5: Back to School Mask Messaging

ASTHO Chief Medical Officer Dr. Marcus Plescia discusses back-to-school mask messaging; Dr. Gillian SteelFisher of the Harvard Opinion Research Program offers help to public health teams communicating mask and vaccine requirements in schools; and...

ASTHO Chief Medical Officer Dr. Marcus Plescia discusses back-to-school mask messaging; Dr. Gillian SteelFisher of the Harvard Opinion Research Program offers help to public health teams communicating mask and vaccine requirements in schools; and ASTHO’s Amber Williams talks about the mental health of weary public health workers.

The changing guidance and requirements on masks in schools

Back to school: Parent views of COVID protection

Taking care of the public health workforce post-pandemic

New report on the mental health impacts of the COVID-19 pandemic

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This is Public Health Review Morning Edition for Monday, August 16th, 2021. I'm Robert Johnson with today's news from the Association of State and Territorial Health Officials.

It's back-to-school time across the nation, and that means more and more public health teams will find themselves in conversations with parents and educators about the benefits of mask wearing to prevent the spread of COVID-19 and the Delta variant.

ASTHO chief medical officer Marcus Plescia says, when in these conversations, it's best to stick to the signs.


I think we need to be real upfront with the people we're talking to because the science wasn't clear early on and that caused a lot of confusion.

And there may need to be some additional conversation about the fact of yes, you know, the science isn't always clear—and to begin with it wasn't—but now we feel very secure about the science, and we feel like this really is the most important intervention if we want to open schools and keep them open.


ASTHO has written a blog post about mask guidance in schools. Look for the link in the show notes.

There's new information available now to help you communicate with parents and other stakeholders about mask and vaccine requirements in schools.

ASTHO, the National Public Health Information Coalition, and the Harvard Opinion Research Program have teamed up for a series of surveys about COVID-19 communications. Data from the latest wave of the tracking survey includes responses from parents of school kids ages five to 17 years old.

Dr. Gillian SteelFisher directs the work. She joins us for a morning conversation.

What are parents thinking about mask and vaccine requirements as they send their kids back to school under the cloud of this surging Delta variant?


So, what we see is that there are some policies where getting parental support will be harder and more messaging will be trickier, and some where it'll be easier. So, there's some good news for communicators, but let me start with the harder parts.

Let's talk about vaccination requirements. There's pretty low support with only about half of parents supporting such a requirement for kids who are eligible right now—kids who are ages 12 to 17—is a lot lower than the support we see for other childhood vaccines like measles.

And, not surprisingly, parents who aren't as likely to vaccinate their own children are much more likely to oppose such requirements. In fact, we see lower support for all protection policies among parents who are less likely to vaccinate their children—so, if they're less likely to vaccinate, they're also less likely to support mask requirements, for example.

But we do see some bright spots in this for communicators.

First, we see a majority of support for some kinds of masking for older children, with universal masking—that's masks for all kids and not just the unvaccinated—being least polarizing.

And we see majority support, even among those who are less likely to vaccinate their children, for other kinds of school policies like increased hand-washing, symptom checks at home, on-site temperature checks, and social distancing.


So, how can your findings help public health agencies communicate during these very tense debates?


Well first, use the vaccination rate in your jurisdiction as a guide to parental support for these policies.

If you're in an area with lower vaccination rates, you are probably an area with less support for school-based requirements of any kind. Approach your communications with this in mind and emphasize things that'll be most appealing and least polarizing.

So, to start, if you have a choice, put forward a universal mask policy rather than one that targets unvaccinated kids. It’s probably going to give you a stronger foundation to start. And as you put out that policy, you know, talking about it, situate it in the range of things that you're going to do to protect kids. Connect it to things that have widespread support and are familiar to parents already, like hand-washing, symptom checks, and even social distancing.


That's all very useful and actionable advice.

Is there anything else that teams ought to know before they get involved in these discussions?


Yes. My best advice is that when you need to talk with parents about school requirements, find someone with a stethoscope and bring them with you.

Doctors and nurses are routinely the most trusted messengers for information about COVID. They have what I consider the secret sauce for messengers. They have two ingredients: the first is that people think that they're knowledgeable about health—doctors are trained professionals who understand how viruses and vaccines and immune systems work; and the second is that people think they care about their children—doctors and nurses have a lifetime of service and caring for patients. So, find a doctor who works with children in the community.

Even better that doctor should reflect the community. Find someone with a shared history, similar racial and ethnic background, culture, style of speech—that helps parents know that this person will have their back and brings trust into the picture, particularly for marginalized communities.


The work is funded by the CDC.

Finally, this morning, public health professionals are beginning to show signs of stress.

A new CDC study indicates more than half of public health workers surveyed have experienced a mental health condition this year.

Amber Williams is ASTHO senior vice-president of leadership and organizational performance.


In the age of COVID where, you know, the work of public health is not even seen as valued but it's even vilified, I think this is a real point for organizations to think about how can you show appreciation and the way that your staff will feel that their work is valued and valued.

And then, really, normalizing some of the resilience and coping strategies, whether that's providing time for those individual factors at work—the meditation and yoga and things like that—making sure that people have access to employee assistance program.

But really, normalizing taking care of your own mental well-being in the workplace are some of the things that we can do.


Public health leaders looking to help their employees can find tips and a blog post on the topic.

There's a link to the post and other resources connected to this report in today's show notes.

Also, don't forget to follow us on Apple Podcasts and Spotify, or listen on Alexa.

Remember to join us tomorrow for more ASTHO news and information. Plus, we'll have a discussion about COVID-19 vaccine supplies and plans to make the best use of doses before they expire.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition.

Marcus Plescia MD MPH

Chief Medical Officer, ASTHO

Gillian SteelFisher PhD MSc

Senior Research Scientist, Harvard T.H. Chan School of Public Health

Amber Williams MS

Senior Vice President, Leadership & Organizational Performance, ASTHO