States may end school mask mandates. Should my child still wear one?

In the two years that we’ve been dealing with COVID-19, wearing face masks while grocery shopping or at the gym has become routine for many of us. But, thanks to falling COVID-19 numbers and the latest guidelines, the majority of people in the U.S. live in areas of the country where they’re no longer required to wear masks — including in schools.

While lifting restrictions like these may come as a welcome sign of life returning to something like normal, public health experts emphasize that every family, community and school is likely dealing with different COVID-19 dynamics. As we shift to making these decisions more individually, it’s important to know your own risk factors and to keep others’ risks in mind as well.

Face masks are still a key public health tool in the pandemic

Along with vaccines, frequent testing, increased ventilation and other measures, face masks are part of an effective layered strategy to help prevent the spread of COVID-19, Saad Omer, director of the Yale Institute for Global Health and professor in the department of infectious diseases at the Yale School of Medicine, told TODAY.

The most recent mask guidelines from the Centers for Disease Control and Prevention don’t do away with masks entirely; rather they recommend people wear face masks as their community COVID-19 levels increase — and leave it up to the individual to decide whether or not to wear one when the level is low. That community metric is based on case numbers but also incorporates data about the level of burden on health care systems in the local area.

Case numbers have declined from the February peak of about 400,000 per day to more like 50,000 per day in early March, according to NBC News estimates. With that in mind, some experts told TODAY that it makes sense to rethink mask mandates now, knowing that they’ll probably have to come back if another surge hits.

Should your child keep wearing a mask even after the mandate is lifted?

For some schools, it makes sense to make masks optional, although they may come back if and when another COVID-19 surge happens, Dr. Megan Ranney, emergency medicine physician and associate dean for strategy and innovation at the Brown School of Public Health, told TODAY.

But figuring out when to let mask mandates go is particularly tough for schools. That’s largely because vaccination looks very different in kids than it does in adults. While about 65% of the total population is fully vaccinated, according to CDC data, the rates for children are much lower. Among 12- to 17-year-olds, 58% are fully vaccinated and only 26% of 5- to 11-year-olds are fully vaccinated as of March 2, the most recent CDC data available shows. Children younger than that still can’t get vaccinated against COVID-19 at all.

Those levels of vaccination are “not high enough, in my opinion, to take away one of the mitigation measures that we know works,” Dr. Taison Bell, assistant professor of medicine in the divisions of infectious diseases and international health and pulmonary and critical care medicine at the University of Virginia, told TODAY.

“My child who’s low risk and healthy, I’m not particularly concerned about him,” Bell said. “But I don’t want to assume that the kids in his classroom are also in that same boat, especially if there’s a high chance that they’re unvaccinated as well.”

Overall, “vaccination coverage is high but not as high as you would like in the context of a highly contagious variant like omicron, and booster coverage is extremely low,” Omer explained. He added that “there’s a huge chunk of children for whom these vaccines are not available,” so it may still make sense to have masks in school for now — especially for that youngest age group.

And with the latest data on Pfizer’s vaccine in 5- to 11-year-olds suggesting a significant drop in efficacy against omicron, “I and others suspect that school masking mandates have been released a bit on the early side in many schools,” Ranney said.

Making the best decision for you, your family and your community

“There is a time to unmask,” Ranney said. And, in general, that’s “when cases are low and vaccine uptake is high.” And there are some people, particularly those who are immunocompromised, who will probably keep wearing a mask even when the community COVID-19 levels are lower. “Then there’s this kind of mushy middle ground for which we have to make our best possible decisions on both a community level and on an individual level,” Ranney said.

Ultimately, the decision about whether or not to continue masking can be a complicated one, Aaron Milstone, pediatric infectious diseases specialist at Johns Hopkins Children’s Center, told TODAY. And the answer for your child will depend on individual risk factors, the COVID-19 situation in your community and your family’s personal level of risk tolerance.

For instance, think about whether or not your child or anyone in your household has underlying conditions that put them at a higher risk for severe COVID-19. Consider your community COVID-19 level; are there a lot of COVID-19 cases in your community right now? How high is the vaccination rate in your community? All of this information can be helpful when choosing when to wear a mask.

And there may be practical ramifications of your child getting (or avoiding) COVID-19 as well. Ranney’s daughter, for example, is continuing to wear a mask even though it’s optional at her school because she doesn’t want to get sick before performing in the school play.

But the reality is that others have already abandoned masking in some situations, like when playing sports or attending sleepovers, Milstone said. “They made a different decision of what risks they were willing to accept.”

With or without mask mandates, schools and families can also use other strategies, Omer said, like frequent testing and prioritizing ventilation, to identify any COVID-19 cases early and keep everyone as safe as possible.

“I don’t want to just focus on the decision to mask,” Bell said, adding that the singular focus on masks doesn’t necessarily capture the bigger picture of precautions schools might employ. “I also want to know, is the school able to do testing on a regular basis? Has the school upgraded its ventilation systems? Are they able to distance students if they need to?” he said. “We have to discuss these all together. It’s kind of a package deal.”

And Omer stressed that the option to continue masking should still be there for those who want to do so. “Schools should make sure that those who choose to wear a mask are not stigmatized,” he said.

Will masks come back?

In the future, experts said it’s challenging to really predict what will happen with this notoriously unpredictable virus. But it’s clear that, as we gradually shift to the endemic phase of COVID-19, mask use may ebb and flow as local case numbers and hospitalization data change.

“Can I say that they’re done forever? I don’t think anyone can say that for sure. I certainly hope we’re done forever,” New Jersey Governor Phil Murphy told CNBC on Monday. “But it feels very much like we are on that road from pandemic to endemic,” he said, noting that we may be able to live with the virus in way that’s similar to the seasonal flu. “It very much feels like that’s where we’re headed right now, and let’s hope it stays that way,” he said.

In the long-term, some people may continue to use masks — including for reasons unrelated to COVID-19. And, in the absence of official mask mandates, we may keep wearing them during the winter cold and flu season or during COVID-19 outbreaks that may pop up.

“I think there are some people who have enjoyed not being sick for the last two years. They’ve recognized that, ‘Gosh, by wearing a mask I didn’t get my seasonal runny nose that led to a few weeks of cough,’” Milstone said. “I don’t think that’s going to be common, but I do think there’s a segment of the population that is going to wear masks a lot because they tend to be more risk-averse.”

Bell agreed that some will continue to wear masks, especially in crowded public situations during cold and flu season. And he noted that, for the first time ever, he didn’t see a single case of influenza in his ICU last year. “There are people who are alive today because they didn’t catch the flu because we were masking to try to avoid COVID,” he said. “That’s a powerful thing to think about.”