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As more states loosen mask requirements, how should children be protected?

A MARTINEZ, HOST:

Now, you may have noticed it in your own communities. But the masks are coming off. More states and cities are loosening requirements on masking as omicron cases take a downward slide in pretty much every U.S. state except Maine. The CDC says it's reworking its guidance on masks and may change it as early as next week. Here's Rochelle Walensky, the head of the CDC, addressing reporters at the White House on Wednesday.

(SOUNDBITE OF ARCHIVED RECORDING)

ROCHELLE WALENSKY: We want to give people a break from things like mask-wearing when these metrics are better, and then have the ability to reach for them again should things worsen. If and when we update our guidance, we will communicate that clearly. And it will be based on the data and the science.

MARTINEZ: Still, questions persist, such as, will that include loosening mask restrictions for kids, and should it? Let's ask Dr. Ruth Kanthula, a pediatric infectious disease specialist at MedStar Health in Washington, D.C. Doctor, about a quarter of kids between the ages of 5 to 11 are vaccinated. So do you think masking should remain in place in schools?

RUTH KANTHULA: So my opinion with regards to masking is - really stems from my approach as a pediatric infectious disease doctor. In my practice, I tend to think about things in terms of, like, what is the worst-case scenario? And so that being said, I also want to think about ways to prevent the badness, which in this case would be COVID infections in children who are less than 5. So for my families, I will continue to recommend vaccine - or masking, especially for children who are less than 5 years old, and then for my immunocompromised children that I take care of.

MARTINEZ: Of that number that I mentioned - a quarter of kids between the ages of 5 to 11 - what would that have to be for you to be a little bit more confident about removing masks in schools?

KANTHULA: For me, it would be - have to be higher than 50%...

MARTINEZ: OK.

KANTHULA: ...Probably between - somewhere between 50 and 70%.

MARTINEZ: Fifty or 70%. Now, there's been a ton of pushback against child masking mandates at the state level, especially for the littlest of kids. What about masks for children under the age of 5, those who can't get the vaccine yet? Should those remain in place?

KANTHULA: So I think that children who are aged 2 to 5, because they can't get vaccinated, as you stated, should continue to wear masks in indoor spaces, especially in schools, because that's where they'll most likely encounter people who are not part of their family group.

MARTINEZ: Keeping the mask on their faces, though, (laughter) that's the difficult part, right?

KANTHULA: It's a hard thing to do. The problem is we are still in winter, right? And winter is the time when children have snotty noses, runny noses. And this was even before COVID. Having a cold or sniffles was a common thing. Now we have COVID on top of that, which makes it complicated. So any sniffle or runny nose is COVID until proven otherwise. And it also means that families have to take time off of work to take care of children who are quarantined or in isolation. So there are a lot of factors to think about. If masking can prevent children from having to leave school for quarantine and isolation, then I support it for those children who are 2 to 5.

MARTINEZ: But those kids that are under 5 who haven't been vaccinated are statistically less likely to get really sick if they're infected. So I mean, isn't that a good place to start, Doctor, when we're looking at maybe moving to an endemic stage rather than a pandemic stage of COVID?

KANTHULA: So that is true. So children 2 to 5 are less likely to get serious infections or - from COVID. But things to consider are that in that group, we still have immunocompromised children who have yet to be vaccinated. And they're at risk for serious infections. We also have children who have asthma. We also have children with other comorbidities, such as obesity. The other thing to consider is that with COVID, yes, children get mild infections. But there are still post-infectious complications of COVID that we're still learning about - so for example, long hauler syndrome and multisystem inflammatory syndrome of COVID.

MARTINEZ: One more thing, Doctor. I mean, what would you need to see ultimately, overall, on all of this, in order to really, really feel comfortable recommending that kids can go to school unmasked, kids of all ages?

KANTHULA: So as we talked about earlier, I'd like to see higher vaccine rates above 50, closer to 70, and even higher than that. I would also like to see that the pandemic, it becomes more predictable...

MARTINEZ: OK.

KANTHULA: ...In the sense that what we're seeing - or the predictable cycle - so for example, having surges in the winter and not in the summer. And I don't think that we're there yet.

MARTINEZ: OK. Perfect. That's Dr. Ruth Kanthula, a pediatric infectious disease specialist at MedStar Health in Washington, DC. Doctor, Thanks.

KANTHULA: Thank you. Transcript provided by NPR, Copyright NPR.