The delta variant-fueled rise in COVID-19 case counts comes as students and families in Maine prepare to return to full-time, in-person learning in a few weeks.

While many had been hoping for a more normal start to the year, the variant has made it apparent that some health and safety precautions still will be necessary. Schools already have adopted a range of guidance on protocols like mask wearing, with some, like Portland and Bangor, planning to require masks, while others, like Lewiston, are leaving decisions on masks to individual families.

Medical experts said it’s possible for schools to return to full in-person learning safely as long as there are some protections in place, and they offered advice for how parents can keep their children safe as they return to school.

How safe is full, in-person learning right now? 

While many schools around Maine chose to operate in hybrid models last year with students attending in-person just two or three days per week, districts have committed to being open five days per week for in-person learning this year. The decisions come even as Maine sees higher case numbers than last summer and as children under 12 still aren’t eligible to get vaccinated.

But experts said the experience of operating last year has taught schools about the best practices for keeping everyone safe and healthy. “The pandemic is ever changing, but what we know right now and from the experience of the last year and a half is that children and staff can return to school safely, but it is very critical there be a layered approach, meaning there are multiple strategies that are used to protect everybody,” said Dr. Dora Anne Mills, chief health improvement officer for MaineHealth.

Those strategies include encouraging or requiring vaccinations for those who are eligible, masking, physical distancing, testing and screening, proper ventilation, hand washing and proper sanitation of school spaces.

It may not be possible for every school to implement each of those protocols, but Mills and others said taking a layered approach of implementing multiple measures to the extent possible will help keep schools safe and open.

Schools also should take time to address the mental and emotional health of students and staff. “I think we need to address up front people’s fears and their stresses, not only with students but with school employees,” Mills said. “If people feel emotionally safe at school that will help them stay in school.”

How important is masking in schools with high vaccination rates or where community transmission is low?

The U.S. Centers for Disease Control and Prevention and state of Maine are recommending that all staff and students in K-12 schools wear masks indoors regardless of vaccination status. However, decisions on mask policies still rest with individual school districts in Maine, resulting in a variety of approaches.

Even at a school with a high vaccination rate, there may be people who are medically ineligible for the vaccine or who have medical conditions that prevent the vaccine from completely protecting them, said Dr. James Jarvis, director of clinical education at Eastern Maine Medical Center and senior physician executive for Northern Light Health’s COVID response. The virus also doesn’t pay attention to city or county lines, so even though one county may be designated an area of “low” transmission, it’s important to pay attention to what’s going on in neighboring areas.

“The virus can spread pretty rapidly, pretty quickly, so I think in that case it’s probably wise for us to continue to wear masks,” Jarvis said.

What kind of mask is best for my child?

Cloth and non-healthcare masks that might commonly be worn in schools are effective at preventing the wearer’s germs from spreading, but they don’t work as well at protecting the person wearing the mask. “If you are saying, ‘We’ll make it optional …’ the problem with that is you’ve got kids whose parents think they’re well-protected wearing a mask, but they’re actually helping other people more,” Mills said. “The kids who aren’t masked are exposing the kids who are masked to their germs.”

In places where masks are optional, Mills said parents may consider having their child layer two masks to provide additional protection. But she said masking works best when everyone is wearing one. If that’s the case, a well-fitted fabric mask should be fine, though parents also might consider a N95 or KN95 if they want their child well-protected at school.

Children who are especially vulnerable to severe disease should consult with their physicians about the most effective masking options.

Has wearing a mask for extended periods been shown to have any negative impacts on children’s health or emotional well-being? 

Since the implementation of mask mandates, some concerns have arisen about possible negative impacts of masking, though two studies shared by the U.S. CDC this year – one among adults and the other among children – found no indication of decreased oxygen or increased carbon dioxide levels in the blood of participants, or any clinical signs of respiratory distress.

The CDC also has reviewed dozens of other studies on mask wearing and found community masking is an effective way to reduce transmission of COVID-19 with no clinically significant impacts on respiration or gas exchange.

Dr. Laura Blaisdell, vice president of the Maine chapter of the American Academy of Pediatrics, said she has found children to be very adaptable and good at wearing masks when they need to, though there are some children for whom wearing masks can be difficult, such as those who are deaf or are in specialized education programs where facial expressions are important to their learning.

“I do empathize with parents because none of us want our children to have to go to school and have to wear a mask,” Blaisdell said. “Unfortunately, if we don’t use masking, schools aren’t going to be able to stay open. … If we do the experiments and if we allow children to attend school without masks in areas that have moderate to high COVID transmission there will be outbreaks.”

How dangerous is the delta variant for children? 

As COVID-19 cases rise, the number of cases among children also is increasing. On Monday, Reuters reported the number of children hospitalized with COVID-19 hit a record of just over 1,900 last weekend — about 2.4 percent of the nation’s COVID-19 hospitalizations. New hospitalizations for people in their 20s, 30s and 40s also hit new highs.

It remains unclear whether children are being more severely impacted by the delta variant or if because more are getting sick there are also more serious cases. “What we do know is this is far more transmissible from one person to another,” Jarvis said. “We know people carry about 1,000 times more of the virus inside them, so there’s that much more that they can spread out there.”

What else can parents do to keep their children safe aside from the steps schools are taking?

Experts encourage everyone who is eligible, especially parents and older siblings, to get vaccinated because that will help protect younger children and minimize their exposure to the virus. Taking steps to mitigate community spread such as staying home when sick and following the U.S. CDC’s guidance on masking also will contribute to conditions that will keep schools open.

Blaisdell encourages families to support their school’s policies and be mindful of the difficult decisions that school boards and administrators face. “It’s a very difficult time to try and keep schools and other childhood programs open,” she said. “Our children need them more than ever. I do understand parents are frustrated, but schools have the best interest of the community in mind so we need to support them by following those policies.”