Mask rules drive parents’ demand for doctor notes

Colorado pediatricians are being bombarded with requests

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Colorado parents are seeking an end-run around mask requirements at their children’s schools: Doctor’s notes exempting them for dubious medical reasons.

And in mask-averse Douglas County, where elected leaders already opted to create their own health department to sidestep unpopular COVID-19 public health orders, some parents aren’t taking “no” for an answer.

Hundreds of parents have called Pediatrics at the Meadows in Castle Rock to request doctor’s notes — some who turned angry when their requests were denied and promised “physical, financial and political revenge.”

“We understand and empathize with families who are looking for ways to help their children avoid the burden of mask-wearing. Trust me, I get it,” Dr. Michael Milobsky said in a Facebook post about the flood of calls that left staff members feeling “under attack.”

But Milobsky said the clinic would continue to side with American Academy of Pediatrics’ recommendations regarding mask-wearing for children — that, with rare exceptions, they can be “safely worn” by children 2 and older.

“If I issue a mask exemption for your child, and they infect a child who is undergoing chemotherapy, a newborn, or a pregnant teacher, who, as a result of being infected (die), I AM RESPONSIBLE.”

Demand for notes jumps

Demand for doctor’s notes is spiking as mask policies remain contested across the state, sparking heated public health meetings and leading to increased police presence at some schools as children returned to classes this fall.

The school year got underway just as the highly transmissible coronavirus delta variant drove a wave of new infections across Colorado. As of Sept. 13, the state Department of Public Health and Environment reported 80 ongoing outbreaks of the coronavirus at K-12 schools across the state.

In recent says, Dr. Hector de Leon in Fort Collins said he has received at least a dozen requests for doctor’s notes exempting children, and that his colleagues based in Denver have received several requests a day.

Explaining to parents who insist their children not wear a mask has been a challenge at times.

“More often than not we are not able to write these letters,” said de Leon, a pediatrician with Kaiser Permanente. “We give families other tips and tools to get the masks going. I understand that it is a tough thing that parents are faced with. But our job is to try to keep as many kids as possible safe and from getting sick with COVID.”

Many pediatricians, like de Leon and Milobsky, stand by the American Academy of Pediatrics’ recommendation for universal mask wearing in schools given that the majority of the student population is ineligible for vaccines. Wearing masks is proven to reduce the transmission of COVID-19 and protect those who are not vaccinated.

Even so, some parents are frustrated and others become upset when de Leon refuses to write the notes, he said.

“It’s important to start by framing for families why we are doing this and why we are asking for masks, still. The fact is, with children, kids under 12 especially, we don’t have a vaccine for them. So we’re trying to get them back in school in a safe way,” de Leon said.

Jeffco reviews requests

As of Sept. 7, Jeffco Public Schools had received 208 mask exemption requests, 59 of which were denied because the application did not meet the requirements outlined by Jeffco Public Health, school district spokeswoman Cameron Bell said.

While the school district does not set the criteria for mask exemptions, it is reviewing requests to ensure they meet the requirements of the public health order issued by the county’s public health department in late August, Bell said.

The Jeffco district also received 281 religious exemption requests, which were all denied as they do not meet the criteria of the public health order, she said.

In southwest Colorado, the schools in San Luis haven’t reported an uptick in doctor’s notes for children, said Toby Melster, superintendent of Centennial School District R-1.

“I’ve seen some of the stories about the contentious board meetings where they are going to be discussing either wearing a mask or not wearing a mask,” Melster said. “But so far, our community has been really good. We haven’t had a lot of pushback, to be honest with you.”

At least three of the schools in the San Luis Valley that do not require its students to wear masks have had to quarantine classrooms due to COVID-19 infections, but the Centennial School District, which is based in the town of San Luis and requires masks, has not had to require any of its classes to quarantine thus far, Melster said.

List of reasons is short

Despite the large number of requests for notes, the list of medical-based reasons to not wear a mask is short, said Dr. Sara Saporta-Keating, an infectious disease specialist from Children’s Hospital Colorado.

“Ultimately, what it comes down to is a person’s ability to take a mask off if there is a problem,” Saporta-Keating said.

Children younger than 2 are exempt, as are children who physically are unable to take off their mask or unable to communicate that they need the mask off in an emergency situation, she said.

“Really what we try to do is weigh the risk and benefits of wearing the mask versus potentially getting COVID,” she said.

While some parents feel wearing a mask could be difficult for children with asthma, it can actually provide them with more protection and potentially shield them from other respiratory diseases that could trigger an attack, Saporta-Keating said.

She said she received an email from her 4-year-old son’s pediatrician earlier this year — before parents could start requesting notes — stating that the practice would be advising children 2 years and older to wear a mask, in line with AAP’s guidance.

“They were proactive about it,” she said.

Her son and his classmates are doing very well with their masks inside the classroom, she said.

“So I certainly think it is not only parents’ peace of mind, but I think the school and teachers’ peace of mind as well, understanding that when there is good mask-wearing, it really decreases the chance of a COVID outbreak occurring within a school,” she said.

Fewer outbreaks in schools also means that children will have more access to their support systems in schools, rather than being isolated at home, Saporta-Keating said.

“We know there are a lot of challenges with mental health, particularly right now,” she said, “but one thing we know is that the return to normalcy and the return to the support systems that children have in their schools is incredibly important and can actually benefit them from a mental health standpoint.”

This story is from The Colorado Sun, a journalist-owned news outlet based in Denver and covering the state. For more, and to support The Colorado Sun, visit coloradosun.com. The Colorado Sun is a partner in the Colorado News Conservancy, owner of Colorado Community Media.

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