Making Sense of Masking in School

VT Pediatricians Group Urges Universal School Masking 

Recent changes to in-school masking guidance from the CDC and professional groups – coupled with new guidance from the state — have left many parents and kids trying to make sense of what to expect. But the head of Vermont’s chapter of the American Academy of Pediatrics wants the message to be loud and clear. 

“Everyone should be masking at school,” says Rebecca Bell, M.D., a pediatric critical care specialist at UVM Children’s Hospital and AAP-VT chapter president. “All of the recommendations are aligned right now, the AAP, the CDC, and others: everyone over age 2, vaccinated or not, should be wearing a mask in school. The Vermont AAP agrees that this is what should be happening for in-school learning next fall.”

“We are saying, yes, your child should be masking in school, whether or not he or she is vaccinated.” 

~ Rebecca Bell, M.D., pediatric critical care specialist at UVM Children’s Hospital and president of the American Academy of Pediatrics Vermont Chapter

What the New National School Masking Guidelines Say

The CDC’s July 9 update to its Covid-19 guidelines included the following statement:

“Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.”

On July 19 the AAP, citing “continued concerns for variants that are more easily spread among children, adolescents, and adults,” also recommended universal masking in school. An accompanying news release laid out the rationale for the new clinical guidance.

“AAP recommends universal masking because a significant portion of the student population is not yet eligible for vaccines, and masking is proven to reduce transmission of the virus and to protect those who are not vaccinated. Many schools will not have a system to monitor vaccine status of students, teachers and staff, and some communities overall have low vaccination uptake where the virus may be circulating more prominently.”

Expert: Universal Masking Key to Consistency in In-School Learning 

Bell, an associate professor of pediatrics at UVM School of Medicine, says universal masking at school is critical to getting – and keeping — kids in the classroom “full time, in person, every day.” AAP guidance recommends in-person instruction for many reasons, including maintaining a consistent learning environment for students. Emerging data suggest a number of detriments to mental and physical health linked to inconsistencies with at-home or hybrid learning. The loss of peer and teacher interactions in particular can negatively affect children’s social and emotional development. As a result, many public health experts, educators, and policy makers have prioritized in-person learning for the 2021 school year.

“Pediatricians in Vermont overwhelmingly recommend their patients go to school in person. We want kids in school, with everyone masked and everyone vaccinated when they can be,” Bell says. “Students do best in person. The benefits are huge. We have a high vaccination rate, and we know masking can be helpful.” 

Anecdotally, Bell says it has surprised some people to see that “kids did really well with masking – better than adults. We know that students can do this.”

The message: Mask up at school. Wherever you are, whomever you are, whatever your vaccination status, wear a mask at school.

Empty ICUs: Masking Prevents Covid and More

When parents ask why their vaccinated child should wear a mask, Bell tells them: “It’s an important layer of protection against Covid and other things that can look like Covid.” Masking not only lowers the risk of a rare breakthrough infection, but limits transmission of other respiratory infections as well. This includes colds and flu, which account for a great deal of disruption to school life in a typical year and would be even more disruptive in a pandemic. 

As a pediatric intensivist, Bell treats really sick children in the Intensive Care Unit. Many of them are there due to flus or colds. “In the past, I’ve spent the winter intubating babies,” she says, referring to the painfully invasive process of placing a tube down the throat for mechanical ventilation. “I don’t think people understand how serious these respiratory infections can be to some kids.”

Last year, she says, “we didn’t see any of that.” The ICU admission rate was the lowest it’s ever been. Masking, she’s convinced, played a big role. In fact, reports across the world point to a virtual elimination of flu transmission in the winter of 2020-21 that is most likely attributable to pandemic control measures like masking, social distancing, and hand-washing.

Hope and Apprehension for the Year Ahead

Bell feels hopeful for the school year ahead – more than she did last year. “We just know more about the virus now,” she says. For example, we now know that the virus doesn’t easily spread via surfaces, so the emphasis on safety has shifted from cleaning surfaces to masking and vaccination. Still, she understands the anxiety parents may be feeling about this year’s back-to-school experience.

“It’s a really apprehensive time for families,” she says. “It’s okay to be uneasy. The pandemic is not over. But we know how to manage it. And we know that masking is a big part of that.”

Learn More and Find Resources

Guidelines on Universal Masking in Schools

Read the CDC’s Guidance for Covid-19 Prevention in K-12 Schools (see Update at the top of the page).

Read the American Academy of Pediatrics news release summarizing its new clinical guidance and the updated COVID 19 Guidance for Safe Schools.

Learn about the situation in Vermont in VT Digger article, CDC recommends universal masking in schools. Will Vermont? (July 28, 2021)

The Washington Post takes an in-depth look at reactions to school-masking guidance nationally in Contention over masks in schools rises as academic year begins for some, by Valerie Strauss (July 24, 2021).

Parent and Caregiver Resources

See our Parent and Caregiver Covid-19 Resources for a curated list of authoritative sources for further information on a range of pandemic-related parenting topics.

Also check out Information for Parents and Caregivers from the Vermont Department of Mental Health. This page includes advice on safe activities to do with kids as well as parental self-care. 

Watch for our new workshop for parents navigating back-to-school uncertainties – coming soon. Learn about all our other FREE online workshops and discussion groups here.

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Blog written by Brenda Patoine on behalf of VCN/Vermont Care Partners for COVID Support Vermont, a grant funded by FEMA and the Vermont Department of Mental Health

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