Your Health

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 mandate by the Buncombe County Board of Education, saying a mandate is “nothing short of psychological child abuse.”

And on the July 27 edition of his Fox News show, Tucker Carlson asserted that it’s a “scientifically established fact that masks pose a far greater threat to children than COVID does. So, strictly speaking as a scientific matter, this is lunacy.”

What does science say about whether masks can harm the wearer?

Generally, we found that concerns about significant negative effects on breathing aren’t well supported. Worries about masks interfering with communication and serving as a barrier to social connection in the classroom may be more reasonable, experts say.

Breathing Concerns

The first thing to note is that masks aren’t recommended for everyone. The American Lung Association cautions people with lung disease, for instance, to consult their doctor before wearing a mask regularly. In addition, the CDC does not recommend that children under 2 years old wear masks. Masks are also generally not recommended during heavy exercise.

But what about people who do not fall into these categories? Could they be hurt by wearing a mask?

Some of the most common concerns raised involve a lack of oxygen, or a buildup in carbon dioxide. We have previously found such concerns to be oversold, as have other fact-checkers.

The issue “has been convincingly debunked,” said Babak Javid, a professor of medicine at the University of CaliforniaSan Francisco.

We should note that studies specific to children have been rare, so most of the scientific literature has involved research on adults. Two studies on children used N95 masks, which are more sophisticated than the masks most schoolchildren will use, but even these found no significant effect on breathing. Other peer-reviewed studies of adults have produced similar results.

A mask “will add some resistance to the breathing process, meaning it may feel like it takes a bit more work to take a breath, but it won’t materially change the makeup of air that comes through 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 authors expressed disappointment at how few studies looked specifically at the impacts on children, and they urged that more research is needed on that specific question.

However, the paper found little reason for worry.

“The eight adult studies, including four prompted by the pandemic and one on surgeons, reported that face masks commonly used during the pandemic did not impair gas exchange during rest or mild exercise,” the authors wrote.

A June study that seemed to indicate breathing challenges for masked children was retracted by the journal JAMA Pediatrics 16 days after publication because of methodological shortcomings and other concerns.

Dr. David Hill, an American Lung Association board member, has written that masks “absolutely” do not cause low oxygen levels.

“We wear masks all day long in the hospital,” Hill wrote. “The masks are designed to be breathed through and there is no evidence that low oxygen levels occur.”

Another reason medical experts aren’t too worried is that “the world has engaged in a massive study—observational, but literally billions of people—on mass maskwearing, and people are not dropping dead left, right and center,” Javid said.

Other Possible Risks

A few other complaints about masks sometimes surface, such as fear that they could concentrate toxins or harm the immune system. But these aren’t well supported either, experts say.

As long as masks are regularly replaced or laundered, “there’s no reason to worry about toxins,’’ said Columbia University virologist Angela Rasmussen. And there’s “no evidence that masks have any effect on the immune system or immune function,” she said.

Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told PolitiFact that swabbing a student’s backpack would probably generate as many (or more) pathogens as swabbing their mask.

And Nicole Gatto, an associate professor of public health at Claremont Graduate University, said pathogens on masks may 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 from 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.

(Photo by August de Richelieu from Pexels)

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small businesses. “We welcome barbershops and beauty salons. We welcome resthe mouths and noses of those who wore taurants. We welcome bodegas,” the mayor said. “Anyone who wants to be a part of this, encourWhile the scientific evidence for aging community members to specific ills such as low oxygen or high carbon dioxide is weak, experts ances of masking could distract from in-class lessons and make it harder to search and Public Health, the authors iological impacts on wearing a mask … cal impacts of mask wearing on the basic language learners, or those who are

“Masks interfere with lip-reading, pacts could be for most children. “This is the first time in most of our lifetimes we lation and masking, so it is not surprising we have insufficient evidence to guide us,” said Amy Price, a senior research scientist

Still, there is evidence that children are adaptable. In a December 2020 study of sions of masked people, researchers at the University of Wisconsin-Madison found es for children incurred by others wearing cally impair children’s social interactions

And child-development experts caution against assuming that any deficits from

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 ment lab at William Paterson University. ticle of clothing. In the beginning it could be distracting and uncomfortable, but like ents are open to masks in schools. A KFF survey taken in July and August found that 63% of parents wanted masks required in

Vaccine

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belief to get any vaccination.

“It’s off of the scripture that their body is a living sacrifice and that it’s their temple,” he said. “Based on the scriptures they provide, I provide them a letter that is addressed to them with their name on it that says they are exempt.”

The letter is meant to be presented to an employer, school or entity with a COVID-19 vaccine requirement. The letter is not meant for the city’s indoor vaccine mandate at restaurants, entertainment venues or gyms.

McCall said he has not given out any letters to people who are not members of his religious institution, even though they have been requested. Those who want to become members simply to get the letter of exemption are also

Violence

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opened fire on the crowd of about 150 people.

As the days go by, more people are becoming victims of gun violence and the people who can help prevent it still don’t have what they need.

The public health emergency declaration created the state’s Office of Gun Violence Prevention to coordinate efforts and direct resources to emerging gun violence hot spots. Funding is also supposed to go towards strengthening police-community relations.

“Just like we did with COVID, New York is going to lead the nation once again with a comprehensive approach to combating and preventing gun violence, and our first step is acknowledging the problem with a first-inthe-nation disaster emergency on gun violence,” Cuomo said last month. “When we see an injustice we don’t look the other way, we stand up and fight it because that’s the New York way.”

In an interview, Lance Feurtado, who serves as executive director of the anti-violence organization the King of Kings Foundation, Inc. in Queens, said the organization met with Cuomo’s team three weeks ago during a forum. Feurtado said he’s not confident that plans will iron out.

“My prayer and hopes are that that conversation was just to gauge or feel the temperature or the pulse of the community,” Feurtado said. “What they were talking about, to me, was a joke. They were talking about investing $5 million statewide. It was a disrespect to folks like myself who are on the ground getting in front of this violence and mediating conflicts before it escalates into retaliation.”

Mike Perry, who serves as program manager of True 2 Life Cure Violence in Staten Island, said Cuomo’s team came to Staten Island to gauge what was needed. Perry said the only result he’s seen so far from the gun violence declaration is an expansion of the Summer Youth Employment Program, which only expanded to 15 youths.

“That’s cool, but it’s not enough,” Perry said. “That’s 15 kids out of thousands and thousands of highrisk kids in New York City that need to be serviced. We don’t have enough gun violence prevention to cover the hotspots. We need more funding. We need more programs. There are only two neighborhoods being serviced in Staten Island. We have another four or five neighborhoods that are being plagued by gun violence that need to be served.”

The state’s Office of Gun Violence Prevention operates within the New York State Department of Health. In a statement, spokesperson Abigail Barker said the department is still working on establishing the office.

“The Department of Health is actively working on the creation of the Office of Gun Violence Prevention, which will lead a task force made up of more than a dozen state agencies to identify concrete steps that can be taken to curb senseless gun violence in New York State,” Barker stated.

come in and get vaccinated, we want those small businesses to benefit. We want to make sure that the individuals from the community come in and get back safe first and foremost, we want them to benefit from it, but we want the small businesses to benefit as well.”

As the city moves forward with its “Key to NYC Program,” enforcement for the vaccine verification program is set to begin in two

turned away. He also said he’s not giving out any kind of fraudulent vaccination cards.

Once word got out that McCall was writing the letters, he received numerous calls from people wanting one and they were all turned away. McCall said that many of the people who have called him are city workers looking for a way to avoid getting the COVID-19 vaccine due to hesitancy.

“When God created this world he gave us the gift of freedom of choice and it’s up to us to choose what we want to do to our body, our mind and our soul,” he said. “If you are a true believer and you want to receive a religious exemption from your clergy leader that you’re a member of, you have the right to do so.”

McCall added that he encourages people to either get the COVID19 vaccine or get tested regularly and wear masks.

Since vaccine mandates were announced there have been weeks on Sept. 13. The program requires proof of vaccination in order to get to entertainment venues, restaurants and bars and gyms.

Small Business Services (SBS) Commissioner Jonnell Dorris said that over 600 canvassers have been out in the field speaking with small businesses. On Tuesday, SBS implemented new industry-specific guidance to further help business owners with the indoor vaccine mandate. Weekly online training will take place every Wednesday.

“If you are a restaurant, you’ll be able to look and see exactly what you need to do. If you are a gym, you’ll have specific help on how to put your plan in action. If you’re a movie theater, you’ll find out on how to keep the line moving. Or any business for that matter, we have specific guidance for you,” Dorris said.

questions over their legality. In previous interviews with the AmNews, civil rights lawyer Joshua Blane of the Gray Law Firm said the city failed to consider religious exceptions when mandating vaccines. Blane added that vaccine mandates could violate people’s First Amendment religious freedoms.

According to the Center for Disease Control and Prevention, COVID-19 vaccine mandates are a matter of state or other applicable law. The agency cites Title VII of the Civil Rights Act of 1964, which states “once an employer receives notice that an employee’s sincerely held religious belief, practice, or observance prevents them from taking the vaccine, the employer must provide a reasonable accommodation unless it would pose an undue hardship.”

The AmNews reached out to the city about religious exemptions for the COVID-19 vaccine and did not get a response at press time. On Tuesday, city officials addressed the issue and McCall during Mayor Bill de Blasio’s daily press briefing.

“I know Reverend McCall, I respect him. I appreciate him. I was very saddened to see that. I think that’s a mistake,” de Blasio said. “I think it should stop. Those, quote unquote, exemptions are not going to be honored. They’re just, that’s not the way to do things. And so I think people should recognize [it’s] so important to get vaccinated; leaders of veritably every faith tradition have stepped forward, encouraged vaccination.”

President and CEO of NYC Health + Hospitals Mitchell Katz said his office has not seen people bringing exemption letters and that no one can grant religious exemptions to the vaccine.

“Religious exemptions are based on someone’s personal, sincerely held beliefs,” he said. “No one can give you an exemption.”