The Bucks County Health Department has recommended that all students be masked in schools this fall — citing concerns from area hospitals about their ability to handle pediatric COVID cases.

The new guidance, issued Tuesday afternoon, marked a shift in policy for the county Health Department, whose director last month advised against requiring masks in schools. As recently as Sunday, the county said it only recommended masks be used as “targeted temporary mitigation” measures.

But “just today, however, the partnership we have with our hospitals has given us new information which causes us to update our previous recommendations,” health director David Damsker said in a statement.

“While our COVID-19 cases among school-aged children remain very low, hospitals are growing concerned that any pediatric COVID-19 cases could stress the system,” Damsker said. He said specialty pediatric hospitals in the area were already operating near capacity due to “non-COVID illnesses and staffing issues.”

Many Bucks school districts have been moving to reopen without requiring masks — in line with previous recommendations from Damsker, who has called for treating COVID-19 like influenza. He endorsed area schools’ lifting their mask requirements before the state mandate expired in June, and told The Inquirer in July that “schools should not require masking” come fall.

His guidance stood in contrast to the federal Centers for Disease Control and Prevention, which advised last month that everyone in schools be masked, vaccinated or not — a recommendation endorsed by Pennsylvania officials. The American Academy of Pediatrics also called for universal school masking.

While a number of area school districts have moved to require masks in recent weeks, many in Bucks County so far have stuck with mask-optional plans. Several school districts did not immediately respond to requests for comment Tuesday on the new guidance.

The issue has been a bitter source of debate in many communities. Parents and medical professionals in Bucks County worried about the lack of school masking requirements — along with other mitigation measures — have voiced concern, particularly for children under 12 who aren’t eligible for vaccination.

Heather Orman-Lubell, a pediatrician in Bucks County, said she has been seeing growing numbers of positive cases among children. Though “we’re not by any means overwhelmed — we’re not Florida, we’re not Louisiana” — schools haven’t opened yet, she said.

“It would only have gotten worse, if these kids were going back to school without masks, and without vaccines,” Orman-Lubell said, calling the county’s recommendation a “step in the right direction.”

John Bochanski, a parent in the Council Rock School District, said he was “glad they have finally come to this conclusion.”

“The threat is real,” said Bochanski, who has been worried about sending his 6-year-old and 4-year-old to school this fall. He hoped their schools would require masks at least until younger children can be vaccinated.

“It would be horribly inconsistent” for school officials that have followed Damsker’s guidance thus far to not require masks now, Bochanski said. “To all of a sudden change … that would really be inconceivable.”