Less than 30% of teens are vaccinated in Kansas. Will schools require masks for students and teachers?
With about a month before classes start, the fourth wave of COVID-19 and a low vaccination rate among youths has Kansas doctors discussing potential mask requirements at schools.
White House and Centers for Disease Control and Prevention data from Monday showed that about 28% of children ages 12-17 have gotten at least one vaccine dose, and only about 20% are fully vaccinated.
The American Academy of Pediatrics issued guidance on Monday called for masking at schools and more vaccinations.
"To be honest, I think it’s a really good recommendation,” said Nathan Bahr, an infectious disease specialist, during a Tuesday media briefing by The University of Kansas Health System. "I’m excited about it. I think it’s going to help prevent COVID spread.
"Logistically, totally get it. And that’s going to be a challenge. Unfortunately there is resistance to wanting to wear a mask, but it’s the right thing for our kids to keep them safe. Man, I’m happy to hear that recommendation, and I hope it’s more widespread in the near future."
The academy’s guidelines call for requiring masks for all staff and all students older than 2 years, unless if medical or developmental conditions prohibit masking. Universal masking is being recommended because many students remain ineligible for vaccines, most eligible students haven't gotten vaccinated and the potential remains for low vaccination rates in the surrounding community.
The AAP encourages all eligible people to get vaccinated.
"It may become necessary for schools to collect COVID-19 vaccine information of staff and students and for schools to require COVID-19 vaccination for in-person learning," the guidance states.
The CDC has recommended that all unvaccinated children and teachers wear masks indoors. However, the American Academy of Pediatrics noted a lack of a system to monitor vaccine status and immunization records, as well as difficulty with enforcing mask requirements just for people who are unvaccinated.
"Universal masking is the best and most effective strategy to create consistent messages, expectations, enforcement and compliance without the added burden of needing to monitor vaccination status," the AAP stated.
Will Kansas schools require COVID-19 masks?
Many Kansas school districts have already rejected mask requirements for the upcoming academic year.
Silver Lake USD 372, Seaman USD 345 and Shawnee Heights USD 450 all have published reopening plans that state face masks won't be required at the start of the 2021-22 school year. The districts also plan to organize vaccine clinics, but not require immunization.
"The district may develop an incentive program upon approval of grant funds to reduce book rental fees for students and provide gift cards for staff who show proof of complete COVID-19 vaccination," the Silver Lake plan states.
In Johnson County, the local health department issued guidance on Friday that called on school boards to require indoor masking among people who are not fully vaccinated.
Shelby Rebeck, director of health services for the Shawnee Mission school district, noted the American Academy of Pediatrics' "goal of keeping students safe and physically in school" during the KU health system's Tuesday media briefing.
She noted that circumstances may be different in western Kansas than they are in Johnson County, adding that school nurses across the state should focus on what is best for their district.
Asked whether she would like to see all kids masked to start the school year, Rebeck sighed.
"Honestly, personally I wrestle with that decision back and forth," she said. "Yes, I know it’s the safest thing. As a nurse, I know that is the safest thing for our kids and probably the best way to keep everybody in school.
"But do I put that on our teachers and our principals and our school nurses and the people who have to police that in the building, knowing that 50% of our district does not want that? I’m not sure. Those people are in those schools to educate, and to kind of put them as the police of masking, I just don’t know that that’s the right thing either."
Some reopening plans note that government mandates could prompt a change in mask policies.
Senate Bill 40, which allowed aggrieved parents to challenge school mask policies this spring, was declared unconstitutional last week by Johnson County District Court Judge David Hauber. Attorney General Derek Schmidt has promised to appeal the ruling.
Local health officers could order universal masking at schools, especially for children younger than 12, due to their inability to be vaccinated.
'How can the children do it?'
Sports medicine physician David Smith noted during the KU briefing that the AAP's mask guidance is "just a recommendation from one organization." He questioned whether young children will be able to follow mask guidance during the school day, pointing to his observation that improper use of masks was commonplace among student-athletes and coaches.
"I can’t imagine if the adults can’t do it, how can the children do it?" Smith said. "So I really have concerns about that.
"On the athletic field, what I see is we’re trying to keep them hydrated, nourished, keep them in little, small groups. But you know they’re handling their face all the time, moving their masks down to drink, moving it back up. Watch the TV, you’ll see a coach scream at his players with his mask down and then pull it back up while he stands alone. I mean, it’s completely the opposite (of how to properly mask)."
Bahr, the infectious disease specialist, said his almost-2-year-old and 4-year-old children are able to wear masks correctly.
"They don’t have a problem doing it if they’re prompted how to do it correctly," he said. "I think buy-in is really important, and I think hopefully parents will buy in on this a bit more, too. It’s all about keeping them safe — this is the only reason behind this."
He said authority figures, including coaches, should set a good example.
"The challenge this year," Rebeck said, "is to get rid of the misinformation that’s out there. Get rid of the myths about masking and the myths about the vaccination and really to have our school nurses focus in on how do we help our kids stay in school to learn and also stay in school to participate in their athletic events, which we know are so important to them."
Quarantine rules may also change for many schools this year. Local health officials have already provided Johnson County districts with guidelines for when there is an exposure to a positive case.
"Those who are vaccinated, as long as they are asymptomatic, will be able to remain in school," Rebeck said. "Unvaccinated, the county health department will be quarantining those individuals."
Game on for fall sports
Smith is a member of the sports medicine advisory committee for the Kansas State High School Activities Association, which met last week.
"Sports is heading forward," he said. "We are going to have fall youth sports. Are we going to be able to keep it going? I sure hope so. If we all work together, we will keep it going."
The doctor emphasized that sick children should stay home and parents should report the illness through the proper channels. Just like a coach makes a winning game plan, teams should have a COVID-19 strategy and work together to keep each other safe during the pandemic, he said.
"I’m hearing stories about parents and children, they don’t want to take them to the doctor because they just don’t want to know because they don’t want to be that index case that shuts down a team," he said. "I find that really disheartening. I’ve always been a proponent of let’s get sports going, but let’s keep it going."
The American Academy of Pediatrics guidelines for school sports generally recommends mask use during indoor and outdoor athletics, both for athletes and spectators.
Athletes who got sick last year should still get vaccinated, especially with the emergence of variant viruses, Bahr said. Smith added that sports physicals could be used as a chance to get vaccinated, though other risk mitigation strategies should also be used.
"Nobody’s mandating vaccination to get back on the youth sports field," Smith said of the KSHSAA advisory committee.