Here’s why most Fresno-area students seeking a school mask exemption won’t get one

A group of Fresno and Madera medical professionals released guidance on Friday to help doctors field requests from parents seeking mask exemptions for their children in California, where the state is requiring masks to be worn at all schools.

The short version: Fresno-area doctors probably won’t issue many student mask exemptions.

In an email blast to area doctors on Friday, the Fresno Madera Medical Society urged local physicians to follow the lead of the Centers for Disease Control and the American Academy of Pediatrics, which say that almost all school-age children can and should wear a mask in school.

Dr. Alan Birnbaum, former president of the society, said the move to create guidance was in part spurred by Clovis Unified School District, which in July, attempted to allow parents to exempt their children from wearing masks in school without a doctor’s note.

The district’s decision was reversed later when the California Department of Public Health said all school mask exemptions would require a doctor’s note.

A group of Clovis parents has called on the district to turn against the statewide school mask mandate. The district has said it will continue following the lead of the state health department.

Birnbaum said most medical professionals were troubled by the Clovis school board’s attempt to put the public health decision in the hands of individual parents.

“Most of us thought that was not a good idea,” he said. “When a parent comes in requesting an exemption for masking for their student, by and large we think this is not a good idea and needs to be avoided, but it needs to be handled effectively, it needs to be handled empathetically.”

Why it will be hard for Fresno-area students to get a COVID mask exemption

Several parents on Wednesday said they had called many doctors in the area, but either were unable to get an appointment or were refused a mask exemption for their child.

Most Fresno-area parents seeking an exemption should expect a denial, even for some medical conditions, the doctors group said Friday.

“Not every cognitive disability or lung disease will qualify for an exemption. Neither asthma nor ADHD, very common pediatric diagnoses, would qualify for medical exemptions,” the doctors said in the statement. “This may be a difficult conversation, so you should be prepared for some resistance.”

However, children with impaired hearing would qualify for a mask exemption under the new local guidelines. Several Fresno-area parents have spoken out in recent weeks about the need for hearing impaired students to avoid wearing masks during class.

The guidance offered talking points for what Dr. Karen Dahl, an infectious disease expert at Valley Children’s Hospital, called a “challenging conversation” that doctors may face when rejecting a parent’s request for a mask exemption.

“As someone who is dedicated to maintaining your child’s health, it is my medical opinion that they CAN safely wear a mask and the mask will help protect them from COVID,” a doctor might say to a parent, according to the guidance.

“Again,” Dahl said, “if there’s a mask exemption, there’s also a requirement that they wear a face shield and a drape. There are going to be very few children then that can’t wear that, either.”

Students returning to school facing a ‘new pandemic’

Fresno County health officials say they are seeing another surge in COVID-19 infections, just as schools begin to reopen and as doctors are seeing more children being infected with the Delta variant of COVID-19.

“This a new pandemic,” said Dr. Erica Gastelum, a UCSF Fresno pediatrician. She said the Delta variant of COVID-19 is different.

“A lot of the community might be (seeing) data about how this does not really affect children, (but) that was last year’s COVID.”

Gastelum said most doctors and the American Academy of Pediatrics still agree that the best place for kids to be is in school due to effects on mental health. But “this needs to be done as safely as possible with as many mitigation steps strategies in place as possible,” she said.

The Fresno Madera Medical Society said children generally have good outcomes following an infection, but some will still be “significantly ill.”

Vaccines in children

Currently, COVID vaccines are only available to those 12 years old and over. But Dr. Chai Rongkavilit, a UCSF Fresno pediatrician, thinks the Pfizer vaccine could earn an emergency use authorization for children between 5 and 12 years old as early as September.

Dahl also advised doctors and parents to keep up with normal vaccines at this time.

“The COVID vaccine can be given regardless of timing to other vaccines,” she said. “We saw vaccination lag for a lot of important diseases such as measles, and we want them to get all their shots, and we don’t want anyone to be confused about that previous two week wait period that was recommended that’s no longer there.”

The Education Lab is a local journalism initiative that highlights education issues critical to the advancement of the San Joaquin Valley. It is funded by donors. Read more from The Bee’s Education Lab here.

This story was originally published August 14, 2021 at 7:30 AM.