“Don’t forget your masks!”

This phrase has been the daily refrain in my household for my children for the past two years. Masking became as natural as wearing a coat in the winter, and going without a mask would have seemed as strange as going to school barefoot.

The new school year has just started for us; my five-year-old had her first day of kindergarten, and my seven-year-old started second grade. For the first school year since the pandemic’s start, they both went to school without masks, a conscious decision that I encouraged and celebrated.

My husband is an infectious disease physician, and I am an obstetrician-gynecologist; we did not take this decision lightly. I will never forget the first wave of the pandemic, when we had few medical supplies, when both of us had exposure to this unknown, deadly virus at work, when the fear of exposing our children to the virus remained omnipresent, when the specter of death became an intimate companion, even in my field which is normally bursting with joy and life.

So, even when the mask mandates were lifted, and my son was vaccinated, he continued to mask to protect his sister, who was too young to be vaccinated.

Finally, this past June, my five-year-old was vaccinated, and my son received his booster. And for the first time since March 2020, the tendrils of fear and worry that had wrapped themselves around my heart finally loosened. The vaccine presented a modicum of hope, and the fact that my children were now protected from severe COVID-19 infection provided a profound sense of relief.

I saw how much my children missed seeing their friends’ faces, or comparing the gaps in their smiles where they had lost teeth, or just giving their friends hugs. I realized that the current situation of the pandemic is the best it has ever been and that we are fortunate that no one in our family has a chronic illness. Just as I get into a car every morning and put on my seat belt, just as I go for my morning bike ride and strap on my helmet, I must balance our lives going forward, knowing that vaccines provide significant protection against severe illness and death.

Since the pandemic started, 1,430 children between the ages of 0 and 18 years old have died from COVID-19. I can only imagine the devastation that each of these families suffered at the loss of their child. Putting emotion aside, which is difficult to do as both a mother and a physician, and focusing solely on numbers, over 14 million children have contracted COVID-19 since the start of the pandemic, and this number is likely underreported. For fully vaccinated children, the vaccine is 83 percent effective in decreasing the risk of hospitalization due to severe COVID-19 infection, including with the Omicron variant. The rates of death and severe illness from the virus are incredibly low for children, but the collateral damage from this virus has not been insignificant. Worsening mental health, widening of the educational gap, increased rates of obesity, and less utilization of needed preventative health services are among the challenges children, in particular, have dealt with during this over two-year-long pandemic.

People have touted the resilience of children throughout the pandemic, but the reality is much grimmer. According to the CDC, the American Psychological Association declared children’s mental health in crisis during the pandemic, and mental health-related visits to the emergency department increased dramatically beginning in April 2020. Children have been infinitely adaptable, but this adaptability has come with a cost.

When I considered my two healthy, vaccinated children and my desire for them to just have a normal school year–my daughter’s first ever school year and my son’s first normal school year since he started attending school–I conceded. No masks. I had thought the kids would be ecstatic, but they accepted this new reality just as readily as they had accepted masking. I watched them cross the street to school, their giant backpacks bouncing on small shoulders, and I saw my son wave hello to a friend and smile–the first time at school that he could show his gap-toothed smile. That smile meant everything to me.

Huma Farid is an obstetrician-gynecologist.

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