For the first time in the pandemic, many families grapple with a new decision — whether their family will continue to mask indoors, specifically in schools.

Colorado hasn’t had a statewide masking mandate since spring 2021. Still, most K-12 schools continued to follow indoor universal masking mandates set by their county health departments to maintain in-person learning.

And it worked, said UCHealth infection disease expert Dr. Larissa Pisney.

“Data shows that masking helps us keep schools open during surges and decreases outbreaks,” she said.

So, why the change? What should families consider when making masking decisions? And what’s the advice on how parents talk to their children about their choice? To help answer those questions, we sought the advice of Dr. Pisney and licensed clinical psychologist Kathy Sigda.

Why is the decision to drop mask mandates happening now?

Public health officials across Colorado have considered several factors in making their decision, Pisney said.

“This decision wouldn’t be the same if we were in the same state we were at the beginning of January,” she said. “We saw omicron cases skyrocket, but the backside of that curve is acting in the same way. Our current positivity rate is dropping almost a percentage every day.”

In Colorado, the seven-day positivity rate was just below 10% in mid-February compared with over 30% during the omicron peak a month ago.

Other factors considered by public health officials, she said:

• While the high transmission of omicron led to many infections it also increased our community immunity, with some models predicting immunity up to 90% by mid-February.
• Colorado has efficient access to at-home testing and N95 masks through state and federal distribution programs. PCR tests are also readily accessible.
• More outpatient treatments are available to prevent serious illness in the high-risk population.

“Transitions are hard and can cause stress and anxiety,” Sigda said. “The kids I’ve talked to, some are excited not to wear a mask, while others, especially teenagers, are anxious.

“Taking their mask off makes them feel exposed,” she said. “Not necessarily to COVID but to the feeling that others are looking at them. It may become hard to focus and work in school when they are worried about that social aspect of people seeing their faces.

“As we move forward, it will be so important for parents to make their decisions mindfully and intentionally as a family,” Sigda said. “They need to communicate with their children in a way that shares their concerns but doesn’t add undue anxiety. It’s a big challenge.”

What should families consider when making masking decisions?

“As we shift from universal community masking to masking for individual safety, it becomes an individual decision that should be based on your comfort level and the risk factors of you and your family,” Pisney said.

Tracking what is going on in your community also can help guide your decision, Pisney said. The CDC COVID Data Tracker reports state and county COVID-19 hospitalization, seven-day positivity rate, and vaccination rates.

Pisney said when and if a new COVID-19 variant pops up, it will be important to pay attention to not just case rates but also hospitalizations to determine the severity of illness that the variant causes. She’ll also pay attention to rates in individuals who are vaccinated to understand how well the vaccine protects people from that variant. And the seven-day positivity rate helps her understand how transmissible that variant is.

All these factors help her determine, as an infectious disease expert and as a mother, what decisions she makes about masking, travel and other preventative measures.

You can also discuss risks with your physician or pediatrician, Sigda said.

“If you are concerned, get that medical advice from your health care provider as to how concerned you should be,” she said. “If there are high-risk situations for your child, you need to consider that. If you have to pursue other options, such as online learning, be aware of your child’s feelings of anxiety about the change and find opportunities to talk about feelings together as a family.”

Should we continue to wear a mask even after mandates drop?

Pisney said wearing a mask will remain important for the immunosuppressed population. The type of mask becomes more critical as we shift to one-way masking.

Because people wearing masks will encounter others not masked, she recommends people upgrade from a cloth mask to a surgical, or even better, a KN95, KF94 or N95 mask, to provide better protection.

“But you have to consider the type of mask that your child will keep on all day,” she said.

“I like to wear a KN95 outside of work because it is more comfortable and it holds up to coming off and on multiple times a day. But we’ve had a lot of trial and error in our family to find which mask feels most comfortable — and we all have a different style of mask,” Pisney said.

Pisney said neither of her children likes to wear a KN95, so her 3-year-old daughter wears a “triple-layer” cloth mask while her 9-year-old son is in a surgical mask.

“If they are not keeping it on, even a superior mask won’t make a difference,” she said.

How else can I protect myself and my family as mask mandates disappear?

Continue to wash your hands

Good hand hygiene continues to be necessary, Pisney said.

“At the beginning of the pandemic, people were scared and wiping down groceries with bleach wipes. We don’t need to do those types of things anymore. Handwashing is important for preventing COVID-19 and the transmission of all types of viruses. Washing your hands after you’ve been out in public and before you eat is still important.”

Get vaccinated

“It’s important to remember that masks are only one layer of mitigation. Getting vaccinated and boosted if eligible remains the most effective way to protect yourself and your family,” Pisney said.

Learn more about vaccines for children over 5, as well as information on booster shots.

Staying home and tests if you’re sick

Pisney’s advice is simple: If you feel sick, stay home.

Testing should also aid in your quarantining decisions.

“Home tests have their place but should be used with caution as they are not as sensitive as PCR tests,” Pisney said. Learn more about at-home tests and how best to use them.

If you have symptoms, she recommends that you do an at-home test, but if that test is negative, confirm that result with a PCR test.

How can I talk to my child about our family decision regarding masking?

Sigda stresses the importance of open communication regarding masking changes.

“Have the conversation with your kids. Discuss the comfort level within the family, and listen to them.

“For most kids, they need to know that parents know the lay of the land and how to keep them safe. It’s been difficult these past two years because, as parents, we don’t always know what that means. But listening to the child is number one. What is their comfort level, and what do they think about masking? If you have a kid who feels anxious about it and wants to continue to wear a mask, let them know that’s ok, even if it’s not the direction that family has taken.”

If your family chooses to continue to mask, Sigda said, parents need to be reminded that they don’t always have control over their child’s actions when they’re not around. You have asked them a million times to wear a coat outside, but do they always listen?

“As parents, we need to understand that our kids will sometimes do what they want to do, and it’s often influenced by what their peer groups are doing,” she said. “That’s why as families, we need to have those conversations together. What are your risks, and how will we mitigate those risks together?”

What if my child is struggling to adjust to new changes?

“It takes time to get used to anything new,” Sigda said.

Anxiety makes us want to avoid things, she said. Parents might find their child no longer wants to go to school because it feels weird not wearing a mask or being around others not wearing a mask.

“We have to get over that hump and through those first few days,” she said. “Kids adapt quickly, and after those first few days to a week, it should become more normal to them.”

Because of teenagers’ social concerns and self-conscious nature, it might take them a bit longer than younger children to feel more comfortable with these new changes.

If anxiety persists more than a few weeks, seek tools or professional help, Sigda said. She and SJ Purcell, a licensed clinical social worker with UCHealth, recently released a video series to help parents navigate child stress related to COVID. The videos provide advice and several different tools for coping with anxiety.