Masks are again required at Wilson Elementary School after about one-third of students were absent earlier this week because of cold and flu-related sickness.

Through the end of this week, students, staff and visitors are now required to wear masks during school hours and encouraged to wear masks during evening events. Masks will be available at the school for those who need them.

The Spokane Regional Health District strongly recommends masking in schools during outbreaks where at least 20% of a cohort are absent due to respiratory illness.

As of Monday, about 30% of students at Wilson were absent.

Parents picking their children up from Wilson Elementary on Tuesday commented on the requirement, many saying they were supportive.

“With so many kids out sick, it seems like a prudent move,” said John Younghusband. His child was one of those out sick earlier this month.

Second-grader Ruby Hastings said only 10 out of 18 students were in her class Tuesday.

“I don’t really want to wear (a mask), but I also don’t want to get sick,” said Whitman Hunt, a third-grader.

His mother, Katlyn Hunt, said the numbers are alarming. “I don’t think anyone loves putting a mask back on,” she said, “but if it keeps the kids in school for three or four more days until Christmas break and keeps them healthy, I feel like it’s a small price to pay.”

Spokane Regional Health District spokeswoman Kelli Hawkins said the masking was not mandated for schools who hit 20%, only that it was a “strong recommendation.”

The decision to require masks will help slow the spread of illness, which can hopefully keep kids in school until the upcoming winter break, Hawkins said.

“We really don’t want to close schools,” Hawkins said. “If we can go with the mask option, that helps keep kids in school.”

One other school, St. John Vianney School in Spokane Valley, also received a strong recommendation from the district to require masks due to the number of sick students.

Hawkins said a number of schools have reached out to the health district after 10% of their students were out sick. The health district has worked with those schools on lowering transmission.

The increase in respiratory sickness in Spokane follows similar trends statewide and nationally as children and adults face a collision of three viruses this year: influenza, respiratory syncytial virus (RSV) and COVID-19.

Health officials continue to encourage people to get vaccinated against COVID-19 and influenza and take other preventative steps, such as wearing masks in indoor crowded settings, to slow the spread of these viruses and help an already overwhelmed health care system.

“Unfortunately, despite these efforts, we continue to face considerable health challenges in our state as we move along this difficult respiratory season,” Secretary of Health Dr. Umair Shah told reporters Tuesday.

The Department of Health continues to recommend masking in large crowded settings, but Shah said Tuesday health officials have no plans for additional statewide mask requirements. Masks will remain required in health care and correctional facilities.

Local health officers and businesses can require masks if they see fit.

On Friday, 12 county health officers and 25 health care leaders from mostly Western Washington issued new guidance recommending masks indoors as a way to prevent against severe flu, RSV and COVID-19 infections. Spokane County Health Officer Dr. Francisco Velázquez did not sign onto the letter.

Hawkins said the district did not sign the letter because Velázquez was not working when they were approached about it, but she said they do agree with it.

“Masking in public spaces is recommended right now,” Hawkins said. “By masking, you can help decrease your risk of catching a virus and decrease the potential of unknowingly sharing a virus that you may have.”

Respiratory viruses impacting entire state

Viruses tend to first peak on the western side of the state and peak on the eastern side of the state about two weeks later, Department of Health Chief Science Officer Dr. Tao Kwan-Gett said. The state is at a point now where cases of respiratory illness are high everywhere.

While cases of COVID-19 remain low across the state, flu and RSV infections remain high.

“These respiratory viruses are impacting the entire state,” Shah said.

Cases of influenza were lower in the past two years due to measures to fight COVID-19, such as masking and social distancing. This year, a spike in flu cases came earlier and quicker than normal, Kwan-Gett said.

So far this season, 23 adults and three children have died of the flu in Washington.

Influenza A continues to be the dominant strain in Washington, and Kwan-Gett said the current flu vaccine offers strong protection against that.

Data from the Department of Health shows that doses of the flu vaccine are going up in recent weeks. Overall, the number of people getting vaccinated against the flu is higher this year than previous years, but Michele Roberts, Department of Health assistant secretary for prevention and health, said there are gaps among age groups, especially younger children.

Cases of RSV are starting to decline from its peak, but numbers remain high, Kwan-Gett said.

“Even though RSV may have peaked, we’re not out of the woods yet by any means,” he said.

The “tripledemic” of respiratory illnesses has continued to affect the already-strained health systems, health officials said Tuesday. The strain that was mostly driven by pediatrics has now moved into the adult system as well.

Susan Stacey, chief executive of Providence Inland Northwest Washington, said Providence is seeing significant numbers of influenza and RSV cases, especially among pediatric patients. COVID-19 numbers have remained mostly stable, she said.

Providence recently opened an additional unit to be able to accommodate the number of RSV cases, Stacey told reporters at a Washington State Health Association news conference.

“It’s another surge for a different reason, but equally as challenging from the hospital standpoint,” she said.

Those strains often mean patients who need nonemergent procedures have to wait to get treatment.

Stacey said something needs to be done, as many community members have not been able to get care in months, or years, at this point.

“We can’t keep kicking this can down the road,” she said. “We cannot keep delaying that care for our community.”

Reporter James Hanlon contributed to this report.