Coronavirus

Do Kids Really Need To Wear Masks at School?

“We essentially reorganized our society around the control of a single infectious disease, when in fact, health is plural," says Stanford professor of health policy Jay Bhattacharya.

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Should kids have to wear masks at school? And, if so, for how long?

Eighteen states require kids—in some cases as young as age 2—to mask all day in class, and nine states have banned school districts from requiring masks.

In July, Republican Governor Ron DeSantis issued an executive order banning mask mandates in Florida school districts, writing that "a right to normal education is imperative to the growth and development of our children and adolescents." DeSantis was influenced by parents like Tina Descovich, a former member of Florida's Brevard County School Board and co-founder of Moms for Liberty, which has 160 chapters and more than 70,000 members nationwide.

"We support parental choice in masking, always," Descovich tells Reason. "We believe a parent has the ultimate authority…the fundamental right to guide and direct the upbringing, the medical care and the education of their children."

Descovich says mask requirements have driven parental engagement to a level that she's never seen before, and that many have come to her with photos of their kids' faces with MRSA and infantigo, which are types of staph infections. Their concerns are very practical she says. "These parents are not out for a crusade."

Descovich says that her 13-year-old son "started experiencing some mental health issues" early in the pandemic. "The isolation at was not good for him….He would hide behind the mask." Descovich says he was diagnosed with the "contamination obsessive-compulsive disorder," a psychological condition in which individuals have an irrational fear of getting sick.

In October 2020, before DeSantis' order, the Brevard County School Board voted to extend its mask mandate, so Descovich pulled her son out of public school.

"It broke my heart, but it was necessary for his health and well-being."

"These decisions that parents are making are not necessarily coming from a place of science," says Lisa Gwynn, president of the Florida chapter of the American Academy of Pediatrics, which supports in-school mask mandates. They're "coming more from just personal preference."

Gwynn testified against the state of Florida in a lawsuit challenging DeSantis' executive order. But the judge in that case sided with the governor, stating in his decision that the school boards "failed to prove that" the state's mask opt-out rules "facilitate the spread of COVID-19 in schools."

"This is why judges should remain in the courtroom and not in the clinic because everything that he said is totally wrong," says Gwynn.

Gwynn acknowledges that COVID-19 poses a low risk of serious illness to young children but says mask mandates are necessary because kids can still spread the disease to adults. She also says concerns that mask wearing in schools hinders childhood development are overblown.

"Have these parents been inside a classroom?…[Teachers know that] kids are adjusting," Gwynn tells Reason. "That's what I love about working with children…they're very resilient." 

In early December 2021, the U.S. surgeon general announced that the pandemic has had an "unprecedented impact on the mental health of America's youth," though without specifically mentioning mask wearing. "The COVID-19 pandemic further altered their experiences at home, school, and in the community."

Because compulsory, all-day masking is a new phenomenon, there are no long-term studies on its effect on childhood mental health and development.

Are the benefits worth the potential costs?

"We think of [masks] as a completely benign intervention, but they are not," says Jay Bhattacharya, a professor of health policy at Stanford who testified as an expert witness on behalf of the state of Florida in the lawsuit over the governor's executive order. "We essentially reorganized our society around the control of a single infectious disease, when in fact, health is plural…A public action that benefits the reduction of one disease might hurt another disease. We have to think about these trade-offs all the time."

Bhattacharya points to an independent study of Florida schools that showed no statistical differences in the case rate between school districts that required masks and those that didn't.

"I don't believe that there's any evidence that it actually did much as far as COVID-19 spread for kids to wear masks," says Bhattacharya.

The most widely cited study in favor of mask mandates used data collected in North Carolina schools, which the authors wrote about on the New York Times op-ed page.  But that study suffered from a fundamental flaw: "Because North Carolina had a mask mandate for all K-12 schools," the authors acknowledged, "we could not compare masked schools to unmasked schools."

Rochelle Walensky, the director of the Centers for Disease Control and Prevention (CDC), recently shared a graphic claiming that "without mask requirements" schools were "3.5 times more likely to have COVID outbreaks." But that statistic is based on research that didn't account for whether schools were open in the period studied, tracked outbreaks as opposed to cases, and didn't control for vaccination status.

"You can't learn anything about the effects of school mask mandates from this study," Jonathan Ketcham, a public-health economist at Arizona State University, told David Zwieg of The Atlantic.

"There's no randomized evidence at all on masking children," says Bhattacharya. "That's what leads to this kind of scientific uncertainty."

Bhattacharya, who's an informal adviser to DeSantis, appeared with the governor on a panel in April of 2021 that YouTube removed from its platform because two panelists, including Bhattacharya, questioned the efficacy of masking children. Though the CDC recommends masking all kids, the World Health Organization only advises masking kids ages 5 and older. The European Centre for Disease Prevention and Control recommends masking kids ages 12 and older.

Parents of immunocompromised children have argued in court that DeSantis infringed on their liberties by making it dangerous for their kids to come to school.

Descovich says these parents already have the tools they need to protect their kids. "If you are concerned about your child's health, you will probably want to make sure they're [vaccinated] if they're high risk and that they are very well masked and that they have a well-fitting mask. But the blanket statement of masking another person's child who may have other issues is unacceptable," she says.

Some superintendents have also said that DeSantis has engaged in executive overreach and undermined local control and decision making in order to further his own political agenda.

"I believe in local control and am a champion of local control," says Descovich. "But on this one issue of government overreach, I think the role of government is to protect its citizens and to defend their individual liberty."

The Florida Department of Education also made available vouchers for any parent looking for an alternative masking policy from the one that's in place at their district school. Descovich supports this move but says that given the transportation challenges that low-income parents looking to exercise choice are likely to face, this approach isn't a solution.

For now, Florida has won its standoff with the federal government, which dropped a cease-and-desist order against the state for withholding funds from school boards resisting DeSantis's anti-mandate order. No district currently has a mandate in place.

Gwynn believes states like Florida that have outlawed mask mandates have taken the first steps down a very dangerous path.

"If we're going to just toss out public health measures, where do we stop? Where do we go from here? Do we start allowing people to not wear our seatbelts?" asks Gwynn. "If you want to do whatever you want to do in the privacy of your own home, that's one thing. But if your behavior affects somebody else, we as public health professionals have to make those decisions to do what's best for the entire community, not just for that one individual's rights."

But Bhattacharya says the more pressing danger might be the extent to which politicians and voters have handed over policy making decisions to public health authorities with a single-minded focus.

"[Public health] is fundamentally a complicated thing. And so to try to make it a morality tale of 'you must stop the spread of this disease at the expense of all else in life,' I think was an enormous mistake."

Produced by Zach Weissmueller; graphics by Nodehaus; audio mixing by Ian Keyser

Photos: ​​ERIC LALMAND/Belga/Sipa USA/Newscom; ev Radin/ZUMA Press/Newscom; Braulio Jatar / SOPA Images/Sipa/Newscom; John Nacion/ZUMA Press/Newscom; Lev Radin/Pacific Press/Newscom;  Mark Hertzberg/ZUMAPRESS/Newscom; Jason Bergman/Sipa USA/Newscom; Mark Hertzberg/ZUMAPRESS/Newscom

Music: Spearfisher and Michael Vignola licensed through Artlist.