to prevent and treat disease. High-level official guidelines will change, and communities may need to respond to emerging local information about outbreaks and infection risk. However, a school or community can still act in a consistent manner by letting children know that wearing masks at school is the current rule, based on the best science we have today, and when we have new information, we will update the rules to keep everyone as safe as possible.

Health professionals should also make sure they are communicating the latest guidance and local policies clearly and effectively to their patients, including parents and kids. Many look to their healthcare providers for expert information about health risks, so sharing recommendations for reputable sources of information on COVID-19 prevention and treatment (such as the CDC and AAP) can help patients avoid falling prey to misinformation or disinformation online.

At heart, both the CDC and AAP recognize and emphasize the importance of schools being open and accessible to children. Schools in the U.S. provide myriad services in addition to academic and social skills, from early intervention to supplemental food and nutrition supports. To reduce the risk of schools having to close due to community outbreaks and reduce the burden of enforcing a policy with loopholes and exceptions, it makes sense for all in a school community to wear masks at this time.

Devon Greyson, PhD, is an expert in public health communication to parents and youth, and an assistant professor at the University of British Columbia’s School of Population and Public Health in Vancouver and University of Massachusetts Amherst Department of Communication.