When can we expect masking to end for preschoolers?

I'm a liberal, pro-science, law-abiding person and I have no interest in allying myself with right-wing crazies. But I'm wondering what we as a community are thinking about masking toddlers, with little data to support the practice, significant harms, and no end in sight. 

There are a number of reasons that masks are harmful to preschool-age children:

--they inhibit social and emotional growth;

--they inhibit language development;

--they irritate the skin;

--they are often unsanitary in toddler populations;

--they promote mouth breathing which impairs proper facial development.

The World Health Organization (WHO) recommends against children under 5 wearing masks as a preventative measure. Accordingly, masks are not recommended for children under 5 in the UK and most countries in the EU (France, Italy, Spain, etc.).

In the US, CDC recommends masks are worn *indoors* for ages 2 and older at childcare facilities. Meanwhile it seems to be the norm around the Bay Area that preschools are requiring masks both indoors and outdoors for ages 2 and over -- this is total masking for toddlers upwards of 40 hours a week for full-time care. Several Bay Area counties including Alameda have criteria for lifting indoor mask requirements for adults (three weeks in CDC moderate tier of caseloads; vaccination thresholds); Marin and SF are already lifting requirements. But childcare settings are an exception to to this lifting, so as far as I can tell there's no reprieve in sight for preschoolers.

Is there some specific benchmark that we are waiting for in California, the US, or as a community before the masking requirement is reduced or lifted for toddlers? Because my patience, as a parent of a three-year old who wears a mask at preschool for 40 hours a week, is wearing thin. FDA vaccine approval for this population, unlike for 5-12 year olds, is very far off (January would be the earliest but that is highly speculative). Meanwhile, there's literally no data to support that masks are effective at reducing transmission in the age 2-4 population. The data shows that COVID is a very minimal risk for children -- a *unvaccinated child* has about as much risk of getting or spreading COVID as a vaccinated 40 year old, if not less (https://www.nytimes.com/2021/10/12/briefing/covid-age-risk-infection-vac...).

As a parent, I feel the strong need to advocate for preschool children's interests here as they are not able to advocate for themselves. Indeed, children do get used to wearing masks, but that is not a sufficient justification for a potentially harmful practice -- children can get used to almost anything, including several forms of abuse.

Do others here share my concern?

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Yes, yes, yes! What are the benchmarks for this changing? The problem is that there are none. 

I completely agree. Our preschool encourages but does not force masks for toddlers. I send a mask to school with my 2.5 year old but don’t expect her to wear it all day (and she doesn’t!). Would love to see this requirement lifted but it’s up to our politicians. 

Thank you for stating this.  I am heartbroken by all the harms caused by masking toddlers (the only country in the world who actually does this), as well as the gaslighting that inevitably comes from certain people when you bring it up.  The fact of the matter is that I, as a healthy but almost 40 year old vaccinated adult, am at higher risk of getting covid and having adverse effects than my unvaxxed toddler child.  Additionally, the idea that cloth masks actually do anything in disease prevention (relative to the vaccine), particularly when worn the way toddlers wear them, is absolutely without logic or reason. I support everything you have said, and share your concerns.  However, I am pessimistic about positive change happening here, other than the tide of public opinion in california magically shifting, which I don't see happening unfortunately.

I agree with your point of view and read of the data (and I'm also a parent of a three year old in pre-school). I am probably less worried about the negative effects than you are but I do think it is ineffective for kids who are together 8 hours a day wearing cotton masks (and in our case, taking them off at naptime), to be wearing them at all. It's providing marginal if any benefit based on all studies I have read about cotton masks and extended indoor exposure times. I will say that masking seems to have cut down a lot on colds, but obviously there are other things going on that could make it hard to untangle what exactly is reducing the colds. 

The point in time at which I am going to feel a lot worse about this situation is if we get our kids vaccinated, achieve a similar level of population wide vaccination in Berkeley that we are seeing 12 and up, and are still requiring our kids to wear masks. I'm very concerned that this community is never going to give up masking as a common practice indoors.

In the meantime, I encourage my child to take off her mask when we are outside and try to give her as much mask free time outside of school as possible. 

I am with you 100%. I also want to know when my elementary school age child will be able to take her mask off on the playground. And if she is able to get vaccinated soon, I expect her not to have to wear a mask inside. The risk of covid to children is about the same as the flu: https://www.npr.org/2021/05/21/999241558/in-kids-the-risk-of-covid-19-an...

I think we just need to keep saying this over and over until public perception starts to change. People are scared, I get it. In addition, in the Bay Area, mask wearing has become politicized and covid protocol is a question of virtue signaling instead of reality. For every covid precaution, there is a price, and we take risks every day because the rewards are worth it. I know that I don't like socializing in a mask, why would my child want to only interact with her friends with masks on? And if she were to be totally ok with it, I worry about what that says about her social/emotional development.

Anyway, no solution, just want to make sure you know that many others feel the same way. Parents need to continue to speak out on this and make our voices heard.

I'm not sure what sort of response you're looking for here -- it seems like you mostly wanted to express your feelings. 

But if you are asking for opinions of other parents of young children, here's mine: I am happy that my preschool requires my two- and four-year old children (and all their peers) to wear masks. Knowing that none of the children at the school are vaccinated, and especially as Delta has demonstrated that kids are not safe from the risks of COVID, knowing that they are masked gives me peace of mind and allows me to send them to a daycare they love (and that allows my husband and I to keep our out-of-the-home jobs) comfortably and happily. I agree that wearing masks outside seems unnecessary. Nevertheless, our preschool requires it and I have no problem with my kids complying with that rule. I have to admit I'm bewildered by your claim of masks causing "significant harms" to kids. Where are you getting that from? I am aware of no research suggesting as much, and in fact have seen studies showing that masks have no impact on social-emotional learning or language development. My children have never complained about wearing masks (the two-year-old was excited to be a "big kid" and wear a mask like her brother once she turned two), and I have noticed no signs of harm to them. Also, my kids have gone close to two years without any illness more serious than a sniffle, which is a huge win in my book.

As far as I am concerned, mask requirements should begin to be lifted when everyone of all ages has access to vaccines -- which seems like it's only a few months away. Considering we've been doing this since March of 2020, wearing masks for 3-4 more months just doesn't seem like a big deal to me. 

Yes, I absolutely share your concern. As you mentioned, it’s not based on science nor do children seem to be affected. The adult population working at these facilities can get vaccinated. So who are we protecting? 

Thank you for asking this question. We actually left BUSD last year when it became apparent that covid risk was the only risk they cared about (as our children had zoom school everyday while schools all over the world successful taught children safely in person, following the science ...). Based on my personal conversations with them, many parents share your concerns and would to see a more data driven approach involving an appropriate risk-benefit analysis. 

I don't know if they deal with preschools specifically, but you may be able to find a subset of the Open Schools Berkeley | Facebook group that is working on this, or maybe they could put you in touch. The larger group will not touch the issue and this seems to be driven by a combination of (a) fear of being associated with "right wing crazies"; and (b) fear that somehow pushing back on mask mandates in the classroom (and apparently also outside during PE) could result in more school closures. I have also been told that at least for school aged children this is a state wide mandate and so there is little use in trying to get local actors to look at the data. But certainly this is a concern for many parents, including myself.

If you want to message me your email, I can try to put you in touch with some people in Berkeley who may know more about how best to advocate for a science and child-centered approach to this issue. I don't think we will see changes anytime soon unless parents start speaking up and educating people about these things. 

I’m not a parent of a preschooler, but of a 7 year old and I completely agree with you. The Bay Area as progressive as it is will likely not do away with masks until either the politicians decide its in their best interest or parents refuse to send their children to school unless masks and mandates stop and the districts lose money. 

Without getting into details, I’m an RN and have been working on the Covid unit in an SF hospital since the pandemic started. I will tell you that what myself and colleagues have seen and dealt with does not line up with what is being reported by the media or the politicians. When we started seeing the “data” being literally created by the doctors choosing who to admit based on their vaccination status and age and not their actual necessity for acute care hospital services requiring hospitalization, we had to ask ourselves why? None of it made sense. 

The bottom line is money. The hospitals get paid by the feds for every covid patient admitted, and billions of dollars spent on the vaccine is lining someone’s pockets for every person that gets vaccinated. Why else mandate it? Especially in California with the lowest covid rates in the nation? With the majority of the Bay Area already 70- 80% sometimes 90% vaccinated?

All this will continue until people realize what’s really going on. I’m neither a democrat or republican. I’m not an anti-vaxxer or conspiracy theorist. I’m going off what I’ve witnessed as a nurse on the Covid unit throughout this entire pandemic.

Covid is real. Its transmissible through respiratory droplets like the flu, rsv, or any other cold virus. If you have underlying disease you can likely get very sick needing hospital care and can possibly die. If you’re healthy, it’ll likely be a moderate flu if nothing at all. Most people don’t get preventative care so they may think they’re healthy, but in fact have underlying disease- high blood pressure, diabetes, etc. Those are the ones who are needing hospitalization or eventually die, but the “data” will say they were otherwise healthy.

Its crazy how we are where we are today in regards to covid and how divided our world has become off of information that is not entirely accurate. I don’t blame anyone for not knowing since most people don’t know someone who is on the literal front line of this pandemic and are going off the news media, cdc, and “data”. 

I would really like to see masking lifted at preschool when the kids and teachers are outdoors. We are lucky enough climate-wise that kids can spend tons of time outdoors year round as well, which could further reduce masking. I understand logistics makes this hard- it's probably a lot of work for teachers to help tons of kids take on and off masks all day, so the default is probably to keep them on at all times. I have also noticed that some schools require masking all day, including outside, but then have kids eat lunch and snacks inside all together maskless- so the inconsistency of policies is frustrating. I do however find myself wanting to overly protect them though as the vaccine nears, so I understand people who want to keep them. It's like, we have done all this hard work for so long and they have been masked for so long and we are so close..why screw it up now? Anyway, thank you for posting. 

I'm hoping it can be the end of the year or Jan/Feb next year once we can get the school/toddler-age population vaccinated.

It's obvious to me that we should not be asking toddlers to wear face masks.  The science doesn't support it, and an honest evaluation of the risks and rewards suggests that it's not worth it.

But it's very difficult for people to calculate risks.  Naturally, all of us parents are risk-averse with our children.  We want to do everything we can to keep them safe.  But sometimes we do too much, and our safety concerns end up harming them.  I'm thinking of the over-protected kids who can't go off to college by themselves because they're so used to having their parents do everything for them.  But it's an issue that comes up with kids of all ages, and it's not just in the social realm.  Even in the realm of physical health, you have to make judgements about what's safe.  Do you tell your kid not to climb on the play structure, because you're scared they're going to fall off?  Or do you push them to take a risk and see how much they can do?  Finding that balance is hard to do.

I think there's a universal tendency in human psychology to over-emphasize the clear and present danger, and not pay enough attention to the long-term dangers or the hidden dangers.  Take, for example, the debate over climate change.  It's hard for people to appreciate the danger of a warming climate, when the worst effects are still years off in the future.  It's a lot easier to see that you need your car right now.  Will we as a society be willing to make the changes to our economy that need to be made, in order to forestall the worst effects of climate change?  Probably not, in my opinion.  But for anyone who has studied this issue, it's obvious that we're making the wrong decisions, and our children will suffer immensely as a result.

I would encourage everyone to bring this same lens to looking at COVID.  People are freaking out about the immediate danger of the virus, without thinking enough about the long-term damage being done to our children by closing schools, limiting social interactions, and disrupting the normal socialization process whereby young children learn to read emotions and express themselves.

I'm not saying we shouldn't have any safety concerns. I'm saying if you look at our history, and our typical pattern of making decisions based on short-term thinking, you can use that to fine-tune your risk assessment.

I share your concern.  Are you on Facebook?  There is a group called CA Parent Power asking the same

questions at the (public) school level, but I wonder if they might be able to connect you to any organizers working

to do the same with early education.

-When did we stop following the science?

I'm going to take some issue with your assumptions here. I think you are coming from a good place of wanting what's best for your child and other preschoolers but as a pediatrician I have not seen any evidence of masks inhibiting social and emotional growth or language development; few skin irritations (and honestly probably less than what I see with people rubbing their face). and in terms of them being unsanitary in toddlers, they are more sanitary than the hand to mouth, hand to butt to mouth stuff that happens without the mask and kids get sick less when mask wearing. whether or not kids mouth breathe more with them on I have not seen studies so can't comment. It does seem like schools where everyone wears masks get a lot less illness in general and COVID in specific.  I do think the masking requirement will get lifted but I doubt it before January. but it doesn't seem to cause harm that I've seen and it seems like it may cause risk reduction so I don't share your concern. Here's hoping that all eligible people get immunized ASAP, the rates drop to negligible and they get to take their masks off! :)

After 20 months of masking, I think 3 more is a small price to pay.  I also know there are plenty of preschools around who are very lax about masking.  If you feel that strongly about it, I'm sure you could find one for your child.  Bear in mind that the families who have kids at schools with strict covid protocols mostly want it that way.  And while we may never return to "normal," I personally think it is fair to ask all people, including adults, to continue to mask indoors and in crowds until vaccines are available to all (6+ mos).  

Yes, I could not agree with you more and sincerely applaud you for raising these points and questions.
I do not understand why parents in the Bay Area (filled with highly intelligent, pro-science people) do not speak up more about this!

No, there is no benchmark. I applaud you for taking such a nuanced and evidence-driven view, and wholeheartedly encourage you to advocate. That said, you're fighting an uphill battle around here. Rejection of COVID mitigation measures has become the red-state hill-to-die-on. Acceptance of mitigation measures, including ones that may not provide benefit is the blue-state converse. Have you ever felt obliged to put your mask back on as you walk out of a restaurant after sitting maskless for 45 minutes breathing your aerosols into the air around you? I'm a pediatrician in one of the hardest-hit communities in the Bay Area. I'll gladly suck up whatever pain-in-the-butt measures will protect me, my family, my patients, and my community. I get really fed up with performative gestures or non-evidence driven overkill that has negative secondary effects. You make a good case that masking preschoolers falls into the latter category, but I think it'll be a while until you get many people on board with you.

Hi there. I also have a preschooler that is masked all day (even outdoors) and share your frustration. All of the teachers/staff at the school are vaccinated so I wish that they will ease up on the masking a bit. However I do not know if all of the parents are vaccinated. I guess if the administration felt comfortable to ask if all of the adults in the children’s lives are vaccinated, we can stop imposing masks on the kids all day. 
Another side effect of a litigious culture?This makes me sad. 

I 100% share your concerns and have been deeply troubled that I (under most circumstances) can't voice my perspective or share data with others'. The disappearance of nuance, ability to discuss things outside of one's viewpoint, and desire to force others into certain behaviors or habits (like masking a 3 year old) has been incredibly disheartening to experience and witness. I unfortunately don't really think there's a way out of this whole thing as people a) won't read medical journals or consider information that goes against the Bay Area narrative ("it's super dangerous for your kids, mask at all times") and I think most parents are so tired that they don't want to do further investigation or acknowledge other realities exist. I cringe when I remember 18 months ago, people taking to social media to encourage "the Teddy Bear campaign" -- "put a teddy bear up in your window so kids can be cheered up when they walk outside!" Then we proceeded to close playgrounds for 8 months, accused children of being superspreaders, and then masked them (indefinitely) with dubious data. It's heartbreaking. All this to say: if you find a way to advocate for preschool children's interests, please let me know; I'd love to join you. I'm also pro-outside playdates, where kids can be kids and interact with each other in normal circumstances. So if that feels like an option, please let me know too. 

Very interesting points that you bring up.

Unfortunately, the mask has been politicalized. People in the Bay Area are the most stringent about masking wearing especially in the more liberal parts of Northern California. My brother and his family live in Orange County where it is more conservative and right leaning. At their daughters' preschool, masking is optional. 

I think it's fine that outdoor masking should be done based upon the cases in the community and vaccination rates. During the Delta surge, masking even outdoors was appropriate. Right now, UK is surging and based on the Delta variant patterns, we should expect it to reach the US in 2 months. So, in theory, we should be okay with no masking outdoors right now since the cases are low.  

We know that preschoolers tend to touch their face with their fingers, can't socially distance, etc so wearing a mask might be best to mitigate even passing the cold and flu. My school age daughter was home last week for a cold but we couldn't bring her back until she had a negative covid test...so even though she was feeling better the next day, she was at home for an additional 2 days waiting for the covid result.  

Although not ideal, kids are adaptable and can learn to understand emotions with masking: https://challengingbehavior.cbcs.usf.edu/docs/Wearing-Masks_Tipsheet.pdf

Yesterday, my kid's preschool announced a teacher tested positive for covid. I was not worried, because they take masking seriously, and because, as you say, for healthy toddlers, the covid risk is minimal. Today, none of the kids in her classroom tested positive. I was very pleased that the preschool's masking and testing protocol worked. You are right that for most preschool kids, masks have important downsides, as well as a few upsides (e.g., fewer colds, less thumb sucking). But for families with high-risk individuals, masking in preschools has huge benefits, and I for one am more than happy to have my preschooler keep on wearing masks for a while. 

Thank you for this thoughtful, well-written post on a topic that strikes a chord with me and others I know. I'm a parent of a 3 year old and a 1 year old and am also a liberal, pro-science member of this community.  I wonder if there is some organizing that can be done around this? I'd also be very interested in removing the city of Berkeley's guidelines that ask everyone to continue to wear masks at playgrounds. The signs asking people to do so are still up at many playgrounds around our home and  people follow rules here (which is great!) but I'm at a loss as to why we're still masking at playgrounds as well. The city's last posting about it cited statewide guidelines, but those state guidelines are no longer in effect so it would make sense to loosen up a bit here too. 

I understand your point, but I do not agree that masks are harmful for children and haven't seen any compelling data to support that. Indeed there are many countries where masks have been used for years during cold and flu season and I haven't heard any negative effects. I think one thing to keep in mind is that while healthy children are unlikely to get very ill - not all children fall into this category. Parents of children with conditions that make them more vulnerable to covid also need care for their kids and excluding them from preschool is unfair to the children. Perhaps you can think of mask wearing for healthy kids as similar to not including nuts in the lunches of kids w/o allergies to protect kids with allergies in the class? Similarly, some parents may have conditions which put them at risk and in some cases these are the same families most in need of childcare. Vaccines for littles are coming soon and hopefully with that rates will fall. In the meantime masks help protect vulnerable families. 

This write-up that rounds up what research exists on the downsides of masking just came in my inbox this morning and thought it might be of interest. Emily Oster is one of my most trusted sources of evidence-based parenting advice. Similar to what has been shared by many of the commenters on here, it doesn't seem like there's a lot of research to show huge negative impacts of masking, but there are clearly some, and we should be thinking about what the off-ramps are to ending the practice.  https://emilyoster.substack.com/p/kids-and-masks?r=nuf65&utm_campaign=po...