Whether students will be wearing masks on the first day back to school in the fall is more likely to be determined by the preferences of their parents and the district where their school is located than on current public health guidance.
Harford County’s public schools are expecting to start the school year without masks, while in Baltimore City everyone — staff and students — will be masked whether they are vaccinated or not.
The varied decisions by local leaders come as the U.S. Centers for Disease Control and Prevention encouraged all schools to throw open their doors to normality in the fall and specifically advised — but did not require — unvaccinated students and staff to wear masks. The CDC and Maryland leaders have left the decision to local school officials, as they have throughout the pandemic.
The federal guidance is widely supported by public health experts, who agree all students should be back in school. That doesn’t mean everyone would follow it or that it would be easily enforceable, said Dr. Aaron Milstone, a pediatric infectious diseases specialist in the Johns Hopkins Children’s Center.
“People may be underestimating the challenge of knowing who is vaccinated,” he said. “It’s an honor system, and given the political climate, that’s a leap of faith. I do think school will pose a challenge in the fall” for administrators navigating new guidelines.
It’s likely fewer than half of students will be vaccinated when schools reopen in August and early September. Vaccines aren’t approved yet for children under 12, while about 50% of children 12 to 17 years old are at least partially vaccinated.
Pfizer has said it would seek emergency authorization in September for children 5 to 11, and it usually takes four or five weeks before federal regulators rule on such a request, according to Andrew Pekosz, a virus researcher and professor of microbiology and immunology in the Johns Hopkins University Bloomberg School of Public Health.
“The under-12 group I think about most these days because come fall, they are going back to school and they won’t have the vaccine yet and they’ll be coming together in a group setting,” Pekosz said.
While children are less likely to get COVID-19 and become severely ill even when they are unvaccinated, there have been severe cases, and related conditions, including long-haul syndrome, where people develop previously unseen symptoms that persist, according to Dr. Kirsten Lyke, infectious disease specialist and an investigator in the University of Maryland School of Medicine’s Center for Vaccine Development and Global Health.
Further, Milstone said the delta variant that is now the dominant strain in the U.S. is far more transmissible, and every time a new person is infected is a chance for new mutations that could be potentially more dangerous to children.
Other respiratory viruses are also making a comeback and more are expected in the fall, such as flu. Masking will help prevent those diseases from overwhelming the health care system and confusing officials about which infections they are dealing with, he said.
Milstone said the accessibility of rapid COVID tests for those with symptoms will be essential for schools, as well as people with a runny nose or sore throat wearing a mask.
Masks were required in nearly all schools last year, but schools quickly shifted their rules after the vaccination rate rose in the state and Gov. Larry Hogan lifted the mask mandate July 1.
The state health department is requiring masks on all public transportation, including school buses. So every student who doesn’t walk or is driven to school will have to wear a mask.
Maryland’s health officials say they “strongly recommend but do not require” individuals who have not been vaccinated continue to wear masks indoors.
On Monday, the American Academy of Pediatrics recommended that everyone two years and older wear a mask in school regardless of whether they are vaccinated. The organization supports students learning in person this fall.
School system officials in Howard and Anne Arundel counties said they haven’t decided whether to require masks or on social distancing, although most schools do not have the room to maintain 6 feet of space between students — as they did last spring — and fully open.
Baltimore County school officials say they will recommend masks for those who are not vaccinated.
“Wearing a mask is now a personal choice and not a health mandate,” spokesman Charles Herndon said.
Carroll County has made face coverings optional for all staff and students, although it will support any individual who wishes to wear a mask.
In Baltimore City, which has a large Black population that has been reluctant to return to school, the policy is the most restrictive. All students and staff will be required to wear masks, and students must maintain a 3-foot distance from one another and staff a 6-foot distance from students.
But Gwendolyn Chambers, a spokeswoman for the city schools, said the system will continue to evaluate its policies going into the fall.
Some Baltimore County parents don’t want students to have a choice about wearing a mask.
“As a school system, we attempt to pride ourselves on evidence-based decision-making,” said Megan Stewart-Sicking, co-chair of the Special Education Citizens’ Advisory Committee. “Where is that now?”
While some special needs students who have difficulty wearing masks should be accommodated, she believes unvaccinated students should have to wear masks.
“By not following CDC guidance, we are in danger of a free-for-all mentality that is based on arbitrary standards rather than scientific ones.”
In Baltimore City, parents generally support the masking requirement, said Larry Simmons, chair of the Parent Community Advisory Board. City kids take public transportation, he said, which will expose them to more individuals who may carry the virus.
While Black parents have been generally more reluctant to send their children back to school, he said, the mask requirement has the support of parents of all races. “I think parents want masks, even if [students and staff] are vaccinated. This is the one time when there is agreement among parents,” he said.
But school districts have also heard from a vocal group of parents who want no mask requirements, citing better COVID outcomes for kids compared with adults.
National surveys of parents show support for masking. A Rand Corp. survey in May showed 74% of parents wanted to keep safety measures, including mandatory masking, in place. A May Morning Consult poll found a third of K-12 and college parents were comfortable sending their students to school without masks.
A National Parents Union survey from June found that 45% of parents whose children remained remote last school year would not send their kids back unless the school was providing masks to every student and staff member.
The state’s largest teachers union has not taken a stance on masking.
“Many systems still haven’t finalized their fall plans and with constantly changing CDC guidance based on the new variant, it makes it difficult to gauge this far out,” said Maryland State Education Association president Cheryl Bost. The union continues to push health and safety measures, including upgrades to air filtration systems in schools. “Healthy air should be a requirement in all schools,” Bost said.
Other public health experts agree that conditions could quickly change and schools should be ready to take steps to protect students, teachers and staff.
The high vaccination rate in Maryland and the low number of cases means the risk is lower in the state than elsewhere in the country, said Matthew Frieman, coronavirus researcher and professor of microbiology and immunology in the University of Maryland School of Medicine.
In the fall or winter, the delta variant or another variant could cause cases to again rise and schools should be prepared to ask everyone to wear a mask. They should also ensure good ventilation and distancing as much as possible.
That doesn’t mean wearing a mask now shouldn’t be encouraged, he said.
“The virus is not gone and the risks are still present,” Frieman said. “We understand little about the long-term consequences of infection, especially in children. Masking is a minimal inconvenience that can readily block infections in our community.”
But Jennifer Nuzzo, a Hopkins epidemiologist, said the CDC also should provide better guidance about when schools can end safety precautions, including removing masks.
“It’s good public health practice to define endpoints for any intervention,” Nuzzo wrote on Twitter.