To Mask, Or Not To Mask: Epidemiologists Debate Rules For K-12 Students This Fall

Download Audio
Students wear face masks in their classroom in Dortmund, Germany amid the COVID-19 pandemic. (Ina Fassbender/AFP via Getty Images)
Students wear face masks in their classroom in Dortmund, Germany amid the COVID-19 pandemic. (Ina Fassbender/AFP via Getty Images)

The COVID-19 advisory panel for Brookline public schools met late on a Friday afternoon last week to discuss, as they had for over a year, safety in the district’s classrooms. But that morning, the Centers for Disease Control and Prevention had thrown what David Gacioch, the panel’s co-chair, called “a curveball.”

The CDC released the recommendation that students who are fully vaccinated don’t need to wear masks indoors this fall. The guidance seemed clear, except for one problem: many students are too young to get vaccinated or simply haven’t gotten the shots. So how exactly, Gacioch's committee wondered, are schools to implement this new guidance?

The answer is a point of debate among K-12 school communities and epidemiologists.

“You could make it an educator option for a classroom,” Gacioch suggested during the meeting. “To give teachers the option of saying masks either are or aren’t required in my classroom.”

“I mean, that sounds very nerve wracking to me,” Liz Crane, a Brookline science teacher, replied.

“OK,” Gacioch said.

“It just puts a lot of pressure on teachers,” Crane said.

She worried it would be difficult to enforce different rules for different classrooms, and the inconsistency might lead to confrontations between students and teachers.

The simpler option is to go with a single rule: require masks for everyone or for no one. Across Massachusetts, school leaders are trying to decide which rule to adopt, and epidemiologists haven’t quite made their minds up either.

Some feel strongly that masks should be optional this fall – across all schools.

“We have enough immunity to keep cases low,” said Dr. Shira Doron, a hospital epidemiologist at Tufts Medical Center. “So, [the decision] has got to be based on what is the level of danger in the community to justify mandating masks.”

Doron co-authored an op-ed in US News and World Report arguing that Massachusetts schools should drop mask requirements this fall in communities where vaccination rates are high and cases are low. She says many communities may now have such low rates of COVID that it’s unlikely the virus will enter the schools.

“When the risk is tiny, and you continue to mandate mitigation measures, you’re not appropriately characterizing the state of the pandemic,” she said.

Children and teens have, by and large, adapted well to masks, but Doron argues they can still interfere with critical learning needs. She points out, for example, that being able to see faces and mouths is important for social development, language learning and even speech therapy.

“Social interaction where you can see people’s faces is actually priceless,” she said. “I can’t give you data on that – I’m not that kind of scientist – but I feel it as a human.”

There are certain scenarios where Dr. Andrea Ciaranello, an infectious disease physician at Massachusetts General Hospital, can see waiving masks – like in places where nearly all students might be vaccinated, or for students with certain special needs – but not for everyone. She thinks it’s better to start the year off with a mask requirement in schools with students under 12, who are not yet authorized for the vaccines.

“We very rightfully are a little bit worried about going back to school in the fall,” she said. “I think to start out that way, it’s quite a bit easier to flip the switch in the opposite direction and say, ‘things are actually going really well. Maybe we don’t need masking anymore.’ ”

Then, school districts could drop their mask requirements mid-year if COVID reached a low enough level and vaccination rates were high.

“In that context, it really doesn’t matter what mitigation measures we use, because there’s just no COVID to prevent the spread of,” Ciaranello said.

The only question is – what exactly is that magic rate of vaccinated people?

“Yeah, I don’t think anyone knows,” said Dr. Benjamin Linas, an epidemiologist at Boston Medical Center.

In theory, he agrees that once enough people are vaccinated, even unvaccinated elementary school kids should be protected from the coronavirus due to the broader immunity in the community. He just isn’t sure what “enough” is.

“And that’s what we’re really struggling with. Like, no one really knows when it would be safe, when you can just fall back on herd immunity and know that it’s safe,” Linas said.

It’s also getting harder to pinpoint that threshold as more infectious COVID variants like the Delta variant circulate. If, by even a small chance, one of these variants takes hold in an unvaccinated pocket of Massachusetts – like an elementary school – the results could be tragic. Plus, Linas says nobody can predict whether new vaccine-resistant mutations will emerge.

“It makes me a little nervous to go all in 100%, that our only mitigation measure going through all the subversions of Delta and into the end of the pandemic – we’re just going to fall 100% on the safety net of the vaccine,” he said.

Just to exercise a bit of caution, even if it turns out to be unnecessary, Linas argues is worth it. So he recommends that masks should be mandatory, at least in elementary school classrooms where kids cannot yet be vaccinated.

There might be another reason to keep masks on, one that has little to do with the statistical risk of catching the coronavirus. Almi Abeyta, the superintendent of Chelsea Public Schools, says if mask requirements can help families feel safer sending their kids to school in the fall – then it might be worth it.

“We’re just so grateful that we’re physically in person, because we were remote so long," she said. "For us, wearing a mask is, like, not a big deal.”

What’s more important to Abeyta is creating an environment where teachers can meet students face to face. Like Brookline, Chelsea hasn’t made a final decision about mask rules yet. It’s something she and other Massachusetts school leaders will continue puzzling over for a few more weeks.

This segment aired on July 15, 2021.


Headshot of Angus Chen

Angus Chen Reporter, CommonHealth
Angus Chen was a reporter for WBUR's CommonHealth.



More from WBUR

Listen Live