State officials this month announced they would provide KN95 masks — which better protect the wearer than cloth masks do — to elementary students when school begins.
Some elected officials have pointed to the mask upgrade as an alternative to mask orders in elementary schools because students who wear them may be less likely to catch the coronavirus from their unvaccinated, unmasked, infected classmates.
But doctors say problems with the masks’ fit and uncertain availability mean they cannot substitute for the safety provided by universal masking in classrooms.
“No mask is likely to provide 100% protection if you’re exposed to large amounts of virus, particularly with this hyper-transmissible strain of virus that we’re seeing,” said Dr. Andy Pavia, a pediatric infectious disease specialist at Primary Children’s Hospital.
Upgrading the masks that schools are providing “is a great step,” he said. “I don’t think it’s enough. I think everyone needs to be masked.”
N95 masks, which are certified for medical use in the U.S., and KN95, which are the Chinese version of N95s, filter out 95% of very small particles. Cloth masks filter the air less effectively.
That means if an infected person wears a cloth mask, it can block a lot of the virus-containing droplets they emit. But if an infected person goes unmasked and fills the air around them with those droplets, they may circumvent an uninfected person’s cloth mask, allowing that person to inhale the droplets and contract the virus.
That’s why cloth masks generally are more effective at protecting others from the wearer than they are at protecting the wearer from others — and the reason health experts have urged universal masking in elementary classrooms, where students are too young to be vaccinated. If only some of the students are wearing masks, they still would be exposed to the virus if an infected classmate is unmasked and freely emitting droplets into the air they share.
N95 and KN95 masks help make up that difference, keeping more virus-containing droplets out of the nose and mouth of the person wearing them.
Theoretically, that would allow students to protect themselves by masking, even if infected classmates choose not to wear a mask.
“We now have something we didn’t have last year, which is a mask that will protect them even better,” Salt Lake County Council member Aimee Winder Newton said in an Aug. 3 meeting, shortly after Gov. Spencer Cox announced the mask upgrade. Winder Newton, along with the council’s other Republicans, voted Thursday to overturn the county health department’s mask mandate in elementary schools.
But the new masks are not a silver bullet, Pavia warned.
The highest-performing medical-grade masks were designed for adults — and even with the state purchasing pediatric-sized masks, it may be difficult to fit them optimally to a child’s face.
“Fit is essential for any of these high-efficiency filtering masks,” Pavia said. “We’re not sure that KN95 masks are going to fit children well enough to have the same degree of efficacy they do in adults.”
The other difficulty posed by N95 and KN95 masks — which, unlike cloth masks, are disposable — is supply, Salt Lake County heath director Dr. Angela Dunn told council members.
“They are harder to come by,” she said.
That’s where state and school officials are hoping to step in. The state has ordered 350,000 child-sized KN95 masks from China — enough for each elementary student in Utah to have at least one.
The masks aren’t washable, confirmed Utah Department of Health spokesman Tom Hudachko. But there are ways to prolong one mask’s life for multiple uses to “get us through the first week of school,” Hudachko said — at least in districts that aren’t starting classes in the next few days. The KN95 masks aren’t expected to arrive from China until later this month.
For schools that open earlier, the state is providing surgical-style disposable ear-loop masks during the first week — less effective than KN95s, but better than nothing and possibly more effective than an ill-fitting cloth mask would be, Pavia confirmed.
Because state officials do not expect every student to claim a mask, they believe the initial shipment probably will last longer than that.
“We’ve also heard from several districts that they’re interested in ordering their own,” Hudachko said.
“There are funds to expand this if kids are actually using them,” said Jennifer Napier-Pearce, spokeswoman for Cox. The governor’s office also believes the Legislature would provide further funds for masks if needed, Napier-Pearce said.
For parents who wish to obtain their own high-efficacy masks, the U.S. Centers for Disease Control and Prevention warns that about 60% of KN95 masks in the U.S. are counterfeit or mislabeled. Buyers should contact the manufacturer to confirm the supply chain is legitimate.
