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(NEW YORK) — Several states across the country are considering lifting mask mandates in schools in an attempt to return to some semblance of normalcy.

New Jersey Gov. Phil Murphy and Delaware Gov. John Carney announced Monday that mask mandates in schools will come to an end in March. Illinois school districts will be deciding whether or not to make masks optional after a judge ruled against the state’s mandate.

Additionally, Virginia Gov. Glenn Youngkin issued an executive order last month allowing parents to choose whether their child will wear a mask in schools, although it was temporarily halted by a judge Friday.

Experts say it is too soon to end mask mandates in schools because vaccination rates are not high enough yet among the school-age population and new cases are still being reported.

“It is not safe at this time for schools to rescind mask mandates [because] even though we do have decent levels of vaccination in the older age groups, as populations get younger, the proportion who are vaccinated gets lower,” Dr. Mercedes Carnethon, vice chair of the department of preventive medicine and a professor of epidemiology and pulmonary and critical care at Northwestern University Feinberg School of Medicine, told ABC News.

Currently, 22.6% of Americans ages 5 to 11 and 56.4% of those ages 12 to 17 are fully vaccinated against COVID-19, according to the Centers for Disease Control and Prevention.

“The proportion of parents who have chosen vaccination for their children is very low and we know that masking works to stop the spread of the coronavirus,” Carnethon said. “Rescinding those mandates where children 5 and up spend their days, I believe we will see rapid spread.”

Proponents of mask mandates say COVID-19 is not an endemic disease yet and lifting mandates will trigger a major rise in cases.

In Wyoming, Laramie County School District 1 — located in the capital of Cheyenne — reported a spike in cases just two weeks after the Board of Trustees voted to end the mask mandate.

First reported by the Wyoming Tribune Eagle, nearly 400 students and 100 staff have tested positive between Jan. 24 and Feb. 4, an ABC analysis of school district data shows.

Similarly, Hopkinton High School in Massachusetts was the first public school in the state to drop masks altogether but reinstituted the mandate after a rise in cases.

Murphy said a drop in COVID-19 infections linked to the omicron variant led him to lift the mask mandate.

“Balancing public health with getting back to some semblance of normalcy is not easy,” Murphy tweeted. “But we can responsibly take this step due to declining COVID numbers and growth in vaccinations.”

Dr. Stanley Weiss, a professor of biostatistics & epidemiology at Rutgers School of Public Health, called it a politically motivated decision.

“Gov. Murphy’s decision is a politically-based one because there is tremendous pressure coming upon everyone to get rid of the pandemic and stop talking about it and stop dealing with it because we’re all tired of this pandemic,” he told ABC News. “It is not scientifically based and I don’t think it is a rational approach based upon what we’re still seeing.”

According to Patch New Jersey, in-school transmission in the state has increased over the past month.

Between Jan. 4 and Jan. 10, there were 11 cases among students and 17 cases among staff. However, between Jan. 25 and Jan. 31, there were 398 cases among students and 57 among staff.

“I have problems with the change in policy,” Weiss said. “Yes, it’s a limited number of cases, but if you look over time, the new outbreaks have been continuing to increase in schools. The number of student cases and staff cases has not declined. It hasn’t gone away.”

In Illinois, some districts have already made mandates optional after a judge ruled school districts statewide cannot require students to wear masks in classrooms.

“If data were driving these decisions, we wouldn’t at all remove mask mandates right now,” said Carnethon. “The school districts in the regions of Illinois that are making this optional appear to be closely aligned with the geopolitical sentiment.”

Carnethon said districts where schools mask mandates are being removed are typically ones with limited testing ability and “limited enthusiasm” for policies such as requiring vaccinations in public spaces.

“These communities continue to be high-district transmission communities. These are the very decisions that are going to prolong the pandemic and lead to far more suffering than we need to have happen,” she said.

Those in favor of ending the mandates in schools say the public health focus needs to shift to learning to live with COVID-19 and more attention should be given to individual choice.

An increase in cases isn’t necessarily a bad thing due to children’s low risk of severe illness, according to some experts. Others, like Dr. Julia Raifman, disagree.

“I think cases are a problem,” Raifman, an assistant professor of health law, policy and management at Boston University School of Public Health who researches state-level policy responses to the pandemic, told ABC News.

She continued, “Cases are a problem because more cases do mean more hospitalizations and deaths. There’s no way around that. More cases mean more missed work and more missed school. More cases mean more people with lingering symptoms. More cases mean more of the unknown health impacts 10 years later.”

Raifman added that school mask mandates should not disappear completely and that one way to keep them in place is to have more outdoor class time for kids because masks are not recommended for outdoors and students and teachers could take a break from wearing face coverings.

She gave the example of Nevada, which has a policy that enacts mask mandates when cases in a county are high.

“If people are really eager for them to end, I recommend that they not end them, that they put in place a data-driven approach that turns on the mask policies when we need them when there are big surges,” Raifman said.

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(NEW YORK) — As new cases of COVID-19 decline across the country for the first time in weeks, the debate over face masks for kids is reaching a fever pitch.

New Jersey Gov. Phil Murphy, a Democrat who has imposed some of the strictest pandemic-related mandates in the United States, is expected to announce Monday that the state’s requirements for masks in schools will end the second week of March. The move would follow a decision last month by Pennsylvania Gov. Tom Wolf, also a Democrat, to rescind his state’s mask mandate for schools.

More than one dozen states and Washington, D.C., currently require face masks in schools, while the Democratic governors of New York and Connecticut have said that they are reevaluating school mask mandates set to expire later this month. Other states, like Texas and Virginia, have banned mandates, according to an analysis by Education Week, an education-focused news organization.

In Virginia, where Gov. Glenn Youngkin’s executive order allows families to opt their children out of mask requirements at school, at least seven school districts have filed a lawsuit against the order.

Last week, in Loudoun County, Virginia, where the district’s school board voted last month to keep its mask mandate, 29 students were suspended for not wearing face masks. Three families are currently suing the district’s school board over its enforcement of the mask mandate despite the governor’s order.

The mask debate has also moved to the courtroom in Illinois, where a judge last week ruled against Gov. JB Pritzker’s school mask mandate after parents and teachers from more than 150 districts filed lawsuits, according to WLS-TV, an ABC station in Chicago.

Studies show that masking in school dramatically reduces the risk of COVID-19 transmission. Fewer outbreaks means schools can stay open for in-person learning. But some parents wonder how masking might interfere with in-person learning.

Karla Alsop, a mom of three in Virginia, blames masks for her daughter’s difficulty with reading. Alsop’s daughter attends a public school in Stafford County, where schools continue to follow a mask mandate.

“She’s saying that she can’t read like a second grader and she’s afraid to go to school. I can’t, as a parent, let that go,” Alsop told ABC News. “This is about parents having the rights to make the best decisions for their kids regarding their health, regarding their education.”

So far, studies show that for most children, masking at school has minimal effect on development and learning comprehension.

Research shows kids also look at body language and eyes for social cues, according to Dr. Erica Lee, attending psychologist at Boston Children’s Hospital.

“That’s something we can still see and still be very expressive with, even if you’re wearing a mask,” Lee said of body language cues.

In Florida, where mask mandates in schools were dropped last fall, Kimberly Lasher continues to send her three daughters, ages 11, 9 and 6, to school wearing masks.

“We just chose to wear masks, I think, to help protect those who maybe aren’t taking the same precautions,” said Lasher. “Perhaps if my daughter is wearing a mask, that can prevent them from spreading COVID to another student or even a teacher and, in our opinion, every little bit helps, for sure.”

According to a poll released last August, 69% of people of supported their local school districts requiring teachers, students and administrators to wear masks in schools at the start of the school year. The same poll, released by Axios/IPSOS, found one in three Americans support state laws prohibiting local governments from requiring masks.

Pediatric cases of COVID-19 surged over the holidays amid the omicron variant but dropped for the first time since Thanksgiving, according to a report by the American Academy of Pediatrics and the Children’s Hospital Association.

About 808,000 children tested positive last week, down from a peak of 1,150,000 cases reported the week ending Jan. 20.

The organizations, however, warn that pediatric cases remain “extremely high” and triple the peak level of the delta surge in the summer of 2021.

Though children ages 5 and older are now eligible to be vaccinated against COVID-19, more than 28 million eligible children remain completely unvaccinated, according to federal and census data.

Both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) continue to recommend universal indoor masking at schools for all people ages 2 and older, regardless of vaccination status.

Dr. Elissa Perkins, a mom and a Boston Medical Center emergency room doctor with expertise in infectious diseases, said she believes there needs to be a more nuanced approach when it comes to kids and masks.

Perkins told ABC News she was a “very early proponent” of community-wide masking, but said her philosophy began to change as vaccines became more widely available, including to kids.

Most health experts counter that because even vaccinated kids can still transmit the virus, removing mask mandates could pose risks to younger siblings.

“That, for me, was the start of the inflection point when it became time to think about what are we accomplishing with mandatory masks,” she said. “At the same time, masks went from being what were what were initially a short-term intervention to a long-term intervention.”

Perkins continued, “Masks have become a long-term intervention, and we need to examine what the possible downsides might be if we plan to continue them.”

Researchers at the National Institutes of Health (NIH) have heard parents’ concerns and are now studying the potential downstream effects of prolonged masking for children, according to Dr. James A. Griffin, chief of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

“We do understand that one of the areas where masks do impair children is in their ability to understand what is being said to them,” said Griffin. “The difference between being able to understand a ‘bill’ and a ‘dill’ with the mask on that ‘d’ and ‘b’ sound can be very hard to distinguish without being able to see the lips, so there are challenges … we do recognize.”

Rachel Simmons, a parenting expert and the author of of the bestselling book Odd Girl Out, said if parents are concerned about their child’s struggles due to mask-wearing, they can help their kids cope by creating a plan.

“When our kids have a plan for who they can go see, what they can do when they get stressed out, research tells us they will have the tools to deal with the situation when it comes up,” said Simmons, who also recommends teaching kids mindfulness exercises, like feeling their feet on the ground, and supplying them with something calming, like a fidget toy, note or mint, to use during the day.

For parents who are struggling with how to respond to their child’s school if they don’t agree with the mask policy, Simmons said the best approach is to be a “partner” to the school.

“If you’re difficult to deal with as a parent, it will be harder to get heard,” she said. “So don’t send emails late at night. Be a partner to the school. Show your kids that you can respect someone even when you disagree.”

Simmons added, “And remember, your best way to be heard is if you have other parents standing with you.”

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(NEW YORK) — Groundbreaking research by several top American medical centers has identified a COVID pandemic spike in cases of so-called “broken heart syndrome,” a potentially deadly stress-induced heart condition that doctors say is disproportionately impacting women.

“My heart felt like it was pounding out of my chest,” said Mary Kay Abramson, 63, of Brookeville, Maryland, who was diagnosed with the condition last year. “It just felt like the blood just couldn’t get through the heart fast enough.”

An otherwise healthy and active corporate travel agent, Abramson said the episode occurred without symptoms or warning signs and even surprised the doctors trying to diagnose it.

“[My cardiologist] comes up to my head and says, ‘have you been under a lot of stress, because your arteries look fine?'” Abramson said of the hospital bed conversation last year. “So, yeah, a little bit: I’ve been furloughed for three months. COVID is going on. You know, can’t get out and do things. We’re shut down. So, yeah, I have been under a lot of stress!”

It was a classic case of Takotsubo cardiomyopathy, or broken heart syndrome, her doctors say. The rare but dangerous form of heart disease is triggered by intense emotional or physical stress when a sudden flood of hormones is believed to stun the heart into pumping less efficiently.

Teams of experts at Cedars-Sinai in Los Angeles, Cleveland Clinic and Johns Hopkins have each been tracking a recent surge in cases, likely spiking substantially during the pandemic, they say. The data is still being gathered and long-term implications examined.

“I don’t know how much we can really blame COVID, or how much of this is that we’re just recognizing more of it,” said Dr. Noel Bairey Merz, director of the Barbra Streisand Heart Center at Cedars-Sinai. “But heart disease is the leading killer of women and all ages, including teenagers, midlife women and older women. This is just a component of that major killer. So it’s really something that needs to be addressed.”

Bairey Merz says cases of broken heart syndrome have risen up to 10 times faster among middle-aged and older women than among younger women and men over the last decade. The disease is most common in this group as well.

Thirty-four-year-old tech recruiter Jenna Pilja of Huntington Beach, California, thought she was mentally prepared to give birth to her first child during COVID but was suddenly overcome last year after an emergency Cesarean section, potentially triggering a broken heart episode.

“Hearing that my son might not have been OK, that certainly could have triggered me, maybe more because of past trauma,” Pilja said. “Despite being on pain medication, I was able to feel some concerning symptoms. I had really bad dizziness and I had the worst headache I’ve ever had in my life.”

Her doctor later diagnosed the episode as a probable case of Takotsubo cardiomyopathy. Pilja is still undergoing evaluation but is expected to make a full recovery.

“As cardiologists we always think the heart is the most important organ. It’s the brain and the brain controls everything,” said Bairey Merz.

The brain-heart connection is at the center of Dr. Bairey Merz’s research at the Cedars-Sinai Smidt Heart Institute. ABC News got an exclusive look inside the hospital’s high-tech simulation center where imaging data illustrates how stress can literally break a heart.

“You hear people say, ‘oh, she’s broken-hearted’ or somebody is broken-hearted because they had a breakup… but they may come in with this and it’s a real diagnosis. It was just, like, unbelievable to me,” said Zearlisha Kinchelow, 35, a single mom and nursing student in Kansas City, Missouri, who was diagnosed with a broken heart.

“They just told me I was at 10% heart function,” she said. Her heart function has since returned to normal with therapy and changes to her diet and exercise, she said.

For Elaine Kamil, 75, a pediatric nephrology specialist in Los Angeles, immense grief after the unexpected death of her 31-year-old-son physically took a toll on her heart.

“The pain was severe. I got lucky,” said Kamil, who believes she has had multiple episodes of broken heart syndrome in the past few years. “I think it’s important to make sure that whoever you’re seeing — cardiologists understand Takotsubo [cardiomyopathy] and what the best treatments there are.”

While many hearts heal quickly, Bairey Merz says one in five people who suffers a broken heart will have another attack within 10 years.

“Taking care of yourself is definitely more than, you know, just taking care of your body,’ said Pilja. “It’s really about looking after your mental health and your overall well-being and making sure that you’re taking time to engage in activities that help relax you and help you process your emotions in a useful way.”

Growing evidence suggests doing so is one key to maintaining a healthy heart.

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