Masks or No Masks

One vexing question as schools and childcare centers reopen is whether to require children to wear masks.  Although the emerging consensus is that face coverings help prevent the spread of the disease, experienced care providers know that children, particularly younger children, are not likely to wear them properly.  Teachers will spend most of their time reminding children to put on their masks, helping them find their masks, and telling them that masks are not slingshots. 

Every guidance recommends against masks for children under the age of 2.  For ages after that, most guidelines give individual organizations leeway to decide for themselves.  The CDC guidelines recommend masks “if feasible.”  Georgia’s guidance for schools varies based on the level of cases in the local community, and gives schools considerable leeway.  The American Academy of Pediatrics clinical guidance suggest requiring masks only for middle- and high-school students, and only then when social distancing is not possible. The guidance does recommend masks for elementary school children “when harms (e.g., increasing hand-mouth/nose contact) does not outweigh benefits.”

Another consideration is which activities the children are engaged in.  For example, face covering is not feasible when children are physically active, particularly on the playground.  Even physical distancing is not practical in those settings, and the harms from not allowing children to be active generally outweigh any risks of spreading the virus.  Fortunately, the risks of outdoor transmission are much lower than indoor, and the AAP in particular noted the advantages of play for children.   

One important factor is what the AAP noted as the “mounting evidence” that children are less likely to have severe symptoms from COVID-19 and may be less likely to spread the infection to others.  A recent article in Science noted those studies, and reviewed what we have learned from countries around the world that reopened their schools early or never closed them.  Although data is scarce, particularly the sort of causal connections that we all wish we had, the trends support the AAP guidance of requiring mask wearing for older students, but not for younger ones.

In short, we still do not know the best ways to reduce the spread of the virus, but face coverings seem to help.  We also know, however, that measures such as distancing and masks carry their own set of mental health harms for children.  There is no one-size-fits-all rule.  As with any policy that you adopt for your organization, document in your files all of the factors that go into your decision of whether and when face coverings are feasible.  Within the various guidelines and emerging science, you have room to find the balance that works best for your particular area and population.

If you have specific questions about policies for your organization, Taylor English Duma will be happy to help.