Despite how widespread all-day masking of children in school is, the short-term and long-term consequences of this practice are not well understood, in part because no one has successfully collected large-scale systematic data and few researchers have tried. Mental and social-emotional outcomes are hard to observe and measure, and can take years to manifest. Initial data, however, are not reassuring. Recent prospective studies from Greece and Italy found evidence that masking is a barrier to speech recognition, hearing, and communication, and that masks impede children’s ability to decode facial expressions, dampening children’s perceived trustworthiness of faces. Research has also suggested that hearing-impaired children have difficulty discerning individual sounds; opaque masks, of course, prevent lip-reading. Some teachers, parents, and speech pathologists have reported that masks can make learning difficult for some of America’s most vulnerable children, including those with cognitive delays, speech and hearing issues, and autism. Masks may also hinder language and speech development—especially important for students who do not speak English at home. Masks may impede emotion recognition, even in adults, but particularly in children. This fall, when children were asked, many said that prolonged mask wearing is uncomfortable and that they dislike it.

This last reason is important in considering a pivot to requiring children to wear N95 or KN95 masks, which are thought to be more effective at preventing the spread of Omicron. A few school districts, in response to the growing awareness of the ineffectiveness of cloth and surgical masks, have decided to escalate rather than scale back masking by requiring these types of medical-grade masks, which are significantly less comfortable to wear and can hinder communication more than other types of masks.

As with our existing school-mask policies, no real-world data indicate that these masks decrease transmission in school settings—data that matter greatly, as these masks require a very tight fit to function effectively, and that may not be possible for many kids. N95s are not approved or sized for children, proper fit is hard to achieve even with adults, and a June 2020 study shows they have very high failure rates when taken on and off or worn for multiple hours. Though KN95s, the manufactured-in-China equivalent, are available in kids’ sizes, they also require a very tight seal to function properly, which is unrealistic for schoolchildren to maintain for multiple hours a day. Early-pandemic recommendations to mask at school, soon followed by mandates, were laid down in the absence of data. We should not repeat this mistake with a new generation of masks.