Zornio: School is back in session and so is COVID-19. Should kids be masking up again?

School is back in session. There are new classrooms, new students, new activities, new teachers and new subjects. There’s also Pirola, a new COVID-19 variant. 

If that sounds lame, I agree. We all wish the virus would just go away. But that isn’t happening yet, so we’ve got to talk about it.

First and foremost, admit it: You clicked on this column with your mind already made up. Pro-mask or anti-mask doesn’t matter. What matters is that you likely have a preconceived notion of what the right answer is. In true school spirit, I challenge you to be open to learning and changing your mind.

So, let’s dive right in: Given COVID-19 cases are on the rise, should kids start wearing masks again? The answer is yes and no.

Before I elaborate on the nuances of why, I want to acknowledge those of you who follow my columns and who might have noticed that this answer is a little different than the resounding yes I gave to masks earlier in the pandemic.

To be clear, this difference is not because the science of masks has changed. Worn correctly, masks remain a deeply effective tool in reducing the spread of airborne viruses such as COVID-19. It’s why surgical teams have long worn masks while operating, and why cancer patients wear masks to reduce the likelihood of infection.

The change comes because the pandemic has evolved over the past several years. While universal masks for COVID made sense before, conditions are somewhat different now. As is always the case, different variables yield different outcomes, so we have to reassess.

Looking back at when the pandemic started, there were no vaccines, no understanding of variant lineages or transmission methods and the global population was immunologically naive. Combined with a spiking rate of hospitalizations and deaths, it was clear from the beginning that extreme preventative measures would be necessary to prevent millions of Americans from dying.

It’s hard to remember, but only a few years ago thousands of American health care workers were dying of COVID-19 and hospitals were so overrun by the virus that we resorted to storing dead bodies in refrigerated semi-trucks. Since then, more than 1.12 million Americans have died of COVID-19, and millions more still struggle to recover from the effects of the illness. For context, these staggering death rates dwarf cold and flu deaths by up to 10 times or more annually, and the average American life expectancy has already dropped by almost three years since COVID first reached our shores.

It’s easy to feel we failed given such immense loss, but it could have been so much worse. This was the impact of COVID-19 in America with partial prevention methods such as testing, isolation, masks and vaccines. Could it have been better with full prevention? Likely. But imagine what the death toll would have looked like had we not slowed the spread of the disease. I shudder to think of it.

Luckily, a lot has changed since 2019, although the virus remains a serious health matter. We now have vaccines, and at least for those who choose to get them, they work to reduce the severity of the disease. For those who don’t, the rate of death by COVID-19 remains notably higher, and there have been more than 318,000 preventable COVID-19 deaths nationwide so far. By the way, over 4,500 of those deaths are estimated to have come from Colorado. Do you know someone who died because someone told them not to get vaccinated?

Even more telling, after the vaccines became available a partisan divide in use has led to a whopping 43% increase in excess Republican deaths compared to registered Democrats. In other words, Republican leaders who pushed anti-vaccine narratives are literally killing their own base at higher and unnecessary rates, a staggering political influence on health given there was no disparity in death rates by political party prior to the availability of vaccines.

Another change since early in the pandemic is that the population is no longer naive to the virus. Last week, the Centers for Disease Control and Prevention updated their website to reflect estimates that 97% of the U.S. population is now likely to have some antibodies to SARS-CoV-2 via either natural infection, the vaccine or a combination. While long-term impacts are still an ongoing area of research, it’s expected that this change will help to at least partially mitigate the severity and lethality of COVID-19 going forward, particularly if people continue with vaccine boosters. 

Yet it’s critical to note that having antibodies does not guarantee the prevention of infection, and in addition to the severity of infection correlating with organ damage, even mild cases of COVID-19 have correlated with persistently reduced lung function. This further illustrates the importance of employing an array of infection prevention strategies, particularly as the impact of repeated mild infections and the subsequent potential for compounding lung, heart and brain damage remains unknown.

This brings us back to schools. Given the above, it’s clear that keeping infections low is still in the best interest of public health. And as schools are a place with lots of new people mingling, they are a fantastic breeding ground for viruses. Add to the mix that children are exceptionally cute Petri dishes, reducing the spread of COVID-19 in schools will directly equate to reducing the likelihood that a child’s parent, caregiver or other adult family member will become very sick or die.

To this end, the most effective prevention strategy is to layer germ-fighting methods starting with a mandate in schools for COVID-19 vaccines. This remains a cheaper and easier option than treating COVID-19 patients, and especially if combined with testing and air filtration, these options could substantially reduce the need for students to wear masks in many if not most classrooms. 

Still, there are exceptions. If a student or teacher has recently tested positive, it would be smart for the class to resume wearing masks to reduce the likelihood of further spread. Similarly, if a classroom has particularly poor air circulation, poor vaccine uptake and/or medically vulnerable people, then choosing to have students still wear a mask makes sense. It’s also a great learning opportunity in science and compassion for others.

The Pirola variant itself might not be poised to significantly worsen COVID-19 outcomes, but as the virus continues to evolve, so, too, must we evolve with it. For now, that means continuing to employ basic prevention strategies in appropriate situations to reduce spread, and yes that sometimes includes masks.

One more thing before the school bell rings: If you’re still not convinced to help lower infection rates for others, consider doing it for yourself. I don’t know about you, but I’m not excited about risking internal organ damage with repeated mild to moderate cases of COVID-19 when I have cheap and easy access to tools that can prevent it. It’s the same reason I don’t smoke and make an effort to get exercise. Efforts to prevent myself from getting COVID-19 are no different.

Trish Zornio is a scientist, lecturer and writer who has worked at some of the nation’s top universities and hospitals. She’s an avid rock climber and was a 2020 candidate for the U.S. Senate in Colorado. Trish can be found on Twitter @trish_zornio