The New Mask Guidelines from CDC… and Kids

Emily Oster

11 min Read Emily Oster

Emily Oster

The New Mask Guidelines from CDC… and Kids

Emily Oster

11 min Read

Last week, the CDC released new guidance on masks.

The basic idea of the guidance is to help people think about what the safety of various activities, both inside and outside, depending on their vaccine status. The biggest take-away for most people was the idea that it isn’t necessary for fully vaccinated people to mask outside. A number of locations (for example: where I live in Rhode Island) have relaxed outdoor mask mandates as a result.

Along with this, the CDC made a push for vaccines: get vaccinated! Move to the right side of the graphic! Look at all the great stuff you can do! But, among some parents, there was a palpable sense of frustration. My kids cannot be vaccinated yet! Do I have to wait forever for anything?

This was exemplified for me by Savannah Guthrie interviewing Dr. Fauci. Their exchange is confusing — she’s confused, I think, and he doesn’t totally explain himself — but I feel her frustration coming through the screen. For many parents, I sense it feels like we’ve spent over a year holding our kids back even though the risks to them are small, so we can protect others. And now somehow even though they’re low risk, we have to hold them back even more.

Our older parents are chillaxing with their friends on vacation in Florida drinking fruity cocktails at the swim up bar and we’re still supposed to make our three year olds wear masks at the playground. THIS FEELS VERY UNFAIR.

Breathe.

I wanted to try to cut through a little of the chaos today. First: What does this CDC thing mean, really, for kids? Second: Why don’t they explicitly call out kids separately, given that we know they are low risk for illness? Third: Is it just going to be like this until they get a vaccine? And when is that anyway?

Before getting into this: I want to acknowledge that these CDC guidelines are just that — guidelines. They aren’t rules, and individual states and municipalities have their own statements. Whenever I write about this, I hear from people who live in areas — say, Texas or Florida or North Dakota — with many fewer mask restrictions and a looser set of guidelines in general. They are often very confused about why this is such a discussion. The explanations for this split are too lengthy for this newsletter, so let’s just leave it there.

What Does This Mean?

As Dr. Facui confusingly states in the interview, kids are unvaccinated and, therefore, the “unvaccinated” guidelines above apply to them. What this means, though, is that if you’re out walking around with your kids, with just your household, it is fine for them to be unmasked. In addition, if you have a gathering of fully vaccinated people and one household worth of unvaccinated kids are there, they can be unmasked.

The CDC guidelines, if taken to the letter, also suggest both vaccinated and unvaccinated people should be masking for basically any indoor activities other than small gatherings (like with family) with only one unvaccinated household.

Where masking in kids is still recommended are places like playgrounds or playdates, either indoor or outdoor. This is where I think people have come up against the inequities. If I meet a friend and their kids at a playground, in my house or in my backyard and the adults are fully vaccinated, the guidelines say adults unmasked and kids masked. This feels odd to a lot of people, but that’s what the CDC says.

Why Aren’t Kids Separated Out?

Why not discuss kids separately, especially little kids, since we know their illness risks are low? This is a question not just for this particular set of mandates, but one that comes up in general. The CDC and other public health bodies have been reluctant to talk about more freedoms for younger groups.

The reason for this lies in the goal of this messaging.

When they send health messages, public health officials have two goals. One is to help people protect themselves. The other is to protect the broader health of the public. Sometimes, the first part is the really key goal — when we give diet advice, it’s mostly about how to be healthy for yourself. And for that part of the advice, it really makes sense to distinguish between risk levels. But when it comes to COVID-19, public health messaging at this point is still very focused on lowering spread; we are still seeing around 50,000 infections per day.

Kids are lower risk for COVID infection in general, but the risk differences are much less extreme than for serious illness. According to the CDC, kids 5 to 17 are only slightly less likely to have COVID at all relative to adults, even as they are much, much less likely to be seriously ill or die.

The differences in guidance for vaccinated and unvaccinated people are really focused on their risk of spreading to others. And from this standpoint, kids are similar to adults and it doesn’t make sense to separate them out. (Some people have asked how to interpret some of the statements coming out of Michigan that younger people are more important in driving spread in the last wave. My read is this likely reflects the fact that they are a relatively larger share of cases, since older people are now vaccinated).

So, is it going to be like this forever until kids get vaccinated?

I do not have a crystal ball but, I think, no. Here’s the thing: these guidelines are specific to this moment in time when we are still seeing 50,000 cases a day. As these numbers go down — as we vaccinate more people and more people move from partial to full vaccination — this will make it possible to extend more flexibility to everyone. The situation can feel hard to predict, since vaccine hesitancy is real, but as we get to 50 or 60% of the population vaccinated, which I think is feasible, case rates will continue to drop.

Herd immunity is a bit of a red herring, neither necessary nor sufficient, but the fact is that more vaccines = less spread = (ultimately) more ways to be safe even for unvaccinated people. The concern with extensive interactions among unvaccinated people is that someone will bring the virus, and others will be infected. But as case rates lower and more high-risk people are vaccinated, it both becomes less likely that anyone shows up with the virus, and less problematic if they do.

CDC guidelines aren’t set in stone; they change. As case rates decline, it will be reasonable for them to relax more. And it may start being reasonable for them to focus messaging more on individual choices and to distinguish among unvaccinated people by risk level. As David Leonhardt has helpfully pointed out, there will be more than one reasonable way to behave with your children once all adults have had the option to be vaccinated.

I don’t know when any of this will happen, but when I get frustrated and impatient, I try to remember that things look very different right now than a month or two months ago. If we keep pushing to vaccinate more, they can look even more different in a month.

What about camp? Are we going to be masking at camp? And school next year? ARGH. Why?

I get a lot of mask questions about camp and school. CDC camp guidelines are angering a lot of people, likely due to the somewhat extreme approach to masking and other mitigation. Last summer, my kids went to tennis camp and there was no masking except at drop off and pickup (there were no COVID cases). The current guidelines are considerably more stringent than this.

This seems to many people kind of backward, since at this point all the counselors will be vaccinated, case rates are likely to be a lot lower, kids are low risk and outdoor activities are very safe. David Zweig has a skeptical piece on this which I agree with. Yesterday, Dr. Fauci expressed some skepticism and suggested updates might come. I think that would be appropriate.

As for schools… the fall is hard to predict. We do have some opportunity to learn about the value of masks in these situations from — for example — the experience of schools in this latter part of the spring in states which relaxed their masking rules (e.g. Texas). Whether data like this will matter to these decisions, I’m not sure.

In some ways, I find this frustrating and I worry about not seeing a way out. Are we going to make kindergarteners wear masks at school until no one has COVID anywhere? I would support this if we thought it mattered a lot for transmission, but it’s not clear it does especially when adults are vaccinated. I think we are also missing some of the significant costs for students with disabilities, who may struggle more with these restrictions in various way.

Having said this: if the tradeoff in the fall is masks or no school, my strong sense is that masks are better than no school. Many kids have worn masks all year without issue. As economists say: it’s not the first best, but it’s maybe the second best. With no in person school as a distant third.

I do want to name here that I’d like to see more clarity from the CDC about younger kids. It’s hard to get a 2 year old to wear a mask and I’m not sure what evidence we’d point to to suggest that it matters, especially when case rates are low.

When will kids be vaccinated anyway?

The FDA is reportedly set to extend the Emergency Use Authorization for the Pfizer vaccine to adolescents (12-15) next week. Realistically, this means in a couple of weeks we will start seeing that group vaccinated.

Pfizer has said they’ll apply for an EUA for kids 2 to 11 in September. Moderna is in a similar space. So in principle we could have vaccines for this group in the late fall. This is a bit earlier than the January timeline that I’d seen predicted.

So, this is when your child could be vaccinated. But will you? People sometimes ask me: will you get your kids vaccinated? I will, as soon as they can. If we had access, I would likely have enrolled them in a trial.

However: I am expecting more vaccine anxiety and hesitancy around kids than there has been around adults, especially kids in the younger age groups. For a low risk 8 year old (for example) the individual benefit of the vaccine is low. Yes, kids can get severe COVID, so the vaccine benefit is not zero. But it’s much, much smaller than for (say) their 75 year old grandparent. The most significant benefits to childhood vaccines are to lowering spread to other people — these benefits are real! But, overall, the risk-benefit calculation is different in kids than older people.

This comment, in Lancet Infectious Disease, is a more academic take on this questions. My bottom line is that I think it will be an uphill slog to getting high vaccine rates in kids, especially those under 12, until schools require them. And many schools in many places will not.

Final Thoughts

It is an amazing triumph of science that the COVID-19 vaccines are so effective. What it means — and this is reflected in the CDC guidelines and general rhetoric — is that people who are vaccinated can start to get back to normal. Like real normal. And a big part of that is not thinking through every f*ing activity to decide it if fits in today’s “risk budget” or whatever we are calling it. Want an eyebrow wax? Just get it. Forgot strawberries at Whole Foods? Just go back.

I think many parents are experiencing, basically, decision-fatigue-induced-vaccine-jealousy. I just want to be able to make simple decisions about playdates and vacations and camp and extracurriculars without a calculator. (Yes, I like my calculator, but I wish I didn’t have to use it.) It seems like we are facing at least a few more months of these complicated decisions and it is frustrating and tiring.

I have no real solution other than to name the feeling, to note that it will get easier, and to celebrate the small changes. Example: none of us will mask when we are hiking as a family this weekend and we will retire the front-of-line-there-is-someone-coming-mask-up-hand-signal my husband introduced a year ago. It’s a small thing, but it’s something.

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Updated CDC Guidelines for School and Child Care

NO QUARANTINES!!!

Emily Oster

Instagram

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Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
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It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents

It was an absolute pleasure to be featured on the @tamronhallshow! We talked about all things data-driven parenting and, in this clip, what I call the plague of secret parenting. To balance having a career and having a family, we can’t hide the fact that we’re parents. If mothers and fathers at the top can speak more openly about child-care obligations, it will help us all set a new precedent.

Watch the full segment at the link in my bio 🔗

#tamronhall #tamronhallshow #emilyoster #parentingsupport #workingparents
...

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor

Invisible labor. It’s the work — in our households especially — that has to happen but that no one sees. It’s making the doctor’s appointment, ensuring birthday cards are purchased, remembering the milk.

My guest on this episode, @everodsky, has come up with a solution here, or at least a way for us to recognize the problem and make our own solutions. I’ve wanted to speak with Eve for ages, since I read her book Fair Play. We had a great conversation about the division of household labor, one I think you’ll get a lot out of!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#emilyoster #parentdata #parentdatapodcast #parentingpodcast #householdtips #fairplay #invisiblelabor
...

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better.  Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough. 

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips

Prenatal vitamins 💊 If there is any product that seems designed to prey on our fears, it’s this one. You’re newly pregnant and you want to do it right. Everyone agrees you need prenatal vitamins, so you get them. But do you want to be that person who just… buys the generic prenatal vitamins?

Good news: fancier vitamins are not better. Folic acid is the most important prenatal ingredient. Iron (with vitamin C) and DHA are also nice to have. Other included ingredients have only weak or no evidence to support their use. (If you do not consume animal products, add B12, plus a few others depending on your diet.)

Vitamins are just vitamins. Any prenatal vitamin that contains these is enough.

Comment “Link” for a DM to an article with everything you need to know about prenatal vitamins.

#emilyoster #parentdata #prenatalvitamins #pregnancydiet #pregnancytips
...

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips

When it comes to introducing your newborn to the world, timing matters. It’s a good idea to minimize germ exposure in the first 6-8 weeks; after that, it’s inevitable and, very likely, a good idea! This doesn’t mean you need to be trapped inside. The most significant exposure risks are from seeing other people at home — family, etc. These interactions are not infinitely risky, but they do pose more risk than a walk or a trip to the grocery store, since they involve closer interaction. Think simple and make sure everyone is washing their hands before holding the baby. 💛

#parentdata #emilyoster #newborncare #parentingadvice #parentingtips
...

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth

The first edition of Hot Flash is out now! Comment “Link” for a DM to learn more about the late-reproductive stage.

There are times when we expect hormonal shifts. Our reproductive lives are bookended by puberty and menopause. We discuss those changes often because they are definitive and dramatic — a first period is something many of us remember clearly. But between ages 13 and 53, our hormones are changing in more subtle ways. During the late-reproductive stage (in your 40s), you can expect a lot of changes in your menstrual cycle, including the length and symptoms you experience throughout. It’s an important time in our lives that is often overlooked!

🔥 Hot Flash from ParentData is a weekly newsletter on navigating your health and hormones in the post-reproductive years. Written by Dr. Gillian Goddard, Hot Flash provides all of the information you need to have a productive, evidence-based conversation about hormonal health with your doctor.

#emilyoster #parentdata #hotflash #perimenopause #womenshealth
...

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata

There are plenty of reels telling you how to parent. Plenty of panic headlines saying that “studies show” what’s best for your kid. Even good data, from a trusted source, can send us into a spiral of comparison. But I want you to remember that no one knows your kid better than you. It’s important to absorb the research, but only you will know the approach that works best for you and your child. 💙

Now tell me in the comments: what’s a parenting move you’ve made recently that feels right to you?

#parentingcommunity #parentingsupport #parentingquotes #emilyoster #parentdata
...

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships

Let’s talk about sex (after) baby! Today on the podcast, I was lucky enough to speak with @enagoski about her new book on sexual connection in long-term relationships. Especially after having kids, this is something many people struggle with. Emily tells us to stop worrying about what’s “normal” and focus on pleasure in its many forms.

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #parentdatapodcast #emilyoster #emilynagoski #comeasyouare #cometogether #longtermrelationship #intimacy #relationships
...

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles

Ever wondered if you can safely use leftover baby formula? 🍼 The CDC says to throw out unused formula immediately because of the risk of bacterial growth. However, research suggests that bacterial concentrations do not appreciably increase after 3, 12, or even 24 hours at refrigerator temperatures. Good news! This means there’s not a strong data-based reason to throw out formula right away if you store it in the fridge.

Comment “Link” for a DM to an article on another common formula question: should you throw away old formula powder?

#emilyoster #parentdata #babyformula #babyfeeding #parentingstruggles
...

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity

What’s the most important piece of advice for new parents? Here’s one answer, but I want to hear from you! Share your suggestions in the comments ⬇️

#emilyoster #parentdata #parentingtips #parentingadvice #newparents #parentingcommunity
...

What's in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you.

What`s in the bag of a Vagina Economist? 👀 Someone please tell me this looks familiar to you. ...

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport

Comment ”link” for a DM to learn more about tongue ties 🔗

Breastfeeding is often difficult, especially at the start. For babies with tongue ties, many infants (and their moms) struggle to get the hang of a good latch. This can lead to painful nipples and to inefficient feeding, and then low weight gain.

So what does the data say about the increasingly common practice of cutting tongue-ties in infants to improve breastfeeding success? Several weeks ago, @nytimes published a long and quite scary article on this topic.

After diving into the data, here is what I found. There is limited evidence that frenotomy procedures improve breastfeeding efficacy and the harms of the procedure are minimal. Many women do report that it alleviates pain and helps them with breastfeeding. However, it should not be a first-line treatment for breastfeeding problems.

#parentdata #emilyoster #tonguetie #tonguetiebabies #breastfeedingsupport
...

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way. 

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes

Tag a friend who needs to hear this 💛 For many choices in parenting, there is no one right answer. We can use research and data to make informed decisions, but ultimately, it won’t tell you what to do. Only you can decide what will be best for your kids and your family.

I’m here to remind you to take a deep breath and trust yourself. I’ll be here to support you along the way.

Thank you to everyone who submitted videos, including:
@sarah.consoli
@jess_lynn627
@nicolevandenwills
@thedrblair
@ncbenedict29
@haleycimini
@iamkellysnodgrass
@calesse_smith
@garnet__gordon
@jencoopgaiser87
@danigirl18c
@jamielundergreen
@carly_comber
@thecelebratingmama
@emilyannbynum
@eeliz413

#emilyoster #parentdata #parentingadvice #parentingsupport #parentingquotes
...