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With COVID-19 Cases in Children Rising, Health Experts Urge Masks in School

Students at desks
Students take notes on the first day of class at Hopewell High School. (Photo: Crixell Matthews/VPM News)

Last month, the Virginia departments of health and education jointly put out guidance to schools on how to safely reopen for the fall. They recommended, but did not require, local school districts adopt universal masking, at least in elementary schools.

Due to the recent surge in COVID-19 cases, partially fueled by the highly contagious Delta variant, the Centers for Disease Control and prevention issued new guidance to schools last week: masks for everyone regardless of vaccination status

Due to a law passed this March, Gov. Ralph Northam says those guidelines form a mandate for Virginia school districts. That law, as proposed by state Sen. Siobahn Dunnavant (R-Henrico), contained only one line: “Each local school division in the Commonwealth shall make in-person learning available to all students by choice of the student's parent or guardian.”

But during the legislative process, additional language was added requiring school districts to follow any CDC guidance “to the maximum extent practicable.”

According to Northam, that means all districts must follow the new recommendations put out by the CDC last Wednesday. They include universal masking for all students, staff, teachers and guests regardless of vaccination status.

“I expect school divisions to follow it. If they choose not to follow it, they should have a frank discussion with their legal counsel,” Northam said during a press conference last week.

Dunnavant, however, argues universal masking might not be practicable everywhere.

“This is something that if you fix one mandate... it just doesn’t work,” the senator said.

Margaret Riley, a professor of health law at the University of Virginia, says she “tends to side” with Northam’s interpretation.

“I don’t think a single legislator, even if an original sponsor... gets to have a single notion of what a bill means,” she said. “The language of the statute is pretty explicit. It uses the word ‘shall,’ which is a mandatory word.”

But Dunnavant says requiring masks statewide could keep some children out of the classroom, which she says runs counter to the original intent of the bill.

“There are a lot of parents that have children with extraordinary anxiety that have other issues with masking, and those kids should not be excluded from the classroom by an arbitrary mandate,” she said.

Riley says students with verified anxieties related to masking will likely be able to get exemptions to mask mandates. The same is true for students with medical conditions that make mask wearing dangerous, according to Riley.

Dr. Suzanne Lavoie, a pediatric infectious disease specialist with VCU Health, says those types of anxieties are rare.

“Of the children that I have come into experience with over the last year and a half when we’ve been dealing with this, not one of them has complained to me about wearing a mask,” she said. “The children are learning from us, and if we make it a big deal, then it’s a big deal. If we make it not a big deal, then they won’t make it a big deal.”

The CDC guidance was updated to require masks even for vaccinated people “due to the circulating and highly contagious Delta variant.” Lavoie says it appears to affect children more severely than previous variants.

“While children still make up the minority of cases, the number of acute cases with Covid that we’re seeing among children is going up,” she said.

Over the past two months, nearly 10% of coronavirus cases in Virginia have occurred in children under 10. This time last year, that figure was less than 4%. At the beginning of July, the seven-day average of new cases in children under 10 was about 20 per day. That’s now over 140, fast approaching the January peak.

Since the beginning of the pandemic, nine Virginians under 20 have died from COVID-19. Five of them have died since June 25.

Due to Dunnavant’s law, every school district will open in person. One of the first in the state to do so was Hopewell City Public Schools. Since opening July 26 with a mask mandate in place, the district has reported 40 cases of COVID-19, though only four have been traced back to the school.

Lavoie says schools should use every mitigation strategy available to them in order to curb the spread of COVID-19, including hand washing, social distancing and mask wearing.

“I have three children in Henrico schools, and I’m very eager for them to go back to school. I’m fortunate that my children are all 12 and up so they’re vaccinated, but I still feel very strongly that they should wear a mask,” she said. “I want them to wear a mask not only to protect themselves, but also to protect their friends and colleagues.”

Several school districts, including Powhatan County, have reversed course on masking, deciding to mandate the practice in the wake of Northam’s statements. Riley says she expects others will follow suit.