Shira Doron, an infectious disease physician, is hospital epidemiologist at Tufts Medical Center and an associate professor at Tufts University School of Medicine. Westyn Branch-Elliman, also an infectious diseases physician, is an associate professor of medicine at Harvard Medical School. Elissa Perkins is an associate professor of emergency medicine and director of emergency medicine infectious disease management at Boston Medical Center/Boston University School of Medicine.
The Centers for Disease Control and Prevention updated its guidance on masks this past week, stating that respirators, such as N95s, are more protective than surgical masks, which in turn protect better than cloth masks. These updates are appropriate from a scientific standpoint. They also offer a pathway to compromise in the place where masking policies are most hotly debated: schools.
Respirators and other high-quality masks are highly effective at protecting their wearers, regardless of what people around them are doing. That makes the old mantra “my mask protects you and your mask protects me” obsolete. As a result, schools can finally safely make masks optional for students and staff.
We were strongly supportive of universal masking policies in the fall of 2020. Masks were a necessary safety net that allowed many — but not all — schools to reopen. Opening schools and keeping them open is essential; in-person school is critical to the health and well-being of children and for a functioning society.
But universal masking policies in schools have not come without costs. In certain parts of the country where CDC mask guidelines were rigorously adhered to, children have not seen the faces of their teachers or classmates since early 2020. This affects learning and development, particularly for our youngest learners. Maintaining aggressive mitigation policies, including strident mask rules, also sends children, families and staff the message that schools are not safe. This is simply not true.
Children have been nothing short of amazing in their willingness to adopt public health guidelines. Some have embraced mask-wearing and do so happily. Others are less enthusiastic and less compliant as a result. And they have good reasons: Some have sensory issues. Others with more scientific understanding wonder why, now that everyone has the option to be vaccinated, it is still necessary. And others are just experiencing pandemic fatigue. Clear off-ramps were not implemented up front, meaning that there has never been an end in sight, and sustaining mask-wearing for the entire school day, especially with no hope of normalcy, is hard.
counterpointThis is your captain speaking …
As parents of school-aged children, we have also noticed a disturbing pattern, especially during the omicron surge: punitive mask culture. This can take many forms. Some older children, for example, have been given detentions and even suspensions due to “mask slippage” or improper mask-wearing. Younger children have also been subjected to harsh rules to minimize the spread of covid-19 during lunch hours, often their only mask-free time during the school day. Some must eat in total silence during mealtimes. Others have “expedited” lunch or are instructed to pull their mask down to take a bite and pull it back up to chew. Activities intended to relieve stress, including recess and gym, have been curtailed because of the danger of “increased exhalation.”
The news about covid-19 and schools has been relentlessly negative, only compounding these issues and encouraging increasingly harsh restrictions in schools. This tells students that they are disease vectors while failing to recognize that they are also growing children in need of social interactions for proper development. There is a youth mental health crisis in this country, yet punitive actions that limit social interaction and normal life continue. School should be a place where children feel safe and supported, even if their mask-wearing isn’t perfect.
Hopkinton High School in Massachusetts, in a region which boasts a 98 percent vaccination rate, offers a glimpse of what happens when students are given the opportunity to move from mandatory to optional masking. During their brief masking-optional pilot, the school reported that “smiling is more contagious than covid-19,” and a survey of students found that 70 percent said the policy improved their experience, including their ability to learn.
The CDC update adds further reason for schools to follow Hopkinton's example, as does the Biden administration’s commitment to distributing 400 million respirators. Everyone now has tools to protect themselves from severe disease, or any infection, if they so choose. Making this shift also respects that people will have different risk tolerance levels.
The omicron wave will soon be behind us, and, barring the imminent arrival of the next variant, we can all hope for quieter times this spring. We urge public health and school officials to educate communities on one-way masking, emphasizing personal choice regarding self-protection and supporting those who choose to remain masked. Time and energy that staff spend policing mask use is far better spent on teaching and supporting children. It’s time we stopped worrying about what others are doing and started focusing on protecting ourselves. We have many more tools in 2022 than we did in 2020, and our policies should shift to reflect these advances.
Our children have sacrificed a lot to protect us. Now it’s time for us to give them their childhood back.