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To mask or not to mask: Three doctors answer the big lingering questions

Top physicians answer the biggest questions surrounding unvaccinated kids under 12 and the new CDC guidelines.
"Morning Joe" booking producer Cat Rakowski and her 5-year-old son Lincoln.
"Morning Joe" booking producer Cat Rakowski and her 5-year-old son Lincoln.Courtesy of Cat Rakowski.

The last 14 months have been rough on everyone, including parents. As a single mom to an active 5-year-old boy — with no childcare and a full-time job— it’s been a hazy, difficult year. And now, here we are approaching summer 2021. I’m fully vaccinated, as are all the adults in my close circle.

But with the vaccine only approved and available for children ages 12 and over, it puts parents with little ones in a difficult spot.

The questions dangle like a poorly worn N95 mask. The CDC now says I don’t have to mask or physically distance except required by law. Infectious disease expert Dr. Michael Osterholm says I can party hard, but what about my kid? Can he party a little? Is it safe to bring him to our planned family reunion with other unvaccinated cousins? Am I setting a bad example for my child if I’m unmasked at the playground, or if I drink an iced coffee while we stroll down the street?

I asked three top doctors some of those burning questions. Dr. Kavita Patel is a physician in Washington, D.C. and a former health policy director under President Obama. Dr. Vin Gupta is a critical care pulmonologist and affiliate associate professor of Health Metrics Sciences at the University of Washington. And Dr. Lucy McBride is an internist in Washington, D.C. and a Bloomberg New Voices Fellow who is an advocate for incorporating mental health into the care of physical health.

Here’s what they said:

Q: What’s the risk for masked kids under 12 to enter stores or restaurants with unmasked, unvaccinated people?

Dr. Gupta: The risk of Covid-19 to younger kiddos in most public places is VERY low. That changes if the variants (particularly the one circulating in Brazil) starts to dominate here, but I still think we’re very much in a place where risk remains minimal to kids. That said, for now, we still mask our 4-year-old in public.

Q: As role models for our kids, should we keep masking if our children aren’t old enough to be vaccinated yet?

Dr. Patel: Yes. In my opinion, masks are a minimal trouble, and “do as I say, not as I do” is confusing to kids. Besides, until more adults are vaccinated, masks are our best defense.

Dr. Gupta: I mask up when I’m with my kid in when I’m in public for that exact reason. If they’re masking at school events, soccer practice or in indoor settings, I’d recommend that parents do so as well.

Dr. McBride: From a purely medical standpoint, vaccinated people do not need to mask, indoors or outdoors. But some people may opt to mask because they are not quite ready to relinquish that sense of safety, they want to role-model for their kids, or they want to be respectful of people who have not yet gotten vaccinated and might feel vulnerable. Parents need to role model confidence and optimism about the end of the pandemic. Masking outdoors — even for unvaccinated people — can end now.

Q: What’s the latest on Multisystem Inflammatory Syndrome in Children (MIS-C)? How worried should I be?

Dr. Patel: Parents should not be as worried about MIS-C, especially as we see total cases dropping. We know much more about how it presents and how to manage it in the hospital than we did a year ago.

Dr. Gupta: MIS-C is extremely rare. I would not be worried. A few thousand cases out of likely tens of millions of kiddos that have either tested positive or are positive (and just weren’t tested). There’s helpful info here on demographic risks.

Q: Regarding summer travel — What do you advise for plane travel with kids under 12? Should they test/mask when they arrive to grandparents’ homes?

Dr. Gupta: If grandparents are vaccinated, particularly with U.S.-based vaccines, the risk of exposure to Covid from a child that may have acquired in flight is very low to nil. I’d continue to mask children (and yourselves) in flight for now, but I would not recommend masking or testing on arrival.

Dr. McBride: Unvaccinated people are still at risk for Covid-19, so if traveling by airplane, it would be wise to get a PCR test before travel and five days after arrival at the destination. If you’re traveling by car and only visiting vaccinated adults, testing is not necessary.

Q: If you’re vacationing this summer with your own children and others outside your immediate family who are under 12 (who are obviously unvaccinated), can you all stay in the same house this summer?

Dr. Patel: If the adults have been wearing masks and behaving sensibly, it’s incredibly low risk if you know that prior to the trip they are being sensible – unvaccinated wearing masks in mixed places, etc.), and I would also consider testing them three days before the trip and again when they arrive. That would make it extremely low risk. I would not expect them to wear masks.

Dr. McBride: In general, Covid presents a tiny risk to kids, and the emotional and social tolls of restrictions are so great. If adults are vaccinated and there’s no elevated co-morbidities it really doesn’t make sense anymore to mask kids at all. But of course, if the kids or adults are high-risk, masks may still make sense.

Q: As we look toward the next school year, there’s been renewed focus on ventilation inside schools, but most parents are not exactly ventilation experts. Is there something specific we should be asking of our schools to feel more secure they’ll be safe by the fall?

Dr. Patel: When it comes to Covid, clean air is a more powerful disinfectant than bleach. Opening windows, using portable air cleaners, and upgrading to HEPA filters should be the priority.

Dr. Gupta: The questions I’d ask are: Does your ventilation system allow for increased air exchanges? Are there MERS or HEPA filters in place that can filter out airborne viral particles? I suspect the new CDC guidance issued on May 13 will fast-track approval of the vaccine for those under 12, so hopefully ventilation becomes less of an issue once younger students are vaccinated.

Q: Give me a metaphor I can understand. If my child is under 12 and doesn’t have comorbidities, how sick will they get if they catch Covid-19 today?

Dr. Gupta: Most likely, they won’t feel it at all. At most, nap time might be a little longer and you might notice a runny nose. If chickenpox is a 10/10 in terms of the sickest most kids get, the most common profile of a sick child with Covid is 2/10: They’ll behave like they didn’t get a good night’s sleep the night before or they’ll be grumpy. Like when they’re hangry.

Cat Rakowski is an Emmy-winning journalist and a booking producer for MSNBC's “Morning Joe” and “Way Too Early with Kasie Hunt." She lives in Queens with her son, Lincoln. Follow her @catrakowski.