School districts around Portland say they are keeping a close eye on public health guidelines, particularly as flu and RSV season hits its peak, pushing up occupancy in pediatric intensive care units across the metro area.

But so far, none have decided to return to mandatory indoor masking for students and staff, though a handful of larger districts — including Gresham and Beaverton — say the topic has come up or is slated for discussion.

The fraught calculus for schools comes on the heels of late November guidance from the Oregon Department of Education that school districts should “support the use of masks in crowded indoor spaces [and] re-teach students and staff correct use of face coverings,” as part of a drive to keep school buildings open this winter.

And at least one local private school — Portland Montessori School in Northeast Portland — began requiring masks again for teachers on Nov. 28 and for students the following day, after a rash of sickness and absences.

“A lot of kiddos got sick over Thanksgiving, and they still aren’t back — it has been a rough season,” said Andrea O’Neill, the school’s director of operations. The school enrolls about 160 students, from ages 15 months to 12 years, and illness-related absences have been highest among toddlers and preschoolers, she said. The school will reassess its mask guidance after winter break, O’Neill added.

Pediatric intensive care units at the metro area’s three major hospital systems have switched to crisis standards of care, which allows medical staff to care for more patients at once, in part because of a spike in RSV. That common virus can be particularly acute in children under the age of 5.

Hospitalizations of people with or for COVID-19 are also rising again, though they are not expected to hit anywhere near the peak levels seen in summer of 2021 and early winter of 2022. A recent forecast from OHSU says that COVID-related hospitalizations should top out at 408 on Dec. 12.

Returning to mandatory masking is not an easy or automatic call for schools. Studies on whether that policy substantially reduced transmission of COVID in schools have produced mixed results, with some pointing to meaningful and measurable effects and others suggesting otherwise. The most protective medical grade masks are not made to fit children, and researchers say it has proven difficult for school masking studies to control for other factors, like community vaccination rates and ventilation levels.

Additionally, some teachers and parents have said that masks can make it more difficult for young children to learn to read and decipher social cues, for example, or for students with disabilities to communicate. Others, particularly those who are immunocompromised, say masking is a small measure to protect the most vulnerable.

So far, the state Department of Education says it knows of only two public schools out of more than 1,200 statewide that have had to close down due to widespread illness-related absences, both before Thanksgiving. One was in Toledo, near the Oregon Coast, and the other in Umatilla, in eastern Oregon.

“We are continuing to monitor absences and have seen no big concerns at this time,” Traci Rose, a spokesperson for the Tigard-Tualatin school district, said Monday. If more than 20% of students in a particular grade, or 30% of students at a school, are out due to respiratory illness, she said families would receive messages to “strongly encourage masking.”

“We have had discussions [about masking]” said Athena Vadnais, a spokesperson for the Gresham-Barlow school district. “We have decided to remind the community of effective mitigation strategies.”

In lieu of mask mandates, most districts say they are stepping up messaging on public health to families. Portland Public Schools said they are planning an email blast to families in the coming days to “reiterate our mitigation measures” including a “strong recommendation” for indoor masking. The Reynolds school district, in eastern Multnomah County, sent a message out on Monday to ask families to “please consider wearing a mask in school,” while noting that they were optional.

In Beaverton, masking and public health are up for discussion this week, said spokesperson Shellie Bailey-Shah, while a spokesperson for the Hillsboro school district said administrators there “have not discussed bringing back mask mandates, and currently have no plans to do so.”

Another factor: different levels of guidance from local public health agencies. Multnomah County health officer Dr. Jennifer Vines last week called for residents to voluntarily wear face coverings indoors through the end of the year. Her counterparts in Washington and Clackamas Counties, from which districts there take their cues, have not yet publicly followed suit.

“North Clackamas School District will continue to work with Clackamas County Public Health and monitor the situation,” said Seth Gordon, a spokesperson for the district.

—Julia Silverman, @jrlsilverman, jsilverman@oregonian.com