Worries over rising health risks and “mask shaming” when Hawaii public schools eventually drop their COVID-19 indoor mask requirement is keeping some parents awake at night.

A Central Oahu mother named Mercy says her 8-year-old daughter who has asthma has been bullied by schoolmates for continuing to wear a protective mask at all times even after the state Department of Education made outdoor masking optional starting March 9.

The girl came home in tears one day last week after some schoolmates on the playground called her “stupid” and “a sheep,” said Mercy, who asked that her last name be withheld because she fears retaliation against her daughter. She worries the harassment will get worse when the indoor mask requirement for schools ends at some point.

“She has severe asthma. She shouldn’t have to explain her mask to anyone,” Mercy said. “I wish her teachers would say (to her harassers), ‘She has a right to wear a mask and she needs to wear a mask.’ I wish they would protect her more.”

Now that Gov. David Ige has declared the sunset of the general statewide indoor mask mandate at 11:59 p.m. March 25, how and when the public schools will follow suit is a topic of vigorous discussion in parts of social media and some advocacy and parent groups.

It was also reportedly one of the topics discussed at a March 9 virtual meeting between the state’s principals and health officials.

For now the indoor mask requirement still stands in Hawaii’s 257 public schools, with no set end date, the DOE confirmed Wednesday. State health officials have recommended indoor masking for more densely populated “congregate settings” such as schools, public transportation and prisons.

“If and when DOH revises its school guidance regarding indoor masking, we will look at any necessary updates to our health and safety guidance for public schools,” said DOE Communications Director Nanea Kalani.

“Our updated guidance that indicates outdoor masking is optional includes this language: ‘Schools should be supportive of students and staff who choose to wear a mask beyond these requirements.’”

Still, Mercy said she cannot sleep when she thinks about how her daughter’s continued mask use will “stick out like a sore thumb” even more to bullies when indoor masking here ends. She also worries that her daughter will be at a higher risk of catching the coronavirus when most students around her will be unmasked indoors. The CDC says a chronic lung disease such as severe asthma can make a person more likely to get very sick from COVID-19.

A Google search of “mask shaming in schools” turns up numerous cases of angry conflicts in school districts on the mainland as they have relaxed masking rules.

Dr. Scott Miscovich, who is president, CEO and founder of Premier Medical Group Hawaii, says the public needs to understand that about 7% to 14% of the population should continue masking even after mandates are dropped, because those people have health conditions that put them at higher risk of severe illness or death from COVID-19.

Miscovich says even though coronavirus in Hawaii overall has declined enough to cut back on many mitigation measures, students and teachers with health risk factors ought to wear masks especially during prolonged periods together indoors and during close contact.

“First advice I’m giving to our patients is that if you have a child with any degree of risk, whether they are asthmatic or they have any conditions, including if they are overweight, then they should be wearing a mask,” he said.

Students and teachers with diabetes and other health conditions shown to raise the threat of the coronavirus, and those whose immune systems are suppressed because of illness or medications, also still should wear masks even when rules don’t require it, he said.

“I strongly believe that these kids should be allowed to wear masks, and their parents should encourage it, and schools should take steps to stop any mask shaming,” Miscovich said.

He added that the schools ought to use this “lull” in the pandemic to thoroughly test classroom air quality to lessen the risk of viral spread.

Osa Tui Jr., president of the 13,700-member Hawaii State Teachers Association, said he feels continuing indoor masking at schools for now is “not a bad idea.”

“I don’t think it will hurt to wait just a little while longer, especially as we’re coming out of spring break,” Tui said. “Usually we see spikes happen after breaks. The BA.2 variant is a concern, the lack of ability to social distance in classes is a concern. We don’t know which students are vaccinated. All of this makes it all the more unsettling.”

Some parents are eager to see the indoor masking rule end in schools. Maureen Lenzi, a Mokapu Elementary School parent who launched a petition drive to end outdoor masking at that campus, says she hopes state health and education officials will now follow CDC recommendations to relax indoor masking guidance for low-risk areas, especially now that coronavirus spread has slowed here and Hawaii has a relatively high vaccination rate.

The testing positivity rate was 2.3% and the completed vaccination rate was 76.8% as of Wednesday, according to the state Health Department COVID-19 dashboard.

“Long-term cloth masking of children is far more disruptive to the learning process than beneficial in the prevention and spread of COVID-19 …,” Lenzi said. “Schools will continue to be safe places for students and staff even without masks indoors.”

But some other parents are praying the DOE will keep the indoor masking rule longer — and when the time comes to drop it, that the department will give a longer lead time and more strongly supportive messaging than they feel came with the end of the outdoor masking rule. The school outdoor mask requirement was dropped with just one day’s notice.

Desi McKenzie of Mililani, who has two daughters, including one with multiple disabilities, feels that “every student with a medical condition who’s at high risk needs to be empowered to wear a mask.”

For McKenzie’s family, school masking has been a crucial issue. Her older adult daughter is a DOE educator; her other 23-year-old daughter, who has been a DOE student, has Down syndrome, autism, hearing loss and a weakened trachea; and McKenzie has worked as an advocate for Down syndrome organizations and has health risk factors herself.

She feels that families with special needs children, and students who have multiple generations including kupuna at home, should be applauded and encouraged to take steps to protect their health. Several other parents have told McKenzie that their children recently have been bullied for wearing masks.

“Parents must feel free to ensure that all adults regularly empower your child to be able to confidently self-advocate that they want to wear a mask in school or community setting,” McKenzie said. “A child should not be subjected to intimidation or bullying by adults or peers while exercising their individual right to be proactive to protect his or her own health.”

She added: “I feel like it’s a matter of protecting our haumana. We want them to feel if they make the choice to wear a mask, it is pono. We have to be consistent in our messaging to our students.”