Child masking early in pandemic reduced child care program closures, Yale study finds

Child care programs in the United States that instituted child-masking policies in the early months of the COVID-19 pandemic were less likely to close in the following year, according to a new Yale study.

The study, published Jan. 27 in JAMA Network Open, a peer-reviewed journal of the American Medical Association, tracked 6,654 center-based and home-based child care professionals from all 50 states during a one-year period starting in the late spring of 2020.

Child care programs that required masking children 2 years and older early-on in the pandemic (from May through June of 2020) saw a 13% reduction in program closure over the following year, according to the study, which was conducted by the Yale Children and Adults Research in Early Education Study Team. Researchers found that continued masking throughout the year was associated with a 14% reduction in program closure, while controlling for other mitigation measures such as social distancing and symptom screening.

“It’s the disruptions in learning opportunities and care routines that harm children, not the masks,” said Walter Gilliam, a professor of child psychiatry and psychology at the Yale Child Study Center and the study’s senior author.

Researchers pushed back against claims that masking limits children’s ability to see emotional cues, leading to social and developmental delays. Such claims often rely on point-in-time studies, researchers said, and “how quickly children adapt and recognize other emotional cues, such as body language, is not known.”

The study, which controlled for the extent of COVID-19 transmission in the surrounding community, is among the first large-scale longitudinal studies of the impacts of COVID-19 safety measures in child care programs.

Over the course of the one-year period, 43% of child care programs in the study closed at least temporarily due to a suspected or confirmed case of COVID-19 among employees or children.

Researchers found that among a number of safety measures, from social distancing and staggered arrivals and departures to outdoor drop-off and pick-up, child masking was the most associated with reduced rates or program closure. For instance, six-foot distancing policies were associated with a 7% reduction in child care closure—roughly half the rate of reduction associated with child masking.

Dr. Thomas Murray, associate medical director for infection prevention at Yale New Haven Children’s Hospital and the study’s lead author, noted that the hospital has seen an increasing number of young children, who are not yet able to receive a COVID-19 vaccination, being admitted for care.

“It is heartening to know that following child masking recommendations for children two years and older may be an effective means for keeping young children in child care programs and potentially lowering their risk for COVID-19,” he said.

He also urged adults and older children who interact with young children to get vaccinated in order to protect them.

Few child care programs required child masking in the early months of the pandemic, researchers found. That proportion rose from 9% in the late spring of 2020 to 33% by May and June 2021. Masking rates were higher among employees, however; 64% of child care programs in the study reported that all staff members were masking in May and June 2021.

“We know that children benefit from in-person learning opportunities, and this includes young children, and we know that many parents rely on child care in order to go to work,” Gilliam said.

“Child masking will not eliminate all child care closures, but it may help reduce some of them, keeping our young children with caring adults who support their learning and development.”

Eliza Fawcett can be reached at elfawcett@courant.com.