Masks won't be mandatory for Manitoba students in September. Here's why experts say that's a good thing

Manitoba students won't be required to wear masks when they return to school in the fall, and infectious disease experts say there are good reasons for that.

As long as children under 10 years old appear to spread the virus less than older kids and adults, and as long as the rate of community spread of the coronavirus that causes COVID-19 remains low, epidemiologist Cynthia Carr says the potential benefits of kids wearing masks could be outweighed by the possible harms.

"There are other issues pertaining to masks, in terms of how it makes kids feel," she said. 

On Thursday, the provincial government announced its plan to reopen schools in September. It calls for students in kindergarten to Grade 8 to return to class full time, while high school students will likely return with a mix of in-classroom and remote learning.

The plan does not include a recommendation for students or staff to wear masks.

Science has yet to answer many questions about the novel coronavirus, but a large study from South Korea, published by the Centers for Disease Control and Prevention in the U.S., found that children under 10 years old infected others in their households just 5.6 per cent of the time, while children 10 to 19 spread the virus at the same rate as adults, nearly 19 per cent of the time.

Masks can disrupt learning

While Carr is not aware of any research on the emotional impact of wearing masks for kids, many adults report feeling anxious while wearing them.

"The area around your nose and mouth … tends to get hot to begin with, and when we feel heat, it makes us feel anxious and claustrophobic. So that could also apply to children," she said.

Distraction is another issue, said Carr, as is disruption of language development, especially for "kids that might have trouble with their articulation, their speaking. Those are things that we learn in elementary school."

Kids who are learning a second language might also have trouble understanding what other students are saying if a mask is muffling their voice, Carr added. 

Teachers, older students bigger spreaders

Ontario also released its school reopening plan on Thursday. It requires students in grades 4 to 12, as well as teachers and staff, to wear masks.

Although she doesn't think it makes sense to require students in the lower grades to wear masks, Carr would support a recommendation for teachers to wear them.

"There's no evidence that young children are … good at spreading the disease, and the point of wearing a mask is to stop one person spreading it to another," said Carr.

"It's the teachers and the older students that are more likely, research shows, to spread the virus."

Allan Ronald, a retired infectious disease expert and professor at the University of Manitoba, agrees it would be difficult to force students to wear masks.

"I think it's going to be hard to get the kids to not dislike them," he said. 

As long as schools follow other procedures outlined in the province's plan — such as encouraging good hand hygiene, physical distancing, and cohorting measures — and cases are followed up with rapid testing and contact tracing, Ronald believes infection clusters can be contained. 

He encourages parents to get their kids immunized against seasonal influenza, to reduce confusion if kids develop symptoms. 

Like Carr, however, he would support teachers wearing masks. 

"We don't want teachers to be afraid of being involved in educating," he said. "It's not easy — it's frustrating wearing a mask and trying to talk and teach. But I do think that teachers should know that at least they have the option of wearing a mask in secondary school."

It might be more difficult for some kids, like those who have hearing impairments, to understand a teacher wearing a mask, so Carr says accommodations should be made, such as using microphones.

Health officials in Manitoba will monitor infection rates, as well as school reopening plans in other jurisdictions, when considering whether to make masks mandatory, Chief Public Health Officer Dr. Brent Roussin said at a news conference on Thursday.

"As we move closer and closer to fall, masks are likely to become more and more a part of our plan," said Roussin.

For now, Carr says the province's back-to-school plan strikes the right balance between caring for the physical and mental health of children while also meeting their educational needs. 

"There's always consequences and risks to decisions, and those are public health risks, the social risks and the economic risks," she said.

"But I think it shows that the government is listening and learning."