9/21/21 Two factors should be considered when making the decision on how to proceed with the health and safety of our children regarding COVID-19. First and foremost, the danger of COVID-19 to children. When this pandemic began, of course the answer to this question was unknown. It was easy to make a decision to mask children in the hopes that it could have some benefit and we could provide in-person instruction, as we knew that was what was best. Now after reviewing data of the impact on COVID-19 for 18 months we know that the effects of the virus are minimal in children. According to the CDC, Children under age 20 have a 99.997% rate of surviving COVID-19. There are 104 children ages 0-17 who died from COVID-19 and 287 from COVID + Influenza out of ~73 million. The American Academy of Pediatrics reports that 0.9% of COVID-19 cases have resulted in hospitalizations and a 0.01 percent death rate with the Delta Variant.
Influenza has a much shorter season and results in more deaths in children each year than COVID- so why weren’t we masking before? Simple answer- studies showed it wasn’t effective. Data is what drives our decisions, it certainly should, at least. Data is emotionless and factual. Data doesn’t see politics or agendas, it reports truths.
If we know that COVID-19 doesn’t harm our children then we should be able to stop there, knowing that the unintended consequences of causing a high anxiety and long term state of fear will probably have more consequences to our children’s health, but yet the issue of masking remains so the next obvious consideration is to examine the effectiveness of masking our children.
Up until a recent Bangladesh study, published 9/1/21, which looked specifically at COVID-19 spread, only studies on influenza and masks were available. One could surmise that two viruses have similar size and attributes that they would react to masking similarly. There are several studies that have been conducted in the past that showed cloth masks had no effectiveness (all cited and linked at the bottom of my position) in stopping the spread of influenza. Yet despite this we were told to mask. Some could argue this was understandable then but now we know more. The time has come to move forward.
The Bangladesh study is the first study specifically addressing the effectiveness of masks in stopping the spread of COVID. It had over 300,000 participants although the study isn’t directed at children (one could assume children are less effective at wearing a mask given their cognitive abilities and maturity), it yielded some huge results. The study concluded cloth masks had absolutely no significance in stopping the spread of covid. Rates of infection between non-masked people and people wearing cloth masks were similar. Although the study had great implications to the positive effects of surgical masks stopping the spread of COVID, that is not what our students wore last year in school and that is not what the majority of people continue to wear.
Why aren’t scientists, doctors, and the media talking about this???
As a Board Certified Behavior Analyst my job in behavioral pediatrics is to implement an intervention to change significant social behaviors. My job as a scientist (yes it’s science) is to take data before an intervention (baseline/pre-intervention) and then implement an intervention. The most important part is not the intervention itself but the data to determine how effective my intervention is. If there is a significant difference after my intervention I can successfully conclude that my intervention was effective because of my data. No matter how much I hope, no matter how much I pray, no matter how much I talk about following the science, if science does not actually show my intervention as being successful it is not successful.
We would expect the same scientific approach when looking at Reading, Writing, and Math interventions at our schools. If the curriculum or program does not show a significant impact then why would we implement it? We would choose an intervention that has data and research to show it’s effectiveness- again research on the effectiveness of cloth masks for children does NOT exist.
Throughout the 18 months of the pandemic we have heard over and over again “masks save lives” and “Follow the Science.” I don’t like this term- what does “the science” mean? Is there only one science? Does that mean we shouldn’t study the science of psychology (study of mind and human behavior)? Does that mean we shouldn’t study sociology (the study of social interactions and cultural exchanges)? Does that mean we shouldn’t use the science of statistics (science concerned with developing and studying methods for collecting, analyzing, interpreting and presenting empirical data)? What science are we only focusing on here? The answer seems to be whatever ‘science’ fits the narrative. The term “follow the science” is so widely used now that it’s almost become a buzzword, if you say this that you don’t actually have to provide any science. It seems to imply that science means you trust the opinions of others without actually doing any data measurement or collection or even reading research. In fact that’s as far from science as you can get. According to sciencecounsel.org their definition is as follows: “Science is the pursuit and application of knowledge and understanding of the natural and social world following a systematic methodology based on evidence. Scientific methodology includes the following: Objective observation: Measurement and data (possibly although not necessarily using mathematics as a tool) and Evidence.”
Saying “Follow the science” implies singular science, maybe even suggesting there’s only one path to the answer. This again is false, science changes and evolves, science does not have all the answers at once and science has also been wrong. In 1946 “science” and the medical profession believed DDT was an option to prevent polio, in addition to its use as an insecticide. The medical professionals advised people to spray DDT directly on to children, on food surfaces, buildings, etc. It took decades before people began to question the safety of this product. “Since 1996, EPA has been participating in international negotiations to control the use of DDT and other persistent organic pollutants used around the world (EPA).” It is now classified as “moderately toxic.” Nicotine, asbestos, heroin, smoking/drinking during pregnancy and the “recommendation” for women not to breastfeed their children are examples of the changes in science. Prescribed medications are another example of this. There are 35 FDA approved drugs that are no longer approved by the FDA and it took an average of 11.7 years to be banned. Can you imagine in those 11.7 years how much harm was caused or what would have happened if ‘the experts’ told people to just “follow the science” and no further studies were done. Which is why science relies on long-term or longitudinal studies to show us further information.
What long term consequences does masking have? At the time we do not know but knowing that masks are 1. Ineffective and 2. Covid is not a significant threat to our students, why do we continue this?
Being a critical thinker and questioning science does not make you ‘anti-science.’ Our society, us as parents, caregivers, and our educational system should be encouraging a generation of critical thinkers. We should praise people that look at information from multiple angles and not just approach it in a singular form. I am disappointed to see the majority of the media as well as many medical providers using the approach that if you do not believe in what is going on you’re anti-science. Not only does it create a very divided community, it scares those that feel differently (even professionals) to voice their opinions and critically analyse information.
Another recent study we can think critically on was a study conducted in Spain. In Spain, children are required to wear masks at the age of 6. If masks were effective we would assume that the cases of COVID positive children would be decreased after this age when the intervention is implemented. The results of the study do not show this. In fact, it shows a steady increase in the amount of Covid positive cases the older a child gets, despite the masking intervention.
A recent study out of Georgia also concluded that masks,ventilation systems, cleaning protocol etc. did not have a significant difference in those communities in schools in which these were implemented. From an article published by ‘The Intelligencer’ the writer notes “At the end of May, the Centers for Disease Control and Prevention published a notable, yet mostly ignored, large-scale study of COVID transmission in American schools. A few major news outlets covered its release by briefly reiterating the study’s summary: that masking then-unvaccinated teachers and improving ventilation with more fresh air were associated with a lower incidence of the virus in schools. Those are common-sense measures, and the fact that they seem to work is reassuring but not surprising. Other findings of equal importance in the study, however, were absent from the summary and not widely reported. These findings cast doubt on the impact of many of the most common mitigation measures in American schools. Distancing, hybrid models, classroom barriers, HEPA filters, and, most notably, requiring student masking were each found to not have a statistically significant benefit. In other words, these measures could not be said to be effective.” https://nymag.com/intelligencer/2021/08/the-science-of-masking-kids-at-school-remains-uncertain.html (I would encourage everyone to read this short yet thorough article if you haven’t)
FCSD#1’s decision not to mask our students is not as ‘radical’ as some people suggest it is. The United Kingdom, throughout the entire pandemic has not mandated masks for children under the age of 12. Yet the UK’s COVID numbers are similar to our country. Again if masks were effective shouldn’t the US’s covid numbers be lower? Sweden and Norway are other countries that are not masking their children. In fact the U.S. is not following the science and public-health policy of many other countries. Many nations around the world — including the U.K., Ireland, Scandinavia, France, the Netherlands, Switzerland, and Italy — have exempted students from wearing masks in classrooms, at varying ages. There’s no evidence of more outbreaks in schools in those countries relative to schools in the U.S., where the solid majority of kids wore masks for an entire school year. In fact, the CDC deviates from recommendations from the World Health Organization. The WHO recommends children 12 and older to wear masks, and advises against masking kids 5 and under. Yet the CDC is recommending 2 and older to wear a mask. The UK also does not mask caregivers working with infants and young children knowing the vast amount of research and data that suggest caregiver interaction and face exposure is extremely important for the development of infants and young children. Yet despite this research the AAP and the CDC are now recommending caregivers and children as young as 2 to be masked. Recommendations that have in fact changed several times- and again based on what data?
Dr. Vinay Prasad, MD MPH, a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco, also has spoken extensively on the lack of data to support masking. He reports social emotional development, academic development, and speech and language development all can be hindered by mask wearing. There are healthcare providers and scientists throughout the country that have questioned the cost benefit analysis of wearing masks. They are discredited and their character is attacked when they make these suggestions based on data.
What we do know is that more children died last year during lockdown’s and virtual instruction due to suicide than actually died from the virus. This fact is beyond disturbing, yet we aren’t considering our student’s mental health and the negative effects masking could have on this. A study from 9/17 from the CDC reports “the rate of body mass index (BMI) increase approximately doubled during the pandemic compared to a pre pandemic period. Persons with pre pandemic overweight or obesity and younger school-aged children experienced the largest increases.” Another unintended consequence of lockdowns and pandemic procedures that could be more significant than COVID itself.
If the data in our schools were to suggest that in-person instruction without masks was harmful to our students and ineffective I would support whatever needed to be done to keep our students safe and in school. With us entering the fifth week of the 2021-2022 school year, FCSD#1 has less than 1% of staff and students testing positive for COVID-19 (between 10-20 people out of 2,000 plus). https://docs.google.com/document/u/1/d/e/2PACX-1vTb5VCMsgbNifEn67I5qNCdiFo59E8y77s8DyWeB_RBx5pJgvXUpvx2hEh0I3dF8ZrjCxqEuoaKqNiW/pub
Last year during the peak of the pandemic and before vaccines were available we had 1.07% active cases- which totaled 22 cases out of 2,050 staff and students testing positive (11/12/2020). These numbers without masks are not significantly different from the numbers last year and the vaccine is available to all adults who choose to receive it.
For comparison FCDS#21 which has some of the strictest guidelines in the state- mandatory vaccines for staff, weekly testing, testing for students involved in activities, and masking for all- had 2.3% of their staff and students testing positive for COVID-19. (Superintendent report dated 9/15/2021). Again, this data would suggest these measures do not seem to impact the spread of COVID throughout schools.
I will conclude with this- As adults we need to stop putting this burden on our children, we need to stop this mind game and division and allow families personal choice. I can’t help but think of the confusion some of our children may feel when they are told to mask up to “save lives” but it isn’t consistent. Some adults, who are calling for masks that have been seen at movie theaters, restaurants and other events without masks throughout the summer. A child can walk down the street and see adults congregating in restaurants and bars laughing and going on with no mask in sight and not a care in the world. It is unfair to ask them to mask up and social distance when the majority of adults are not doing this. I refuse to let this be the status quo, this is not how our children should live. Where is the end game here if less than 1% of our students have COVID and we are requiring masks?
At this point it doesn’t really even feel like it’s about our children or their safety or the truth of what is effective, but about being right. As adults we have a responsibility to teach our children right from wrong. We have a responsibility to teach them about bullying and peer pressure and about personal choices. What better way to teach them these things than by our actions. To allow others in the community to make their own choices and respect those decisions and individuality of everyone.
In conclusion, the data doesn’t support the effectiveness of cloth masks and we do not know the long term effects of continued mask wearing. If a family wants to send their child in a mask, an N95 mask is shown to be effective in stopping the spread of COVID-19. Due to the low numbers of positive cases in our school I will continue to support optional masking in schools. I will continue to be a voice of the stakeholders in this community that voted for me last year when I ran opposed to mandatory masks. Until the data changes my stance on this will not change.
Respectfully,
Taylor Jacobs, M.S, BCBA
References and Resources
https://www.cdc.gov/mmwr/volumes/70/wr/mm7021e1.htm
https://www.cdc.gov/mmwr/volumes/70/wr/mm7037a3.htm
VARIOUS FACE MASK STUDIES PROVE THEIR INEFFECTIVENESS1.
- “The use of cloth masks during the coronavirus disease (COVID-19) pandemic is under debate. The filtration effectiveness of cloth masks is generally lower than that of medical masks and respirators; however, cloth masks may provide some protection if well designed and used correctly. Multilayer cloth masks, designed to fit around the face and made of water-resistant fabric with a high number of threads and finer weave, may provide reasonable protection. Until a cloth mask design is proven to be equally effective as a medical or N95 mask, wearing cloth masks should not be mandated for healthcare workers.”
https://www.medrxiv.org/content/10.1101/2020.04.17.20069567v2.full.pdfExternal Link). Filtration effectiveness of wet masks is reportedly lower than that of dry masks (3).
Chughtai, A. A., Seale, H., & Macintyre, C. (2020). Effectiveness of Cloth Masks for Protection Against Severe Acute Respiratory Syndrome Coronavirus 2. Emerging Infectious Diseases, 26(10), 1-5. https://doi.org/10.3201/eid2610.200948.
- “Our results highlight that there is currently no published research on the efficacy of cloth masks. The few available studies on cloth masks are either descriptive or in-vitro. Studies show that some fabrics may provide better protection than others, and that in-vitro filtration capacity improves with increasing fineness of fabric and number of layers. The presence of moisture, distance traveled by the droplets and the design of mask were identified as other important factors related to the in-vitro filtration efficacy. Cloth masks may provide some protection and reduce exposure to respiratory aerosols, but this is unproven in the absence of a RCT. Given that cloth masks are widely used around the world and are not adequately addressed in infection control guidelines, research is required to test the clinical efficacy of cloth masks. Other future research questions should include filtration efficacy, length of use, methods of decontamination and fit testing. The use of cloth masks should be addressed in policy documents to inform best practice in low and middle income countries.”
Chughtai, A., Seale, H., & MacIntyre, C. (2013). Use of cloth masks in the practice of infection control – evidence and policy gaps. International Journal of Infection Control, 9(3). https://doi.org/10.3396/ijic.v9i3.11366
- “The use of reusable cloth masks is widespread globally, particularly in Asia, which is an important region for emerging infections, but there is no clinical research to inform their use and most policies offer no guidance on them. Health economic analyses of facemasks are scarce and the few published cost effectiveness models do not use clinical efficacy data. The lack of research on facemasks and respirators is reflected in varied and sometimes conflicting policies and guidelines. Further research should focus on examining the efficacy of facemasks against specific infectious threats such as influenza and tuberculosis, assessing the efficacy of cloth masks, investigating common practices such as reuse of masks, assessing compliance, filling in policy gaps, and obtaining cost effectiveness data using clinical efficacy estimates.”
MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection in healthcare and community settings. BMJ. 2015 Apr 9;350:h694. doi: 10.1136/bmj.h694. PMID: 25858901.
- Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities — United States, July 2020
The US Centre for Disease Control performed a study which showed that 85 percent of those who contracted Covid-19 during July 2020 were mask wearers. Just 3.9 percent of the study participants never wore a mask.
Original: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf Erratum. correction: https://www.cdc.gov/mmwr/volumes/69/wr/mm6938a7.htm?
scid=mm6938a7_w https://www.theblaze.com/op-ed/horowitz-cdc-study-covid-masks
- “There is some evidence to support the wearing of masks or respirators during illness to protect others, and public health emphasis on mask wearing during illness may help to reduce influenza virus transmission. There are fewer data to support the use of masks or respirators to prevent becoming infected. Further studies in controlled settings and studies of natural infections in healthcare and community settings are required to better define the effectiveness of face masks and respirators in preventing influenza virus transmission.”
Cowling BJ, Zhou Y, Ip DK, Leung GM, Aiello AE. Face masks to prevent transmission of influenza virus: a systematic review. Epidemiol Infect. 2010 Apr;138(4):449-56. doi: 10.1017/S0950268809991658. Epub 2010 Jan 22. PMID: 20092668.
- This study used 5462 peer-reviewed articles and 41 grey literature records.
“Conclusion: The COVID-19 pandemic has led to critical shortages of medical-grade PPE. Alternative forms of facial protection offer inferior protection. More robust evidence is required on different types of medical-grade facial protection. As research on COVID-19 advances, investigators should continue to examine the impact on alternatives of medical- grade facial protection.
Study Article: https://pubmed.ncbi.nlm.nih.gov/32371574/
7. Physical interventions to interrupt or reduce the spread of respiratory viruses
“There is moderate certainty evidence that wearing a mask probably makes little or no difference to the outcome of laboratory-confirmed influenza compared to not wearing a mask”
Study article: https://pubmed.ncbi.nlm.nih.gov/33215698/
8 Disposable surgical face masks for preventing surgical wound infection in clean surgery
“We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials”
Study article: https://pubmed.ncbi.nlm.nih.gov/27115326/
9. Disposable surgical face masks: a systematic review
Two randomized controlled trials were included involving a total of 1453 patients. In a small trial there was a trend towards masks being associated with fewer infections, whereas in a large trial there was no difference in infection rates between the masked and unmasked group.
Study article: https://pubmed.ncbi.nlm.nih.gov/16295987/
10. Evaluating the efficacy of cloth facemasks in reducing particulate matter exposure
“Our results suggest that cloth masks are only marginally beneficial in protecting individuals from particles<2.5 µm”
Study article: https://pubmed.ncbi.nlm.nih.gov/27531371/
11. Face seal leakage of half masks and surgical masks
“The filtration efficiency of the filter materials was good, over 95%, for particles above 5 micron in diameter but great variation existed for smaller particles.
Coronavirus is 0.125 microns. therefore these masks wouldn’t protect you from the virus” Study article: https://pubmed.ncbi.nlm.nih.gov/4014006/
12. Comparison of the Filter Efficiency of Medical Nonwoven Fabrics
against Three Different Microbe Aerosols
“The filter efficiencies against influenza virus particles were the lowest”
“We conclude that the filter efficiency test using the phi-X174 phage aerosol may overestimate the protective performance of nonwoven fabrics with filter structure compared to that against real pathogens such as the influenza virus”
Study article: https://pubmed.ncbi.nlm.nih.gov/29910210/
13. Aerosol penetration through surgical masks
“Although surgical mask media may be adequate to remove bacteria exhaled or expelled by health care workers, they may not be sufficient to remove the submicrometer-size aerosols containing pathogen Study article: https://pubmed.ncbi.nlm.nih.gov/1524265/
Taylor Jacobs for School Board 