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March 07, 2022

It's OK if some families aren't ready to go maskless, CHOP doctor says

Mask mandates are being lifted, but the youngest children cannot be vaccinated. Parents must make decisions based on their risk tolerance

Children's Health COVID-19
COVID-19 mask children Marcos Cola/Pixabay

With COVID-19 cases and hospitalizations falling, mask mandates have been lifted throughout the country. But unlike everyone else, young children are ineligible to be vaccinated.

As COVID-19 cases continue to drop, most restrictions, including indoor mask mandates have been lifted throughout the Philadelphia region. But some families, particularly those with young children who are not eligible to be vaccinated, may have concerns about protecting their children. 

Dr. Julia Shaklee Sammons, a physician in the division of infectious diseases at Children's Hospital of Philadelphia, detailed why it is an appropriate time to drop mask mandates. She also acknowledged that some people may not feel comfortable going maskless. 

"We are seeing some of the lowest levels of COVID-19 disease activity and hospitalizations to date," Sammons said during a media briefing Monday. "At my own institution, we have seen test positivity decline from a peak of over 40% at the height of the omicron surge to now around 2%." 

Sammons, who is also an assistant vice president in CHOP's Office of Preparedness, Prevention and Response, said this trend is expected to continue over the next several months. She also noted that the region is at a different point than when the pandemic began two years ago – vaccinations and natural infections have built a much higher level of collective immunity.

"And finally we are also seeing differences in the virus," she said. "While we expect that new variants will emerge, what we saw with the most recent omicron variant is that while it was more contagious, it was less virulent. I can say as a pediatrician, we saw a large number of children infected with the omicron variant – many more than we had seen in other stages of the pandemic – but many were presenting with clinical syndromes that are very similar to the ones that we see year after year during peak respiratory virus season due to viruses such influenza and respiratory syncytial virus.

"These syndromes are things like croup and bronchiolitis, so for us, these were all signs we are beginning to move to another stage of the pandemic."

Though the conditions are right in certain places to start lifting mask mandates, Sammons said that some communities may be slower to lift COVID-19 restrictions and that mandates might need to be reinstated if case counts and hospitalization rates spike again.

"Even with lower cases numbers, some individuals may not be ready to unmask yet and that is OK," Sammons said.

In areas without mandates, going maskless becomes a personal decision that families must make based on their risk tolerance, especially for parents of unvaccinated children or those who are immunocompromised. 

Because it remains a fluid situation, Sammons recommended parents consult guidance from local public health officials and the Centers for Disease Control and Prevention to get a better sense of the level of COVID-19 transmission in their areas. 

She also encouraged anyone who has not been vaccinated to do so, noting it takes time to get to the highest level of immunity. Pfizer's COVID-19 vaccine has not yet been authorized for children under age 5, but Sammons said it may happen as early as April. 

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