Utah doctors believe there are two big hurdles in getting students to wear masks at school this year: state lawmakers and misinformation.
There’s little they can do about the ban on mask mandates passed by the first one. But they are trying hard to address the second.
With most kids now back in the classroom, physicians say masks are key to limiting the spread of COVID-19. That is especially the case as the contagious delta variant spreads and with those younger than age 12 not yet eligible to get vaccinated.
Of the 1,491 new cases reported Thursday by the Utah Department of Health, 358 were among kids in grades K-12.
But doctors say they still are seeing many parents not sending their kids to school in masks — and it is putting them at serious risk. Kids can get very sick with the virus, they stressed.
“With the delta variant, things are going to get worse,” said Dr. Richard Orlandi, chief medical officer for the University of Utah’s department of ambulatory health. “I wish I didn’t have to say that. And if we have a lot of spread among children in schools, those children then bring the virus home to their parents and grandparents.”
Already, pediatric cases of the virus are making up about 20% or more of the new diagnoses each day in the state — just a week or two into classes for most school districts. Orlandi believes a spike in child hospitalizations will shortly follow. And, he added, much of that can be prevented with a piece of fabric.
Last year, face coverings were required in Utah’s public K-12 schools. And spread in classrooms was fairly contained. This year, though, there can be no mask mandates issued by school districts because of a ban by the Republican-dominated Utah Legislature.
(Trent Nelson | The Salt Lake Tribune) People fill the room as the Salt Lake County Council voted down Dr. Angela Dunn's mask ordinance for K-6 students, on Thursday, Aug. 12, 2021.
Orlandi hopes to convince parents to listen to the science and choose to put their young ones in face coverings anyway.
These are the top myths Utah doctors say they’re hearing and combatting with facts.
Myth 1: Masks force you to breathe in your own carbon dioxide.
Adam Hersh, an epidemiologist at U. Health and Intermountain Primary Children’s Hospital, says this is the most prevalent untruth about masks.
He says that CO2 molecules that people breathe out are small enough to go through the pores of masks and are not held there for individuals to inhale back in. That means: There is no risk of carbon dioxide poisoning by wearing a mask.
“The concerns that have been raised about carbon dioxide building up in a mask and subjecting kids to carbon dioxide poisoning are fortunately unfounded,” he said.
Masks are meant to prevent respiratory droplets from getting out, which carry the virus and which they are effective at doing, extensive research shows. Those droplets are larger and are captured by the mask.
Orlandi said nothing is “going to be 100%” in this pandemic, and it is possible some of the virus gets through. But “what we’re trying to do is substantially reduce the risks.”
Myth 2: Masks are causing students to develop anxiety or depression.
There is no evidence of any spike in mental health disorders connected to mask usage, said Jeremy Kendrick, an assistant professor of psychiatry at the Huntsman Mental Health Institute.
There has been no increase in pediatric admissions to psychiatric units. In fact, in Utah, reports of mental distress actually decreased for the first several months of the pandemic.
That doesn’t mean there are no issues, Kendrick said. But it’s good news overall.
He believes some parents are noticing changes in mood in their kids, and it’s “tempting to look at masks” as the cause.
Kendrick believes kids are resilient, though. And he suggests they are more likely to be negatively impacted by the confusion and uncertainty of school opening and shutting with outbreaks. And being around their friends is the best boost for their emotions.
“Kids are more anxious now,” he said. “That’s something we can’t deny.”
He also says the pandemic, itself, is causing some general increases in stress. Children often come to him worried about getting their parents or grandparents sick.
And he noted that kids might be picking up on the anxieties of their parents. He said families should openly discuss what’s going on and try not to overplay fear.
That’s more reason, though, he added, to have kids in masks. Mask wearing is shown to reduce cases and transmission in schools, meaning they are more likely to stay open. And kids wearing masks can help limit spread to older family members.
In some societies, too, particularly in Asian countries, where mask use was common even before the pandemic, Kendrick said, there are actually lower rates of depression.
The only concern he has is about bullying of kids wearing masks when most are not. He believes face coverings should be mandated to help avoid that and transmission.
He also said that the state will continue to watch mental health statistics for any concerning trends. The state already has one of the highest youth suicide rates in the country. Kendrick said health experts don’t want to see that get worse.
Myth 3: Wearing masks limits exposure to germs and therefore weakens the immune system.
Orlandi couldn’t help but laugh a little at this one.
As a surgeon, he said, he regularly wears masks to reduce the spread of germs in the operating room. It is shown to work. And it certainly hasn’t impacted his immune system, he said.
“We’re wearing masks all day long,” he said with a chuckle. “Somehow, we’re still functioning.”
And since all health care workers began regularly wearing them, cases of COVID-19 in hospitals has “dropped off significantly,” Orlandi added.
(Francisco Kjolseth | The Salt Lake Tribune) Utah artist Heather Olsen, left, talks with Intermountain Healthcare nurse Maria Black as they talk about the nurses, doctors, respiratory therapists, clinical and non-clinical workers that inspired Olsen’s new painting paying tribute to frontline health care workers during the COVID-19 pandemic, Monday, April 5, 2021 in Murray.
He asked parents to do a “smell test” on rumors like this one: “Does that make sense? Does that really pass the sniff test?”
He said, there “some theory” that being exposed to germs at a young age can be beneficial for building the immune system.
“But I certainly don’t think that wearing masks for a few months, or however long we need to, is going to affect a child’s immune system,” he said.
A big part of decision making right now, the doctor added, should be about weighing risks and benefits. He strongly urges people to understand that the risk of contracting COVID-19 could have lifelong impacts, including in kids.
It is better to put on a mask and avoid that, he said.
Myth 4: Kids can’t wear masks for an entire day. It’s too hard, and they won’t keep them on.
Hersh said, for the most part, kids have no issue with wearing masks. Most students in Utah wore them last year when they were required. And schools have reported few problems with young children keeping them on.
The doctor said they are pretty easy for everyone to get used to wearing. It just has to be normalized.
The biggest side effects he sees are occasionally rashes and acne from the mask, as well as some discomfort and sweating. “Those are real concerns, but they’re concerns that can be managed,” Hersh said.
The key to getting kids to keep masks on is finding one that fits them well and that they like. The includes using masks that are child-size and in fun patterns.
“The best mask for kids is one they’re comfortable wearing for a long period of time, for the whole school day,” he said.
Teachers can also provide opportunities and spaces where a kid can take the mask off for a minute, if needed.
Myth 5: Taking masks off for lunch and recess makes wearing them the rest of the day moot.
Hersh acknowledges that lunch and recess do present challenges. But, he said, it doesn’t have to negate the benefits of masks used the rest of the school day.
“Obviously, eating requires removing masks,” he said. “And it’s true that lunch time is one of our higher risk times.”
(Francisco Kjolseth | The Salt Lake Tribune) East High School students fill the cafeteria for the first day back of school on Tuesday, Aug. 24, 2021
There are steps, though, that schools can take to mitigate the risks at those times.
That includes spacing children out as much as possible and encouraging students to eat outside when weather allows. With recess being outside, that’s already a less risky situation.
The lunchroom should also be well-ventilated with doors open to get air flow. And students should be instructed to limit yelling and shouting that can propel virus droplets.
Even with lunches and recesses last year, schools saw little transmission with mandatory masking for the rest of the day, Orlandi added.
Myth 6: COVID-19 particles can easily get into fabric masks. If a kid isn’t wearing a N95 or a KN95, it’s not worth it.
Hersh said he studied Utah schools during the 2020-2021 academic year. With mandatory mask wearing, most in-school transmission rates were below 1%. (Those in other states without requirements went as high as 50%.)
And any infections here were “almost always linked to an issue with mask use,” Hersh said.
In fact, masks are so effective that now kids who are exposed to the virus at school can remain in school and not quarantine as long as their face was covered at the time.
Hersh believes parents should see that as a strong scientific endorsement. “They are highly effective in preventing transmission,” he said.
And, he added, it doesn’t really matter what kind of mask your kid wears.
No one particle, Hersh noted, causes an infection. And any fabric should be able to block most. Risks are lower with masks that have multiple layers. But parents should feel comfortable sending their kids to school in cotton face coverings, which prevented a lot of transmission last year.
It is more about finding something that your kid will wear and keep on. A higher-quality N95 or a KN95 is not necessary.
And the more people wearing masks means more protection, Hersh said.
He offered a warning, too, for those who still are not convinced: “If you’re not vaccinated and not wearing a mask and going to school, you should assume you’re going to get sick.”
To believe anything else, would be a myth.
