Masks and physical distancing are proving to have major fringe benefits, keeping people from getting all kinds of illnesses โ€” not just covid-19. But itโ€™s unclear whether the protocols will be worth the pain in the long run.

The teachers at New Hope Academy in Franklin, Tennessee, were chatting the other day. The private Christian school has met in person throughout much of the pandemic โ€” requiring masks and trying to keep kids apart, to the degree it is possible with young children. And Nicole Grayson, who teaches fourth grade, said they realized something peculiar.

โ€œWe donโ€™t know anybody that has gotten the flu,โ€ she said. โ€œI donโ€™t know of a student that has gotten strep throat.โ€

Itโ€™s not just an anecdote.

A study released this month in the Journal of Hospital Medicine, led by researchers from Vanderbilt University Medical Center, found that across 44 childrenโ€™s hospitals the number of pediatric patients hospitalized for respiratory illnesses is down 62%. The number of kids in the U.S. who have died of the flu this season remains in the single digits. Deaths have dropped dramatically, too, compared with the past 10 years: The number of flu deaths among children is usually between 100 and 200 per year, but so far only one child has died from the disease in the U.S. during the 2020-21 flu season.


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Adults arenโ€™t getting sick either. U.S. flu deaths this seasonย will be measuredย in the hundreds instead of thousands. In 2018-19, a moderate flu season, anย estimated 34,200 Americansย died.

Itโ€™s not just the masks and physical distancing that are tamping down communicable disease, said Dr. Amy Vehec, a pediatrician at Mercy Community Healthcare, a Tennessee clinic that gets federal funding. Itโ€™s become a serious societal faux pas to go anywhere with a fever โ€” so parents donโ€™t send their ailing kids to school, she said.

โ€œThey are doing a better job of staying home when theyโ€™re sick,โ€ Vehec said. That includes adults who may feel ill.

Isolating when feeling bad could be kept up after the pandemic. But the isolation, the distance and the masks are not working for many kids, Vehec said.

Children with speech trouble arenโ€™t seeing their teacherโ€™s mouth to learn how to speak correctly, for instance.

โ€œI think it has been a necessary evil because of the pandemic, and I have completely supported it, but it has had prices. Itโ€™s had consequences,โ€ she said. โ€œKidsโ€™ education is suffering, among other things.โ€

And with covid vaccines unavailable to children for a while yet, it may be another year of masks in schools.

Some experts, like researchers trying to improve masks, argue that more societies should embrace masking โ€” as some Asian countries have. But even infectious-disease experts like Dr. Ricardo Franco of the University of Alabama-Birmingham doubt thatโ€™s practical.

โ€œIโ€™m a little skeptical that this crisis will be enough for a widespread culture change, given how difficult itโ€™s been to achieve a reasonable culture shift in the previous months,โ€ Franco said.

The most realistic setting for lasting change may be within health care itself.

Doctors and nurses didnโ€™t usually wear masks before covid. Dr. Duane Harrison, who directs an emergency department for an HCA hospital outside Nashville, mentioned a physician colleague who has worn a mask since he got out of medical school.

โ€œWe used to joke and clown with him about this,โ€ Harrison said. โ€œUntil this.โ€

Now that everyone wears masks, Harrisonโ€™s department has found the same thing many other workplaces have: Employees arenโ€™t calling out sick, unless itโ€™s covid.

โ€œWhen covidโ€™s done, this is a practice that most of us will probably continue,โ€ Harrison said. โ€œBecause we wonโ€™t be worried about runny-nose kids and elderly people who donโ€™t know theyโ€™re sneezing in your face.โ€

Some hospital systems, including Nebraska Medicine, have started to relax universal masking requirements for their staffs. But even vaccinated staffers still have to wear a mask when seeing patients. Intermountain Healthcare in Utah has signaled masks will continue to be required when a statewide mandate lifts in April.

โ€˜Is Everyone Going to Need a Break?โ€™

But even believers in the effectiveness of masks have their doubts about the medical community keeping it up.

โ€œThe larger question is: Is everyone going to need a break?โ€ asked Dr. Joshua Barocas, who studies infectious diseases at Boston University.

Whatever the future holds, public health officials say, the time has not yet come to drop mask requirements as the U.S. waits for more people to get a covid vaccine. But eventually, even doctors and nurses are ready to see smiling faces again.

โ€œI know Iโ€™m going to need to retire my masks at some point in the future,โ€ Barocas said, โ€œfor a little bit.โ€

This article was originally published in Kaiser Health News.

WORDS: Blake Farmer


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