Why this immunocompromised mother, teacher believes wearing masks in school benefits entire community


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SANTAQUIN — With the delta variant raging across the country, Utah families are facing difficult decisions at the start of a new school year. One Santaquin mother said wearing a mask is ultimately about community and looking out for your friends — lessons she hopes her children will learn.

Ashley Nguyen is a mother to three and an 11th grade English teacher. She was diagnosed with rheumatoid arthritis 10 years ago.

"I'm on a medication that basically suppresses my immune system so that it doesn't attack my joints," she explained, which also makes it easier for her to get sick.

Without her medications? "It makes it hard to pick up my children … I flare up in my feet; I flare up in my knees; I flare up in my wrists," she described. "I remember going out to check the mail and my neighbor being like, 'Oh my gosh, what's wrong with you? What happened?'"

She said it changes the way she moves and interacts with the world.

If Nguyen were to get COVID-19, she would have to go off her medication to recover. Her situation has forced her to make decisions she's never before considered.

"I was really excited to send him back to school this year," she said about her second grader, Ezra Nguyen. But now, without a school mask mandate, she's chosen to not send him to school in person.

Nguyen also won't be back in her classroom this year — a heartbreaking decision. "I was gonna teach this year, that was the plan," she said. "I would have more tears to cry if I hadn't cried them all already."

"I don't think that this is right for my family to expose myself to this situation," she explained. "I think the hardest part though, is having to choose between my child's mental, emotional, social health and my own physical health like that. That is a difficult decision to make."

Though Nguyen has been vaccinated against COVID-19, she can't risk being exposed to the virus.

Dr. Per Gesteland, a hospitalist with University of Utah Health and Intermountain Primary Children's Hospital, said nearly 3% of our population is immunocompromised according to the Centers for Disease Control and Prevention. "It puts them in a tough position making decisions about their safety and the safety of their families," he said.

Ashley Nguyen has chosen not to send her second grader, Ezra Nguyen, to second grade in person this year for fear he might bring the coronavirus home to her since other kids his age are unvaccinated and are not required to wear masks.
Ashley Nguyen has chosen not to send her second grader, Ezra Nguyen, to second grade in person this year for fear he might bring the coronavirus home to her since other kids his age are unvaccinated and are not required to wear masks. (Photo: Ken Fall, KSL-TV)

Gesteland said people may be immunocompromised for several reasons, including those who might have a cancerous tumor, a hematologic malignancy of blood cancer, or an autoimmune condition that requires immunomodulating medications, along with those with HIV or organ donors and recipients.

Gesteland said there are a lot of people in a tough spot when it comes to COVID-19.

"There are immunocompromised people out there that don't have the luxury of being protected by the vaccine like the rest of us," he explained. "Those patients don't have the same kind of response to those vaccinations. In some cases, they may not get much of an antibody response at all; or in ideal circumstances, even blunted, you know, 10 to 20 to 30 percent from what would be expected in an otherwise healthy person."

He also said immunocompromised patients are at a higher risk for having severe COVID-19 disease, prolonged illness, and can shed the virus longer.

It's families like Nguyen's that have doctors asking people to still be diligent and protect those around them.

"We really should be changing our behaviors, getting vaccinated if you're eligible — (and) if not, wearing a mask in those circumstances — so that we can protect not only those children, but the people that may be vulnerable to that, including the adults in those classrooms," Gesteland urged.

"The spread of COVID in our schools is inevitable," he said. "We're going to open up the schools (and) cases are going to start popping up… we're gonna see that those infections inevitably spread to anybody who's susceptible."


We should let our children know that wearing a mask is about loving their friends.

–Ashley Nguyen


Nguyen hoped people will consider what is best for everyone in the community. "We need to be looking at our friends, kids and our neighbor's kids, and really be thinking about all of them," she said. "I imagine community as a place where everyone is looking out for each other."

Gesteland believes parents must lead by example for their children. "It has to come from the heart, from that parent. And if the parent isn't behind it, then it's going to be hard to get the kids on board," he said.

He suggested parents explain the delta variant is more contagious to their children, warranting the use of masks in school to protect their friends and their friends' families. "Think about the world they live in and how to take care of our fellow citizens and keep each other safe and keep each other healthy," Gesteland said.

"We should let our children know that wearing a mask is about loving their friends," Nguyen said.

Gesteland said the delta variant is now causing even healthy children to become sicker than previously seen during the pandemic, meaning all the more reason for young children who cannot yet be vaccinated to mask up. Masks can also stop the spread of RSV and Paraflu, which he said are also on the rise.

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