Reading this meta-analysis, I wonder how well it would stand up to the independent bias review they used to exclude studies from their findings.
It certainly reads like it has an axe to grind (see Introduction and below).
Although there are certainly populations of children and adults that suffer disproportionately from masking (whether due to respiratory, auditory, or psychological issues, or just from being so young that the mask soaks through in minutes), my overall experience with elementary and middle school aged kids during the early years of the pandemic was that they found masking easy and didn't really care about it. They were thrilled to be in-person with each other.
Of course, their masking practices was not ideal, they often forgot them or wore them wrong, or used less effective materials, but the act of masking itself wasn't generally a big deal.
Our community has a huge Let Them Breathe presence, but even here it was the adults who were making all the anti-masking noise. The kids just didn't care.
I do wish we had better data on efficacy of masking mandates. This review doesn't bring any new clarity.
Here’s my suspicion, based on observation but no statistical evidence:
1. Most masks for children fit extremely poorly. I doubt they do much filtration of incoming air. Maybe they’re useful for source control, especially for pathogens that spread through large droplets (i.e. maybe not Covid).
2. They do have one major obvious effect: when worn even remotely correctly, they keep kid fingers and hands away from kid mouths and noses.
So I expect them to be quite useful at protecting kids from pathogens that are contracted by collecting the pathogens on one’s hands and sticking them in one’s mouth or rubbing one’s nose. And they may also have a strong source control effect for pathogens that come from kid mouths or noses, get on kid hands, and spread onto surfaces.
These are not descriptions of Covid! But there are a lot of diseases that kids get frequently that aren’t Covid. I bet they substantially reduce transmission by the fecal-oral route, for example. And they may help quite a bit against the kinds of viruses that kids actually get from outdoor playground, especially if the kids wash or sanitize their hands after playing.
Getting sick less often? Maybe avoiding norovirus or some cold viruses? Maybe avoiding the flu (on quick search, influenza’s transmission mechanism is not entirely clear, but the flu can be very nasty in small children)?
One might reasonably debate whether it’s beneficial to a small child, and how much, to get sick less often. And one might reasonably debate the tradeoff between that benefit and the down sides of wearing a mask (e.g. more difficult communication). And one might extremely reasonably debate whether any of this would or could justify requiring other people’s children to wear masks.
This. I hope none of you had to endure air travel in the height of the absurd Biden administration's unscientific mask mandates. The poor Delta flight attendants had to go row to row making sure toddlers were wearing a piece of fabric over their face, which the kid would take off every 15 seconds. It was traumatic for me, the staff, my kid, and those around us. And it was all for nothing. I will never forget what they've put us through.
Biden admin? Traveling during the Trump admin was the same. I also found it annoying, having traveled with a toddler and a young kid. But traumatic? Come on.
Notably, I caught COVID for the first and only time when I had a flight just a few weeks after they dropped the mask mandate for flights.
Yes, the Biden admin created the airline mask mandate via executive order. It was shut down by a court, at which point the Biden admin promptly tried to fight for its reinstatement and thankfully lost. [1]
All airlines were already requiring masks for all passengers and employees by that point. The mandate just gave them cover and removed the competitive pressure to stop requiring masks.
Yep, it was absurdly funny in hindsight though, like my out of state buddies who were putting their kid through zoom kindergarten instead of home schooling.
I'm sorry, but I can't see anything funny about closing the schools across the country because of a virus that didn't directly threaten their lives in retrospect. With the literacy rate and school absentee rate, we're going to see a generation of some of the least capable adults in modern history.
No one I know who wore a mask properly and kept a distance from others were infected with covid. If you don't wear them properly they don't work, it's as simple as that and it doesn't matter what your age is.
One of the real issues for children is we didn't have a supply of masks designed for them. We only had access to cheap cloth and paper masks designed to fit adults.
Another is the cheap cloth and paper masks that were available the 1st year were not designed to prevent covid infections, they were only for reducing the distance covid would spread in the air when breathing and coughing.
Where I live, most of the very conservative folks who live here (78% of the population) flat out refused to wear a mask and made a point to boldly walk into stores cocked and primed to take anyone on who told them they must. I wore them and was snarled at everywhere I went. Fair to say their children were taught to refuse to wear them too, and that while required to wear them in school, almost none of the schools staff enforced that here.
So, yeah, if you analyze the effectiveness of masks reducing covid infections in children here you'd conclude they did not work, but you had to be here to know why.
> No one I know who wore a mask properly and kept a distance from others were infected with covid.
This is curious as masks don’t protect from contracting covid. They protect from transmitting covid to others.
So it’s quite possible that your observation is accurate. But very unlikely it has anything to do with their mask usage. But there may be other behaviors responsible. Or just fortune.
The study is compelling but I don't think anyone cares about COVID-19 anymore. Nor do I think you'll ever get kids to care enough about masking to do it properly.
On the contrary, reasonable healthcare providers (who weren't vying for Likes, Shares, TV spots, Op-Eds, and/or book deals) knew back in 2020 that The Real Evidence wouldn't come out until years after it was over.
Children and the general public may not care, but there's still plenty of analysis that will prove useful to medical and policy decision-makers in the future.
On the list of obnoxious regulatory overreach that regulators could engage in, requiring masks in health care facilities seems fine, actually. Maybe even extremely wise.
When someone is sick enough that they ought to stay home, but they go somewhere indoors anyway and wait around for a while, where is it? Likely a health care facility. And there are tons of nasty, often drug-resistant, pathogens that are largely transmitted in health care facilities. And a lot of people visitng said facilities are also vulnerable and/or immunocompromised and/or are taking medicines (e.g. antibiotics) that substantially increase the risk of getting infected by otherwise-not-so-harmful things.
So, please, bring on the infection control measures in health care facilities. Masks, air filtration, ventilation, far-UVC, hand washing, sanitizer, you name it.
I think what people are more interested in is whether people who are dutiful with covid pre-cautions actually work(kids are a tough cohort). I think we know the answer there too.
For example, a systematic review of professionals in a workplace with mask policies versus those without.
Or systematic reviews on other helpful topics like ventilation, filtration, and testing from different cohort perspectives like kids and adults.
The current consensus we all have today is just "don't get infected" which does humanity very little good. There are evidence-based approaches that need to inform public policy makers and for those policy makers to be very clear with the public on what the risk each person entails without pre-cautions.
In my experience, it’s at best and mild aversion, but usually tempered with a pragmatic indifference to being infected. Virtually no one here (UK) takes visible actions anymore. Only a few seem to care.
Get closer to healthcare settings, and things change a little, but not a lot. A few more people take preventative measures, but not many, and interestingly not healthcare staff themselves.
The UK has a covid inquiry going on right now and I believe the former PM expressed their regret for how much they downplayed it alongside explaining their rationale of using the limited tools they had at their disposal. Very uncharacteristic for what their actions were during it.
You also have countries like Germany who are starting to realize the actual burden of infecting the general population and necessity to follow what current evidence we have to tackle the long-tail issues:
True enough. But that was the consensus back in March 2020.
The consensus now is quite different.
Maybe you were referring to March 2020, in which case I agree that it did humanity very little good, at least in regard of its application to children.
No, I am saying that the consensus has largely not changed(i.e. "Don't get infected") although we are ~4 years wiser and have ~400k research publications knowing how this single pathogen affects humanity.
I'm not arguing for or against preventative measures. I am arguing that our health officials could do a better job discussing what we know about it now to help individuals make choices.
Hmm. That’s interesting, and it seems to come down to how consensus is defined.
You highlight the quantity of publications. You’re right. The narrative is already set. The volume is so large.
But what is happening in practice, even in healthcare (at least in the UK), is that little of the theatre is performed anymore. Doctors are mostly unmasked, no one does distancing, and the mandates were unwound long ago. Not sure about testing, but the odd hacking cough here and there draws no petrified stare. So I guess that’s where I disagree: the consensus in practice is running far ahead of the average tone in published science.
I wonder how much that will percolate down. Perhaps we’ll just learn to live with a published scientific position that is grossly at odds with day to day behaviour — how odd! It will give the behavioural scientists something new to work on.
But your basic thesis (that “don’t get infected” is unhelpful advice) is right. It’s simply not actionable.
I've thought the mandates were stupid right from the start. Don't get me wrong, I am not an anti-masker, and I work in healthcare so I've worn a mask every day for the last 3 years.
But forcing people who do not want to wear masks to wear them is just a waste of masks. They aren't wearing them properly or effectively. Hell, a large portion of people who support masks aren't wearing them properly. This is why you see so many people with masks around their chin or below their nose. Might as well have just thrown the mask straight into the garbage.
Any miniscule benefit from forced masking is outweighed by the oppositionary reaction to being forced to do something you don't want to do. Now you have people protesting masks and purposefully wearing them wrong in the name of "muh freedoms".
I agree that required masking wasn't very beneficial to those who didn't want to wear a mask, but it seems very likely to me that it still would have helped reduce spread from those people. Even a poor fitting, poor material mask does a good job of capturing or slowing moisture and other infection carrying materials from leaving the mouth of an infected person.
It was really a sad episode in American history. I suppose it’s been 100 years since Prohibition so we needed a reminder that Americans really do not like having individual liberties infringed. It can’t work here - and that is by design.
"Conclusions Real-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence. The current body of scientific data does not support masking children for protection against COVID-19."
It's funny that it took 3+ years to get a reputable journal to admit what we basically already knew experientially.
The mask debate is so ridiculous I'm astonished that we are still having it. Why do so many (mostly science deniers) constantly have an axe to grind? Those most "propagandized" are almost a complete overlap with those that identify as "independent thinkers". Please, tell me again what Joe Rogan said on a podcast. Ugh.
Replying since you are sorted as top comment at time of this reply...
You seem to be implying the people who spoke out against children masking are Joe Rogan watching, science denying, propaganda believing, "independent thinkers".
Funny place to post that analysis... in the comment section of a massive meta-analysis whose results include:
"Conclusions Real-world effectiveness of child mask mandates against SARS-CoV-2 transmission or infection has not been demonstrated with high-quality evidence. The current body of scientific data does not support masking children for protection against COVID-19."
Perhaps read the article and look at yourself in mirror before jumping to tribal us/them mentality... otherwise its you who may be the science denying, propaganda believing, "independent thinker"
I think GP was referring to themself as science illiterate, maybe?
It seemed like an odd comment to make given this seems like a decently rigorous paper in a reputable journal. So saying “only cool people believe in science, that’s not this science” seems really off and odd to me.
Highly effective at conditioning a generation of submissives who will blindly do what they are told by authority. This is and was the only objective given that we know kids do totally fine with Covid.
It certainly reads like it has an axe to grind (see Introduction and below).
Although there are certainly populations of children and adults that suffer disproportionately from masking (whether due to respiratory, auditory, or psychological issues, or just from being so young that the mask soaks through in minutes), my overall experience with elementary and middle school aged kids during the early years of the pandemic was that they found masking easy and didn't really care about it. They were thrilled to be in-person with each other.
Of course, their masking practices was not ideal, they often forgot them or wore them wrong, or used less effective materials, but the act of masking itself wasn't generally a big deal.
Our community has a huge Let Them Breathe presence, but even here it was the adults who were making all the anti-masking noise. The kids just didn't care.
I do wish we had better data on efficacy of masking mandates. This review doesn't bring any new clarity.