22 • September 2, 2021 - September 8, 2021
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Science shows mask-wearing is largely safe for children By LOUIS JACOBSON PolitiFact/Kaiser Health News Florida Gov. Ron DeSantis is one of a handful of Republican governors trying to block school districts from requiring masks in the classroom. Under DeSantis’ direction, the state health department adopted a rule that lets families opt out of locally ordered school mask mandates. The State Board of Education approved another rule that allows parents to secure vouchers for their children to attend a different school if they encounter pushback on their refusal to use masks. The DeSantis administration threatened to penalize school officials financially if they bucked the rules. Much of DeSantis’ argument was based on his belief that parents have a right to determine what’s best for their child, as well as his doubts about whether mask mandates are effective at curbing the COVID virus in a school setting. (When PolitiFact looked into the latter argument, multiple experts pointed to research showing that mask-wearing is effective at protecting children from COVID-19 and preventing COVID transmission in schools.) But DeSantis also cited specific negatives for mask wearers’ health. In an executive order, DeSantis wrote that “masking children may lead to negative health and societal ramifications” and that “forcing children to wear masks could inhibit breathing, lead to the collection of dangerous impurities including bacteria parasites, fungi, and other contaminants, and adversely affect communications in the classroom and student performance.” DeSantis’ press secretary, Christina Pushaw, told PolitiFact that “there are potential downsides to masking children for eight hours per day, from a developmental, emotional, academic, and medical perspective. These potential downsides are largely unexplored.” She cited concerns raised in an op-ed by Dr. Marty Makary, a professor at the Johns Hopkins School of Medicine, and Dr. Cody Meissner, chief of pediatric infectious diseases at Tufts Children’s Hospital, that said that “masks can lead to increased levels of carbon dioxide in the blood” and that they “can be vectors for pathogens if they become moist or are used for too long.” Makary and Meissner also warned of impacts on verbal and nonverbal communication. Other people aligned with DeSantis’ view have put the harm of kids wearing masks in even starker terms. During a panel discussion convened by DeSantis, clinical psychiatrist Dr. Mark McDonald said, “My position is simple: Masking children is child abuse,” according to the Miami Herald. (Meissner was also on the panel.) Rep. Madison Cawthorn (R-N.C.) spoke out against a proposed school mask man-
the mask,” said Benjamin Neuman, a biology professor at Texas A&M University and chief virologist of the university’s Global Health Research Complex. A paper published in February looked at 10 previous studies of adults or children that addressed questions of breathing while wearing a mask. The (Photo by August de Richelieu from Pexels) authors expressed disappointment at how few date by the Buncombe County Board of studies looked specifically at the impacts Education, saying a mandate is “nothing on children, and they urged that more reshort of psychological child abuse.” search is needed on that specific question. And on the July 27 edition of his Fox However, the paper found little News show, Tucker Carlson asserted that reason for worry. it’s a “scientifically established fact that “The eight adult studies, including four masks pose a far greater threat to children prompted by the pandemic and one on than COVID does. So, strictly speaking as surgeons, reported that face masks coma scientific matter, this is lunacy.” monly used during the pandemic did not What does science say about whether impair gas exchange during rest or mild masks can harm the wearer? exercise,” the authors wrote. Generally, we found that concerns A June study that seemed to indicate about significant negative effects on breathing challenges for masked chilbreathing aren’t well supported. Worries dren was retracted by the journal JAMA about masks interfering with communi- Pediatrics 16 days after publication becation and serving as a barrier to social cause of methodological shortcomings connection in the classroom may be more and other concerns. reasonable, experts say. Dr. David Hill, an American Lung Association board member, has written Breathing Concerns that masks “absolutely” do not cause low The first thing to note is that masks aren’t oxygen levels. recommended for everyone. The Amer“We wear masks all day long in the hosican Lung Association cautions people pital,” Hill wrote. “The masks are designed with lung disease, for instance, to consult to be breathed through and there is no evitheir doctor before wearing a mask regu- dence that low oxygen levels occur.” larly. In addition, the CDC does not recAnother reason medical experts aren’t ommend that children under 2 years old too worried is that “the world has engaged wear masks. Masks are also generally not in a massive study—observational, but litrecommended during heavy exercise. erally billions of people—on mass maskBut what about people who do not fall wearing, and people are not dropping into these categories? Could they be hurt dead left, right and center,” Javid said. by wearing a mask? Some of the most common concerns Other Possible Risks raised involve a lack of oxygen, or a buildA few other complaints about masks up in carbon dioxide. We have previous- sometimes surface, such as fear that they ly found such concerns to be oversold, as could concentrate toxins or harm the have other fact-checkers. immune system. But these aren’t well supThe issue “has been convincingly de- ported either, experts say. bunked,” said Babak Javid, a professor of As long as masks are regularly replaced medicine at the University of California- or laundered, “there’s no reason to worry San Francisco. about toxins,’’ said Columbia University We should note that studies specific to virologist Angela Rasmussen. And there’s children have been rare, so most of the sci- “no evidence that masks have any effect entific literature has involved research on on the immune system or immune funcadults. Two studies on children used N95 tion,” she said. masks, which are more sophisticated than Dr. Amesh Adalja, a senior scholar at the masks most schoolchildren will use, the Johns Hopkins Center for Health Sebut even these found no significant effect curity, told PolitiFact that swabbing a stuon breathing. Other peer-reviewed stud- dent’s backpack would probably generate ies of adults have produced similar results. as many (or more) pathogens as swabbing A mask “will add some resistance to their mask. the breathing process, meaning it may And Nicole Gatto, an associate professor feel like it takes a bit more work to take of public health at Claremont Graduate a breath, but it won’t materially change University, said pathogens on masks may the makeup of air that comes through be evidence that they’re being kept “out of
the mouths and noses of those who wore them, preventing people from potentially getting ill.” While the scientific evidence for specific ills such as low oxygen or high carbon dioxide is weak, experts say it’s more plausible that the annoyances of masking could distract fromC in-class lessons and make it harder to hear other students or the teacher. In a September 2020 paper in the International Journal of Environmental Research and Public Health, the authors wrote that “while there are minimal physiological impacts on wearing a mask … there may be consequential psychological impacts of mask wearing on the basic psychological needs of competence, autonomy, and relatedness.” Such downsides may be especially acute for students who are Englishlanguage learners, or those who are deaf or hard of hearing. “Masks interfere with lip-reading, which has a major impact on communication,” Javid said. The reality is that “there is minimal evidence” on how severe these sorts of impacts could be for most children. “This is the first time in most of our lifetimes we have faced the prospect of continued isolation and masking, so it is not surprising we have insufficient evidence to guide us,” said Amy Price, a senior research scientist at Stanford University. Still, there is evidence that children are adaptable. In a December 2020 study of children’s ability to read the facial expressions of masked people, researchers at the University of Wisconsin-Madison found that “while there may be some challenges for children incurred by others wearing masks, in combination with other contextual cues, masks are unlikely to dramatically impair children’s social interactions in their everyday lives.” And child-development experts caution against assuming that any deficits from masks will linger over the long term. Most children “don’t like wearing pants or shoes at first, but they adjust, like they do for all the other things we require of them,” said A.E. Learmonth, a professor with the cognition, memory and development lab at William Paterson University. “In many ways, a mask is just another article of clothing. In the beginning it could be distracting and uncomfortable, but like shoes, they will get used to it.” Meanwhile, polling suggests that parents are open to masks in schools. A KFF survey taken in July and August found that 63% of parents wanted masks required in schools for people who are unvaccinated.
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PolitiFact’s Gabrielle Settles and Jason Asenso contributed to this article. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues.
