Opinion: Universal masking is vital to keeping children safe, and schools open

I am a pediatrician who has seen, first-hand, the threat COVID-19 poses to kids. I am also a parent who has seen, first-hand, the detrimental impacts of interrupted learning. To protect our children from the physical risks of the virus and the mental and emotional risks of isolation, I am calling on officials, school leaders and parents to encourage masks in school settings.

Colorado is seeing rising case numbers as the delta variant spreads, and the Children’s Hospital Colorado system is seeing more children testing positive for COVID-19, including in Denver. This surge coincides with other factors that are increasing admissions and stressing our pediatric hospitals: an earlier-than-normal season of respiratory viruses like RSV and croup; a growing number of children experiencing anxiety and depression; and a national shortage of skilled healthcare professionals to care for patients.

One thing we’ve learned over the past 18 months is that in-person learning and socialization are vital for our children’s physical and mental health. Youth depression and anxiety were rising before the pandemic, and the isolation and uncertainties of the past 18 months made it much worse. The best way to keep kids out of the hospital and in their classrooms is to practice research-tested prevention measures: getting vaccinated, wearing masks, social distancing, handwashing and staying home when sick. 

Because kids under 12 are not eligible for the COVID vaccine and less than half of Colorado adolescents and teens have been vaccinated, face coverings are crucial to keeping children safe and learning in-person. And, while studies show that face coverings prevent disease transmission, no research indicates that masks damage children’s mental health. We continue to observe that most kids are so happy to be back in school with their peers and teachers, they don’t care about wearing a mask.

Every year when school starts, Children’s Hospital Colorado locations experience an increase in patients due to behavioral health crises and respiratory illnesses. But it’s unprecedented for us to see both rise so early. As of mid-August, overall inpatient volumes are running more than 20% higher than normal for this time of year, and pediatric intensive care unit volumes are running 60% higher. 

Since more respiratory viruses will circulate now (we typically see a 30% increase in emergency department volumes after school starts), we must prevent outbreaks that lead to quarantines, school closures and potential hospitalization. With the delta variant, one unmasked child with SARS-CoV-2 can potentially infect five to six kids in a classroom, compared to the one to two we saw with the initial variant. There’s a much higher risk of widespread outbreaks that could lead to school closures.

And, as the pediatric safety-net hospital for a seven-state region, Children’s Colorado already is caring for sick children from full hospitals in neighboring states. To flatten the curve for children in Colorado, we need to require masks in schools. 

Because masks are a proven tool in stopping the spread of respiratory viruses, we believe that all school staff and students should wear face coverings indoors at schools and childcare centers, regardless of vaccination status. We support universal masking policies in schools for multiple reasons.

First, we know as parents that children are much more likely to keep masks on when everyone around them is, too. In addition to preventing outbreaks and hospitalizations, universal masking policies in schools will reduce the likelihood of bullying tied to mask wearing and reduce uncertainty —  two additional sources of anxiety for kids. 

I understand that everyone is tired of the pandemic. So am I. But as adults and older kids get vaccinated and schools are eager to return to “normal,” we can’t forget the well-being of the youngest among us. Let’s protect them by ensuring that everyone 2 and older wears a mask indoors, stays home and gets a COVID test while sick, and gets vaccinated as soon as possible. Our kids’ physical, mental and emotional health depends on it.  

David Brumbaugh, MD, of Aurora, is a pediatric gastroenterologist and chief medical officer at Children’s Hospital Colorado. He’s also the father of three children.