To Mask or Not To Mask

It’s been a crazy, confusing, and complicated two years to say the least. When the pandemic started, we were told masks weren’t necessary, then face coverings of any kind would protect us and most recently only N95’s and KN95’s offer substantial protection from Covid. Two years ago, it seemed that children were immune to Covid, then we were told they could get Multisystem Inflammatory Syndrome from exposure to Covid and most recently, during the Omicron outbreak there was an explosion of pediatric patients in hospitals and ICU’s (notably, mostly unvaccinated children).  The one thing we know for sure is that there is a lot we still don’t know about this virus!  Now that most mask mandates have been lifted and children have returned to classrooms it is confusing to know if your child should wear a mask or not. Can masks be harmful? Should they mask every day? In the classroom only but not for recess? Are there specific times they should wear a mask?  There are no right or wrong answers to these questions and each individual needs to make a decision that makes the most sense for them. Here are some facts to help you decide what is best for your family.

Are masks safe?

Masks are very safe to wear for extended periods of time. There have been several studies looking at exchange of gases in mask wearers and there were no differences found between mask wearers and non-mask wearers.  Oxygen and carbon dioxide are much smaller molecules then viruses and easily pass through the tiny holes in N95 masks, which is a good thing because surgeons have been wearing masks for years and we want them to stay smart and alert!  

Do masks impact language development and emotional development in children?

 There are many studies that have shown no significant impact on language development in children wearing masks and having those around them wear masks. In fact, well before Covid became a thing we know that blind children develop language normally and children in cultures where mask wearing is routine do not have language delays. There is some evidence that children cannot decipher emotions as well in a masked person. This may affect those younger children in daycare who use an adult’s facial expression to learn if a behavior is acceptable.  However, when masks come off these children rapidly develop these skills.  Children over age 6 quickly learn to use other cues, such as eyes and body language to gauge emotions in mask wearers.  Masks have more of an impact on emotional development in those children with other developmental delays.  However, children with developmental delays have a higher risk of serious Covid infection so parents must weight the risk of Covid based on positivity rates in their community with the risk of mask wearing.

Do masks work?

They do! There was a large government study in California last year that looked at the effectiveness of mask wearing at preventing Covid infection. The study found that wearing N95 masks was 83% effective at preventing Covid compared to 66% with a surgical mask and 56% with a cloth mask.  Masks are most effective when everyone in the room is wearing them but there is still some benefit to wearing a mask when others are not. Which brings us to the next question:

Should my child wear a mask to school?

Each one of us has to assess what the risk is to our child and those people our child comes in contact with when deciding if they should mask at school.  At this point we know that children do and will get Covid when exposed. However, most children will have a mild illness, similar to a head cold. Risk factors for having a more serious illness include not being vaccinated, diabetes, chronic lung disease, chronic heart disease, autoimmune disorders, cancer, obesity, and developmental impairment.  It is also important to think about family members/friends that your children come into frequent contact with and what their risk factors are for serious illness from Covid. Knowing the positivity rate for your community can help as well. During times of low transmission, you may feel more comfortable with your child forgoing a mask at school and then if case counts rise you may decide mask wearing makes more sense.

My humble opinion:

Personally, I think masks are a good thing, that do more good then harm.  Not only do they prevent Covid, but masks also prevent many other viruses, like the flu and RSV. It is my hope that one day there will be no stigma attached to mask wearing and people will be encouraged to wear a mask if they are not feeling 100%.  I would also love to see a classroom of students all choose to wear masks to protect their fellow student or teacher who is high risk, maybe has diabetes or Crohn’s disease, and has to potentially not attend school due to the risk of life threatening Covid infection.  Isn’t that the kind of society we would all love to live in?