Editor’s note: This commentary is by Meg Hansen (MBBS, MA), the former executive director of Vermonters for Health Care Freedom, a health policy think tank. She ran for state-level public office in 2020.
In early August, the Centers for Disease Control issued new guidelines requiring children above the age of 2 years to wear masks in public indoor settings such as schools. Gov. Phil Scott’s administration has mandated universal masking for all K-12 students during the first 10 days of the new academic year, after which it applies to the unvaccinated. Though a mandate cannot be enforced absent a state of emergency in Vermont, social and psychological pressures to ensure compliance abound. Parents can expect that their children will have to wear masks all day.
As children tolerate COVID-19 well, masks are not so much about protecting them as they are about preventing viral transmission to the adults in the school environment. This is an unscientific premise. Dr. Benjamin Lee and Dr. William Raszka (University of Vermont) surveyed worldwide studies (Australia, China, France, and Switzerland) to determine the extent of SARS-CoV-2 spread by children. They concluded that children are “not significant drivers of the pandemic.” Various research over the past year has confirmed this finding. For example, an Israeli study published in the Journal of the American Medical Association (April 2021) showed that children aged 0–9 years do not play a substantial role in transmitting the virus.
Clinicians in Texas determined that children are significantly less likely to become infected or spread the virus because of differences in their lung physiology and immune function. The SARS-CoV-2 virus has a spike protein on its surface that acts like a key. It latches onto ACE2 receptors that are abundant in our lungs and other organs, and then unlocks the path to enter and infect our cells. Dr. Paul Marik (chief of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School) quantifies the viral load as “one billion viruses per milliliter” in the eight-to-10 days after onset of symptoms. Viral replication and shedding takes place during this phase, making COVID-19 highly contagious.
Children have fewer ACE receptors in their lungs, which limits viral entry and the overall viral load. They are thus immune and if infected, the disease rarely progresses beyond mild symptoms. In adults, COVID-19-related hospitalizations and deaths occur as a result of hyper-immune responses leading to extensive internal inflammation and blood clots. Marik describes it as a profound inflammatory disease. Children have a different immune system that prevents excessive inflammation and other abnormal immune reactions. Consequently, the fatality rate for children under the age of 17 is 0.04 percent.
The Delta variant has undergone mutations that allow it to bind better to the ACE2 receptors and thus replicate and spread faster. The reasons why children are resilient to the original virus should apply to the Delta variant as well. The figures support this expectation. California pediatrician Dr. Elisa Song notes that COVID-19 cases in children have been declining since mid-April and have been very low since June. There is no scientific basis to claim that children will become gravely ill from the Delta variant or transmit it to others.
Yet, public health leaders and politicians are citing the mutated virus as justification to mask children in the coming school year. In a recent VTDigger article, Lee abandoned his previous conclusion that “the child is not to blame” for transmitting the disease. He predicts that the Delta variant will spread “more easily within the school” and therefore, supports masking for all students. There has been no evidence of children infecting teachers. There is also no conclusive evidence that masks curtail COVID-19 spread. Notably, a large randomized controlled trial in Denmark (Annals of Internal Medicine, March 2021) demonstrated that surgical masks did not reduce the SARS-CoV-2 infection rate.
The harms, however, of extended mask wearing are manifold. Wearing face masks for prolonged periods decreases oxygen and increases carbon dioxide in the blood, which results in breathing difficulties, headaches, fatigue, and a decline in cognitive performance. As moist and unclean masks turn into bacterial reservoirs, cases of severe acne and skin rashes have been reported. In a Wall Street Journal op-ed, “The Case Against Masks for Children,” Dr. Marty Makary (Johns Hopkins School of Medicine) and Dr. H. Cody Meissner (Tufts Children’s Hospital) write that obstructive masks could force children to breathe through their mouths. Chronic mouth breathing causes abnormal facial development. Further, they warn that masks hide facial expressions and visual cues without which children can develop “robotic and emotionless interactions, anxiety and depression.”
Developmental psychologist Kang Lee (University of Toronto) explains that masks hinder young children from acquiring skills for speech recognition, emotional recognition and social interaction. More young children are falling behind in language and social development, as masks do not allow for lip-reading and access to nonverbal signals for communication. Limited and disrupted interpersonal interactions have created oppressive stress to which children are responding with a host of emotional and mental health crises. In many instances, they are losing previously achieved developmental and behavioral milestones. These signs of regression include thumb sucking, toilet accidents, poor impulse control, temper tantrums, eating disorders and insomnia.
Children are untouched by the virus, but they are taking a beating from policies like universal masking that have been ostensibly enacted to confront it. Why must they endure abusive madness?