Children's Hospital Colorado

Children’s Hospital Colorado Encourages Masking in School Settings

Children's Hospital Colorado | August 20, 2021

With climbing COVID-19 numbers and an early respiratory season beginning before kids have even returned to school, Children's Hospital Colorado says it is more important than ever to keep up the basic prevention efforts that keep us all healthy and safe. That’s why they are strongly encouraging state and local officials, school leaders and parents alike to take action to protect their children mentally and physically.

Voicing support for universal masking in Colorado schools and childcare settings

Throughout the pandemic, Children's Colorado's medical experts have consistently said that the best way to protect ourselves and others is by getting vaccinated, wearing masks, social distancing and frequent handwashing. Because kids under the age of 12 are not yet eligible for the COVID vaccines and only 41% of Colorado adolescents and young adults ages 12 to 20 have been vaccinated, they are voicing support for masking in all Colorado schools and childcare settings for all children and personnel. Additionally, they state that if made a policy at schools, masking would remove uncertainty, which poses an additional source of anxiety, isolation and further reduces the potential for bullying.

"As more adults and older children are vaccinated and schools are eager to return to normal we must not forget the health and well-being of the youngest among us who are still vulnerable on numerous levels – emotionally, mentally and physically," said David Brumbaugh, MD, Chief Medical Officer. "We are seeing patients with respiratory illnesses – including COVID – as well as behavioral health needs that are resulting in significant increase in volumes at our hospitals much earlier in the year than usual. We anticipate those numbers will increase with the start of school as more respiratory viruses circulate." 

"Many of these hospitalizations are preventable. We know masks are a proven tool in stopping the spread of respiratory viruses, which is why we are encouraging our partners and parents to help keep our kids healthy and prevent outbreaks in schools." 

Delta variant increases risk of school outbreaks

Studies have shown the benefit and importance of in-person learning for children. As children return to school, a key to maintaining our kids' resiliency is to ensure they can attend school in person every day. The greatest threat to that is outbreaks in schools, the risk of which will be worse due to increased transmissibility of the delta variant. There are school closures in places like Georgia that had an early start to the school year and had no masking rules. 

Four factors make preventative measures particularly important

Children's hospitals across the country are already seeing increased volumes and are facing mounting challenges as four factors converge, which makes taking preventative measures now so important: the increased transmissibility of the delta variant, an early start to respiratory season, the pediatric mental health crisis and the shortage of front-line healthcare workers.

  • Delta variant: The Centers for Disease Control and Prevention reported new data showing the delta variant is more infectious and is leading to significantly increased transmissibility when compared to other variants. For kids under 12 years of age who are not yet eligible for the COVID-19 vaccine, this contributes to a higher risk of infection.

  • Early start to respiratory season: Some children are currently experiencing multiple viral infections including SARS-CoV-2, RSV and parainfluenza alongside other viral pathogens simultaneously. Infection rates and severity are likely to continue rising at least through the autumn months. 

  • Mental health crisis: In May, Children's Colorado declared a state of emergency for youth mental health as numbers of kids experiencing significant anxiety, depression, feelings of isolation and suicidal ideations doubled and even tripled in some Colorado communities. Returning to school amid so much uncertainty will be stressful for the most resilient of kids. A unified mask policy removes an additional source of anxiety, isolation and reduces the potential for bullying.

  • A staffing crisis: There is a shortage of front-line clinical team members across the U.S., as caregivers experience burnout from the last year and a half and hospitals compete for the remaining resources.

As a result of the first three of these circumstances, Children's Colorado reports that overall inpatient volumes are running over 20% higher than normal for this time of the year and pediatric intensive care unit (PICU) volumes are running 60% higher than normal. Emergency departments are operating at 20% to 50% increased volumes depending on location. Additionally, the system has seen emergency visits for behavioral health crisis double – even triple in some regions – throughout the course of the pandemic.

An unprecedented start to respiratory season

"Every year, we experience an increase in patients due to behavioral health crisis and respiratory illness after school starts and again for respiratory illnesses in the winter due to respiratory season," said Samuel Dominguez, MD, PhD pediatric infectious disease specialist. "Seeing increases in all these areas prior to school even starting is unprecedented. Anticipating that these numbers could increase even more as children return to school is concerning, and we hope parents and our partners will take measures now to ensure that kids are able to stay healthy."

Based on past experience, Children's Colorado typically sees an additional 30% increase in emergency department (ED) volumes within a few weeks of children returning to school. They anticipate visits to the ED for behavioral health crises will double, and based upon data from their Aurora hospital, they expect to see patient volumes rise by 5 to 10 patients per day in that PICU alone.

Experts recommend preventative measures for children

In order to prevent a further increase in hospitalizations, Children's Colorado experts are reminding and strongly encouraging parents and partners to do what they can to protect their children:

  • Everyone 2 years and older should wear a mask indoors to protect themselves and others from COVID-19, RSV and other respiratory illnesses.

  • Ensure children wash their hands thoroughly and regularly.

  • Stay home from work or school and get a COVID test if you are sick or have symptoms.

  • All eligible individuals (12 years and older) should get vaccinated against COVID-19.

Flattening the curve for Colorado's children

"School outbreaks and closures are the worst thing we can do to kids, who need some normalcy in their school experience this year," said Mike DiStefano, MD, Chief Medical Officer for Children's Colorado's Southern Region. "Additionally, as the pediatric safety-net hospital for a seven-state region, our hospitals have already begun to take on seriously ill children from neighboring states' hospitals who have been experiencing these same challenges and are full. We need to learn from what others are experiencing. We still have an opportunity – and responsibility – to flatten the curve for our children in Colorado. That's why it is so imperative to do what is in our power to keep our children and others safe."

Related resources for parents and professionals