Requiring masks in schools has a downside

Scientists have an obligation to strive for honesty. And on whether children should wear masks in schools, especially preschools and elementary schools, here is what I conclude: to stop the spread of COVID-19 in schools. To justify continuing to hide school children – with no end date in sight – we need to prove that masks benefit children, and at what age. States and communities that consider hiding policies just to be safe should recognize that being too careful comes at a cost, while the benefits are uncertain.

Lucy McBride: Children’s fear of COVID-19 ahead of the data

For most able-bodied adults, masks in indoor public places pose only minor inconveniences. But children, who, even amid the disturbing wave of the Delta variant, are suffering severe consequences from COVID-19 at much lower rates than older people– have different needs and vulnerabilities than adults. Early childhood is a crucial time when humans develop cultural, linguistic and social skills, including the ability to detect emotions on the faces of others. Social interactions with friends, parents and caregivers are integral to the growth and well-being of children.

Sheet masks filter some aerosols, but not the majority, so they could catch exhaled virus particles. Recently published results of a large trial in rural Bangladesh found that the widespread use of surgical masks by adults results in a significant reduction in the spread of symptomatic COVID-19. (The effect of the cloth masks was more ambiguous, and the study did not include children.) But the problem facing educators and parents is whether a mandatory masking policy makes school safer than ‘an optional masking policy – and whether the difference is sufficient to warrant taxation on children.

No scientific consensus exists on the wisdom of mandatory masking rules for schoolchildren. The World Health Organization, which recommends that children 12 and over wear masks under the same circumstances as adults, specifically advises against masking children 5 and under. Many European countries have followed the agency’s advice. UK has focused on rapid testing instead of hiding and did not require elementary students or their teachers to wear face coverings.

Monica Gandhi: Caution has its own danger for children

In the United States, however, current guidelines from the CDC and the American Academy of Pediatrics call on children 2 years of age and older to wear a mask in a school environment or in an indoor daycare; the CDC in particular made exceptions to take a nap and eat. (Masking very young children while sleeping is not recommended due to the risk of suffocation.) In other words, prevailing wisdom in the United States calls for children 2 to 4 years old to wear masks in daycare. for six hours or more while they are awake, but unmask themselves by sleeping side by side in the same room. Protecting children from exposure to coronaviruses is difficult for another practical reason: small children get agitated with their masks.

A health recommendation that takes little account of how humans act and what they need is unlikely to be successful. For example, a diet that tells you to eat only two carrots a day would theoretically lead to dramatic weight loss. In practice, such a diet could deprive you of the nutrients your body needs. Plus, diets that are too strict often don’t lead to any weight loss because no one can stick to them. Likewise, mask mandates can be difficult for small children to follow and deprive them of the stimuli they need.

In addition to recommending masks for young children, the CDC guidelines also recommend masks for most immunized caregivers who work in infant day care centers. This advice also deviates from standard practice in other countries, including the UK. strongly agree.

At least some fears about masking are overblown. Despite claims by some critics, children who wear face coverings are unlikely to experience significant problems when exhaling carbon dioxide or inhaling oxygen. However, some mask wearers who exercise may subjectively feel short of breath. Unfortunately, some school districts are also dismissing this concern. The wealthy and highly educated K-8 schools in Palo Alto, California, force children to mask themselves even outside At break. San Diego schools recently announced an outdoor mask warrant as well. Yet scientists have known for some time that exterior transmission is extremely rare, and a lot experts think exterior masking is misguided. When masks are required outdoors, children may experience limitations in play, exercise tolerance, and socialization. And for what gain?

The benefits of mask requirements in schools may seem obvious—they must help contain the coronavirus, right?– but it may not be. In Spain, masks are used in children 6 years and older. The authors of one study looked at the risk of viral spread at all ages. If masks were of great benefit, then the rate of transmission in 5-year-olds would be much higher than the rate in 6-year-olds.

The the results do not show that. Instead, they show that transmission rates, which were low in younger children, steadily increased with age, instead of dropping sharply for older children who were required to cover their faces. This suggests that hiding children in school does not provide a major benefit, and might provide none. And yet, many officials prefer to redouble their efforts to hide mandates, as if basic politics are sound and only the people have failed.

Céline R. Gounder: Americans are losing sight of the end of the pandemic

Before limiting the amount of face-to-face human contact that children experience during most of their waking hours, policy makers need to be fully aware of what children might lose. Unfortunately, the downside of school mask requirements for children has been difficult to systematically assess because, until this pandemic, face coverage policies had never been imposed on so many children for such a long time. period. Longitudinal studies cannot be done on long term outcomes because there are no children in previous generations to study.

In the absence of systematic research on the costs and benefits of mask requirements for children, the issue has turned into a right-left political battle. In addition to masking 2-year-olds, the CDC recommends immunizing people 12 and older. Because both recommendations come from a respected federal agency, supporters of both are likely to say they “follow the science.” But the evidence supporting vaccination is compelling, in the form of multiple randomized studies, while the evidence supporting school mask mandates for young children is sketchy at best. The problem with overselling unproven recommendations is that it risks turning people away from well-founded ones.

Unfortunately, scientists have failed to conduct the kind of randomized trials that can provide more reliable answers. Here, schools, counties or districts would be given a mandatory or optional masking policy, and researchers could simply follow their experience to determine which schools had the most spread of coronavirus. Children would not be banned or prohibited from wearing masks, but rather the policy of requiring all children to wear masks would be rigorously tested.

As of mid-March 2020, few could object to caution. But almost 18 months later, we owe it to children and their parents to answer the question correctly: Do the advantages of hiding children in school outweigh the disadvantages? The honest answer in 2021 remains that we don’t know for sure.