The Douglas County Health Department will allow people to opt out of local masking requirements in schools under a new health order aimed at curbing COVID-related masking mandates for students and staff.

Children’s Hospital Colorado strongly rebuked the move, along with the board’s attempts to link masking with mental illness in children. The Douglas County School District requires universal masking in its schools. An Oct. 10 statement released by the district said "DCSD procedures for masking in schools remain in place with the exception of a new avenue for families to exempt their children from mask-wearing, if desired."

Families may submit written exemptions to the masking mandate directly to their schools, the statement said. Face coverings will still be required by everyone on school buses because of a federal mandate.

Douglas County leaders have charted a new course on COVID safety, steering away from the policies of the Tri-County Health Department, which has overseen public health in the county for decades. Douglas County is now standing up its own public health agency, although it has agreed to draw on Tri-County for public health services at least through 2022.

The order comes as county voters receive their ballots in a hotly contested school board election in which mask policy is a key issue.

Douglas County Board of Health President Doug Benevento said during the Oct. 8 special board meeting that he would not hand down any masking mandates for children without what he called “clear and convincing evidence of the benefits of masking.”

“This board isn’t considering ideological viewpoints,” he said.

The health order takes effect Oct. 9 and declares a student may be exempt from any masking mandate in the county if their parent or guardian provides a written declaration saying a mask negatively affects their mental or physical health. Adults may also opt out of masking mandates, something board members said would allow teachers to opt out.

The health order also states that no Douglas County children or adults without symptoms can be required to quarantine because of an exposure to COVID-19, including if they were exposed to a confirmed case, unless that exposure “is associated with a known outbreak.”

People who are placed in quarantine can be released after a minimum of seven days, if they test negative five days after their exposure, and if that negative result is obtained “no later than 48 hours before the end of the quarantine," the order says. It also says that quarantines can’t last longer than two weeks from an exposure.

But state or federal mandates supersede the local order and could enforce mask mandates or different COVID-19 mitigation measures in the county, and the order is not enforceable at private businesses, Benevento said.

The Douglas County Health Board’s order points to Children’s Hospital Colorado declaring a state of emergency for youth mental health in May 2021. Board member Lora Thomas -- also a Douglas County commissioner -- said youth mental health was a key driver behind her vote on the health order.

Heidi Baskfield, the vice president of population health and advocacy at Children’s Hospital Colorado, called into the meeting chastising the board for linking anxiety and mental illness in children to masks.

“There is currently no scientific evidence to support this concern,” she said. “Masks are not harmful to children’s health.”

Children are experiencing challenges with their mental health for a variety of reasons, she said. The hospital system is also seeing a rise in COVID-19 diagnoses and hospitalization among children.

At this time, “wearing masks is the very best way” to ensure children can stay in school, Baskfield said.

Numerous residents at the meeting praised the board, saying they hope it ends masking mandates in schools. People who opposed masking mandates said they interfere with learning, increase mental illness in children, are ineffective at containing COVID-19 or are not necessary because children are at less risk for severe illness.

“I just want us to have the freedom to choose,” Katie Webb said.

Others pleaded with the health board to let masking mandates continue without an opt-out option.

James Poplawski of Parker said the health order and “being anti-mask” scares him as a parent. The pandemic has taken people’s loved ones — parents, grandparents and people at high risk of COVID-19 — and they will continue to be vulnerable if masking mandates are removed, he said.

“Very few kids wore masks to school,” he said of the 2021-22 school year’s start. “And what did it do to cases? They spiked.”

Debating masks

The health order is largely an argument against masking mandates in schools.

“There is insufficient data to suggest that schools and childcare facilities — including those that do not require students to be masked — are significant drivers of community transmission of COVID-19,” the order states

The order says “studies are inconclusive” about the benefits of masking, and points to a Centers for Disease Control and Prevention study conducted in Georgia, which it says found masking offers some benefit to adults, although not a statistically significant difference in COVID-19's spread among schools that masked and those that did not.

The health order cites strong vaccination rates in the county paired with what it calls low “severity metrics,” such as deaths and hospitalizations among people 17 and younger.

Children remain at low risk for severe illness from COVID-19, while older people or individuals vulnerable to the virus have had ample opportunity to become vaccinated, the order states.

A Tri-County Health spokeswoman said staff were not available when asked for comment about the Douglas County Health Board order and its statements about masking research.

Douglas County still qualifies as an area of “high community transmission” under Centers for Disease Control and Prevention guidance, with a seven-day cumulative incidence rate of nearly 185 per 100,000 people, as of press time.

Incidence rates in the Douglas County School District were cut nearly in half in recent weeks. On Sept. 26, they stood at 358 for 5 to 11-year-olds and 213 for 12 to 17-year-olds. By Oct. 3, those rates were 158 and 97 respectively.

That was down from August, when incidence rates in the district gradually increased until they peaked at 474 on Aug. 29 for 5- to 11-year-olds and 322 for 12- to 17-year-olds.

The seven-day moving daily incidence rate has generally declined among 12- to 17-year-olds in Douglas County since Sept. 5, a few days after a mask mandate went into effect for all people 2 and older inside schools and childcare centers.

Rates also improved among 6- to 11-year-olds between Sept. 5 and Sept. 17, when they began creeping back up, from roughly 27 cases per 100,000 people on Sept. 17 to 35 as of Sept. 24. More recent data is incomplete.

The school district's stance

The order passed Oct. 8 also appeared to take aim at the Douglas County School District’s stance on masking. The school district’s policy is to manage common communicable diseases in accordance with Colorado Department of Public Health and Environment and Tri-County Health Department guidance.

In recent weeks, the district has been steadfast in its policy requiring masks for all people 2 years and older, regardless of vaccination status.

The district implemented that policy when Tri-County Health issued a universal masking mandate that took effect Sept. 1. The Douglas County Board of Health let that mandate dissolve when it took over jurisdiction of public health in the county.

The Douglas County Board of Health’s order says, “state and Tri-County guidelines encouraging masks be required are not to be interpreted as compelling any school district, individual school, or daycare in Douglas County to mandate mask wearing on their premises.”

Those entities could choose to mandate masks, the order says, but that mandate is “subject to the exemption provided in this order.”

Schools Superintendent Corey Wise said in a letter to the community on Oct. 1 that removing masking mandates in schools would lead to more quarantines that can disrupt children’s learning.

A district spokesman said Wise was not available for an interview regarding the Douglas County Board of Health’s Oct. 8 vote and that district leadership was not immediately available to answer questions emailed for the district. A spokeswoman later provided letters the district sent to the community on Oct. 9 and 10.

Wise’s Oct. 1 letter emphasized Tri-County Health still has power to order a school to close, order isolations and quarantines, and require mitigation measure to reduce the spread of illness in outbreak and other high-risk situations.

"Our students and staff need routine and consistency," Wise wrote.

This story has been updated with a statement from the Douglas County School District.