Mask recommendation for schools comes amid surge of 'winter viruses'

July 21, 2021
Girl wearing a mask.
Will parents choose to send children to school in masks? Kids under 12 are unvaccinated unless they've been in a clinical trial. Photo by Sarah Pack

The American Academy of Pediatrics’ recommendation that everyone over the age of 2 wears a mask in school comes as MUSC Children’s Health is seeing an uptick in kids sick with viruses that normally aren’t a problem this time of year.


“Last winter, we nearly eliminated the respiratory viruses that affect so many of our children by wearing masks, physical distancing and hand hygiene,” said Elizabeth Mack, M.D., a spokeswoman for the AAP. “Now, they’re back with a vengeance — RSV, rhinovirus, parainfluenza. Probably the number one reason is because we’ve relaxed our masking.”


The number of kids with COVID in the hospital is up too, she said. “It’s not a huge number, but we’re seeing more than we have been for a number of months. It’s obviously a concerning trend, particularly as we head closer to the start of school.”


Local schools start in mid-August, less than a month from now. They won’t be able to mandate masks because of an executive order the governor signed last May, leaving decisions about masks and kids up to parents. And the AAP isn’t asking them to issue mandates. It’s giving evidence-based guidance, Mack said.


Dr. Elizabeth Mack looking in a window and wearing a mask. 
Dr. Elizabeth Mack at work as a pediatric critical care intensivist in the MUSC Shawn Jenkins Children's Hospital. Photo by Sarah Pack

That includes encouraging all students and staff to mask in school, regardless of whether they’ve been vaccinated. “It’s not like there’s a visual cue that tells us someone is vaccinated,” Mack said. “If everyone wears a mask, we know they have more protection against COVID.”


The nation’s top infectious disease expert has endorsed the AAP’s mask recommendation. Anthony Fauci, M.D., said the AAP is going the extra mile to protect kids as the number of cases rises — and the CDC is now reviewing its own COVID school guidance.


The AAP also recommends that everyone eligible to get vaccinated take advantage of it. But right now, that’s only people 12 and up. “Kids under 12 have not had access unless they’ve been in a study,” Mack said.


“The vaccine studies for kids younger than 12 are going well, but I don’t think they’ll be finished in time for the fall. And even if various manufacturers’ vaccines were approved by the fall, it would take time to get kids vaccinated and move toward any kind of herd immunity.”


Meanwhile, a lot of South Carolinians who are eligible to get COVID-19 vaccines haven’t had a first shot yet. And nationally, less than half of children age 12 to 18  had at least one vaccine as of July 14, according to the AAP. The rate at which kids are getting vaccinated has slowed dramatically.


Against that backdrop, the virus continues to mutate. The fast-spreading delta variant has caused more than 80% of new COVID cases across the country.


But it’s important for schools to be open for in-person classes, Mack said. The pandemic has affected not only kids’ education but also their physical and mental health.


“Schools have showed that they can do this safely. Particularly in the Lowcountry, we have really nice data that showed that mitigation strategies allowed schools to provide a safe environment with the inclusion of masking children. We know that masking and vaccines are safe and effective.”


Whether that mitigation includes masks will be up to families. “The better part of valor and the safer move is to return to in-person school with masking in place,” Mack said.

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