Elissa Perkins, the director of infectious disease management in the emergency department of the Boston Medical Center, told me she spent most of 2020 “imploring everybody I could in every forum that I could to mask.” In the beginning, she said, this was to flatten the curve, and later to protect the vulnerable. But masking, she said, “was intended to be a short-term intervention,” and she believes we haven’t talked enough about the drawbacks of mandating them for kids long-term.
“If we accept that we don’t want masks to be required in our schools forever, we have to decide when is the right time to remove them,” she said. “And that’s a conversation that we’re not really having.”
At least, people in deep blue areas weren’t having it until recently. But as the Omicron wave begins to ebb, that conversation — sometimes tentatively and sometimes acrimoniously — has begun. This week Perkins co-wrote a Washington Post essay calling for schools to make masking optional. The Atlantic published an article titled, “The Case Against Masks at School.”
“Coming off the Omicron surge, I think there’s going to be a tipping point with more and more people questioning does this need to continue in schools,” said Erin Bromage, an associate professor of biology at the University of Massachusetts, Dartmouth. Bromage worked with the governor of Rhode Island to reopen schools there, and later helped schools in southern Massachusetts reopen. He believes in the importance of Covid mitigations, but his views on school masking have evolved in recent months. There comes a point, he said, “at which the reduction in risk that comes from the mask is balanced or begins to be outweighed by the detrimental side of things that come with masking.”
The debate about masks in schools can quickly turn vicious because it pits legitimate interests against one another. Many people who are immunocompromised, or live with those who are, understandably fear that getting rid of mandates will make them more vulnerable. But keeping kids in masks month after month also inflicts harm, even if it’s not always easy to measure.
“I think it would be naïve to not acknowledge that there are downsides of masks,” said Perkins. “I know some of that data is harder to come by because those outcomes are not as discrete as Covid or not-Covid. But from speaking with pediatricians, from speaking with learning specialists, and also from speaking with parents of younger children especially, there are significant issues related to language acquisition, pronunciation, things like that. And there are very clear social and emotional side effects in the older kids.”
That’s why I believe that mandatory school masking should end when coronavirus rates return to pre-Omicron levels. I fully accept that, in future surges, masks might have to go back on, but that’s all the more reason to get them off as soon as possible, to give students some reprieve.
Otherwise, I fear that, at least in very liberal areas, a combination of extreme risk aversion and inertia means that school masking will persist indefinitely. The chief executive of the Prince George’s County public schools in Maryland recently downplayed the idea of a future without masks, saying: “The only off-ramp I want is the one where Covid no longer exists. I don’t think that that off-ramp will exist.” I hope this attitude isn’t widespread, but if it is, it will be incumbent for progressive parents desperate for an off-ramp to push back.
There’s some question about how well masks in school really work; many studies are confounded, since communities with school mask mandates tend to adopt other Covid mitigation measures as well. Much of The Atlantic’s “The Case Against Masks at School” is devoted to reviewing studies either conducted or cited by the Centers for Disease Control and Prevention, and it concludes that the “overall takeaway from these studies — that schools with mask mandates have lower Covid-19 transmission rates than schools without mask mandates — is not justified by the data that have been gathered.”
The fact that experts can poke holes in some studies of masking does not mean that masks don’t make a difference. “Unfortunately it’s being painted as black or white, it’s like either they work or they don’t, but with everything it’s nuance and there’s a gradient,” said Bromage. Cloth masks, he said, might reduce the chance of Omicron transmission by “10 percent going out and 10 percent coming in.” That’s not nothing, but it does suggest that the mask mandates we have now aren’t as protective as some might think.
Higher-quality masks, obviously, are much more effective, which is why Los Angeles is now requiring upgraded masks in schools. But before other cities follow, we need to ask whether we really want to make school mask policies even stricter at a time when vaccinations for kids are widely available, as are masks that protect the wearer even if those around them are unmasked.
As Harvard’s Joseph G. Allen has written, “For anyone who fears moving away from universal masking, the great news is that they can continue to wear an N95 mask — along with being vaccinated and boosted — and live a low-risk life regardless of what others around them are doing.” There was a time when N95s were hard to get, but now the Biden administration has started providing them free. And younger kids who can’t wear adult-size N95s can wear KN95s and KF94s.
For those of us who eagerly awaited the approval of vaccines for kids over 5, the timing of Omicron has been particularly cruel. For almost two years, many of us told our children that once they were vaccinated, they could reclaim many of the ordinary joys they’d had to sacrifice. Omicron postponed that reclamation. It shouldn’t be postponed a moment longer than necessary.
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