How Strict Should Schools Be About Masks? In Orange County, The Question's Part Of The Reopening Debate

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UPDATE, July 14: The Orange County Board of Education voted 4-1 on July 13to recommend local school districts reopen schools without any requirements for mask use or social distancing.

If Orange County public schools resume in-person instruction in the fall, the county's Department of Education has advised schools to "encourage" students to wear masks and face coverings "to the extent feasible."

But several members of Orange County's elected Board of Education have voiced skepticism about the scientific consensus that masks help prevent the spread of COVID-19 -- and they think the department's guidelines don't strike the appropriate balance.

Board members are now moving to publish their own set of guidelines that -- according to this document -- will advise OC schools that "requiring children to wear masks during school is not only impossible to implement but not based on science and could be potentially harmful." Another guideline: social distancing is "unacceptable."

Those forthcoming guidelines in particular have touched off a backlash. In a letter last week, more than 600 parents, students and alumni of Orange County schools accused the board of "gross misinterpretation of the available evidence" about masks and social distancing.

In interviews, two public health experts said they were troubled by what they termed the Orange County Board of Education's cavalier attitude toward masks and social distancing reflected in its statement of "first principles."

"The statement makes me uncomfortable," said Dr. Michael Neely, Chief of the Divison of Infectious Diseases at Children's Hospital Los Angeles. "It is overly broad and it is overly dogmatic, I think. For example, to say that wearing masks is 'not based on science' is false."

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HOW CAUTIOUS SHOULD SCHOOLS BE?

But on another "principle" that will shape Orange County board members' forthcoming guidance, even their letter-writing critics "wholeheartedly" agree: "Delaying the opening of public schools ... is unacceptable."

"I believe understanding the impact that not opening schools has on our children and our community must weigh into any guidelines that get put forward," board president Mari Barke said during a meeting last week. "There should also be recognition that distance learning is not working."

The question looming for parents, not just in Southern California, but across the U.S.: How far should schools go with their rules?

"Reopening [schools] in a cautious and careful way does make sense," said Dr. Richard Jackson, a pediatrician and former head of the California Department of Public Health. "Part of that is for children to be using masks in the beginning ... To make a statement that masks don't work as a statement of theological belief is ridiculous."

'MOUNTING EVIDENCE'

Even as coronavirus cases surge at the start of summer, public health experts are beginning to agree that the harms outweigh the risks of keeping school campuses closed next fall.

Not only are students falling behind in online classes, but "mounting evidence" suggests that children -- especially younger ones -- are less likely to get seriously ill from, or even show symptoms of, the coronavirus. Young children are also substantially less likely to spread the virus; one study suggests children are about half as likely to catch the virus as those over age 20.

A preschool teacher wears a face mask while speaking to students. (Chava Sanchez/LAist)

Last week, the American Academy of Pediatrics -- normally a cautious organization, Jackson said -- issued a statement calling on government officials nationwide to set a "goal of having students physically present in school" this fall. The pediatricians said universal use of masks in schools is "ideal," but also cautioned that schools can't expect all students to wear them, particularly younger students.

Neely and Jackson both endorsed the academy's guidance, saying it's both comprehensive and nuanced.

And, in fact, the person the Orange County Board of Education asked to write its school reopening guidance, Will Swaim, said he was trying to reflect the American Academy of Pediatricians' guidance.

For example, last month, the local chapter of the pediatricians' group issued a statement calling for "flexible" school reopening guidelines. The group added that "wearing masks throughout the day can hinder language and socio-emotional development, particularly for younger students."

Swaim -- a former journalist and now president of the right-leaning California Policy Center think tank -- said he wrote the board's statement of "first principles" based on the pediatricians' advice and the testimony of a selected panel of educators and medical professionals.

Though the group behind the letter criticized the panel for being stacked with skeptics of mask-wearing, Swaim said the board was not trying to fly in the face of established science on mask use in general.

"What we mean to say," said Swaim, "[is], 'There's no science to support the fact that kids are getting sick. Therefore, masking is probably not scientifically indicated' ... And it's unscientific if you think it produces healthy outcomes."

'NO REASON WE CAN'T TEACH MASK USE'

But the Children's Hospital's Dr. Neely also said the risk of children getting sick or transmitting the virus is not zero. One study from China even suggests that placing children into crowded schools cancels out their low risk of catching the virus because they have contact with more people.

"Even though the risk of transmission may be low," Neely said, "you want to do everything you possibly can to lower that transmission risk on a nationwide scale."

And the American Academy of Pediatrics says using masks and physical distancing in coordination can limit that risk. For example, their guidance says that students may only need to maintain three feet of distance -- less than the standard six feet -- if they also wear masks.

In situations where distancing isn't feasible, mask use is most essential -- particularly for older students, the guidance suggests. (Dr. Neely said students' risk of spreading COVID-19 is a continuum that rises with age.)

"No, [masks] are not perfect," said Dr. Jackson, now a professor emeritus at UCLA's Fielding School of Public Health. "But we ought to be wearing masks and there's no reason we can't teach children to be wearing masks in school. I'm not talking about preschoolers, but I'm talking about school-aged kids who have to learn to live with this new reality."

All children entering the Young Horizons preschool facility have their temperatures checked before being admitted. Temperature checks are sometimes part of reopening plans for K-12 schools as well. (Chava Sanchez/LAist)

THIS IS ALL UP TO SCHOOL DISTRICTS

Swaim said the Orange County Board of Education was developing its guidance, at least in part, out of concern that the county's Department of Education had developed its own ground rules with little public input.

Swaim also contended that the board's forthcoming report would not be all that different from the county department's guidance -- which, after all, also doesn't explicitly require mask use: "I think we are all closer than further apart," said Swaim, adding:.

"If anything comes out of that public conversation we had last Wednesday, I hope it'll be that some people say, 'Oh! I didn't know that COVID isn't quite as fatal to children as I thought it was before,' and therefore maybe this important community institution called a school can reopen fully."

In the end, both the county's guidance and the board's advice are not binding. Each district's school board is charged with determining how -- and if -- schools will reopen.

But this is precisely what concerns Lyn Stoler, a Los Alamitos Unified School District alumna who wrote the letter criticizing county board members.

"They're trying to signal to the district policymaker," said Stoler, "that if they want to implement school reopening guidelines that aren't based in evidence, that the [county] school board will back them up."

So Stoler, who also works as a public health professional, and her allies have largely abandoned their appeals to the county board, opting to craft a toolkit to help districts make evidence-based decisions as they reopen campuses.

And Stoler, by the way, believes districts should reopen campuses.

"Can you make that really clear?" she asked in our interview. "Because I've had a lot of community members say, 'It's going to be your fault if schools don't reopen.'"

Correction, July 3, 9:45 a.m.: A previous version of this story misstated the title of Dr. Michael Neely as the "chief of pediatric diseases." LAist regrets the error.