The case against masks at school

https://www.nytimes.com/interactive/2020/us/covid-hospitals-...

I'll tell you that here in Chicago, based off data, and anecdotes: really depends on the neighborhood. Vaccinated areas? Doing fine. Undervaccinated areas? Not doing so well.

Gosh, it's like vaccines work and that's the way out of this.

This has never been true and remains false.

But understand: the vast majority of human history is colored by a desire to grow a family in order to provide strength to their progeny knowing that they, in turn, will face an unkind future and can be protected, in some degree, by their kin.

Sounds like you're at the end of a multi-billion year winning streak. Your ancestors did well.

Some anecdotal evidence, I went through cancer treatment starting Feb 2020, ending Feb 2021, with a few scans since. Including one in a few days. I have never had any of my numerous appointments postponed for covid. But I think it is because I am lucky enough to afford to be treated by a hospital with a large cancer department.

I suspect it could easily lead to broader exemptions and eventually bring up the issue of other infectious diseases not being treated.

My family also got several, none time critical yet time time intensive treatments over the past 2 years. There was no waiting because of COVID here.

Maybe also part of the reason it never turned out to be the healthcare catastrophe Americans some to live trough.

Edit:// not turning away, but giving less priority. Nobody gets or should be turned down. But when it comes to triangulation cancer may should win against a non vaccinated patient with low chance to survive.

Physicians take an oat to care for patients while looking past that.

At this point, mandates have convinced everyone who will ever be convinced. There is no more convincing in our future. A subset of people will always reject masks and vaccines.

You say it as if that's the only consequence of a medical shortage... How about replacing that with "in order to have enough functioning doctors and nurses able to treat patients with cancer, respond to car accidents, and do organ transplants"?

The point of masking in schools was maybe, once, based on the theory that it would keep the children and teachers safe. Now, the point is that we must exert every lever of control at our disposal. It just so happens that the only group of people who we can reliably control are children, as they cannot vote, do not have fully-formed civil rights, and (in the main) are legally required to attend government run schools each day.

So, while they'd love to make everyone else mask, they realize they practically cannot -- so they focus on children. It's grotesque.

I cannot countenance the idea that keeping most of your spit with you rather than floating around the room doesn't reduce spread of a respiratory virus. At best I would suggest instead that schools ought to have had a mandate to use and reuse sterilized n95 masks instead of a loosely fitting cloth mask oft worn with the nose exposed.

https://www.census.gov/content/dam/Census/library/publicatio...

https://www.wolterskluwer.com/en/expert-insights/nursing-fac...

Compensation helps, but having to do much more work with less people increases burnout regardless of how much you're being paid.

https://www.macrotrends.net/countries/USA/united-states/birt...

Are you sure this is true? The data you linked to shows that hospitalization rate for 65+ unvaccinated is 7x 65+ vaccinated. But WA has a great vaccination rate, over 99% for 65+ with one or more shot. So even with 7x the rate, unvaccinated elderly probably aren't massively dominating hospitalizations because it is such a small pool of ppl.

vax rate: https://usafacts.org/visualizations/covid-vaccine-tracker-st...

Instead of blaming unvaxxed people, you should blame the government for not having more capacity and not planning on how to handle surge in demand for hospitals. We're lucky covid is so tame, this could have been a crazy disaster.

This rhetoric where we try to divide the population is insanely toxic when the fault should be placed on the ruling class for mishandling both the planning, the communication and the handling of the pandemic.

Because wearing masks is a good thing. A large part of the resistance to mask wearing in the US stems from seeing it as an abnormal thing and an oppression, but, in fact, wearing a mask when you're sick—even if it's just a minor sickness, not in the context of a global pandemic—is a good and respectful thing to do, practiced as a matter of course in many countries. Kids who grow up wearing masks will not have the horror of them that their vaccine-avoiding forebears did, and hopefully will be better equipped to meet the next pandemic sanely.

> I have full seething burning anger towards the unvaccinated septuagenarians ruining our health care system

What do your medic friends say?

Anything that follows from that will be a flawed argument.

https://www.ama-assn.org/press-center/press-releases/ama-fun...

In any case, we're seeing a surge in cases where the young are facing hospitalizations https://www.nytimes.com/2022/01/07/health/covid-children-hos.... When I trained at a country hospital, it was overwhelmingly people under 50 being hospitalized for COVID-19. Children are at risk and we shouldn't think like it's spring of 2020 anymore.

Adults have offloaded as much of the burden of the pandemic on young people as possible.

- Suicide rates are through the roof

- Developmentally delays

- Societal debt

And it goes on. Medical professional have it rough… oh well! Open up more medical schools, theres far more people willing to go to med school than get in.

Id rather not go to the Dr. and not need prescriptions to buy most drugs. Lets loosen those regulations and 80% of the reasons Ive been to the Dr. in the last six years will be covered with the same formula: 10 days of augmentin.

Do you have a link? I would not be surprised if there were significant developmental issues, but two standard deviations is such an enormously large effect size that I'm doubtful.

When the media, the government and "science" double-down on policies we all know are total bullshit, it makes people lose faith in the media, the government, and "science."

In Europe seatbelts are mandatory, and it is forbidden to smoke in most places. I think that these are reasonable measures. I think, for the exact same reasons, that mask mandates are reasonable.

In public transport is mandatory to wear at least a t-shirt, as skin to skin contact gets unhealthy fast. And restaurants require to clean your hands after going to the toilet.

What does not fit with my idea about the USA is that you can go naked in the street, as it seems quite a Puritan country. And books being censured in schools for mildly nudeness also seem to be the norm. Is not that worse that mask mandates?

Edit: seatbelt

> Rule utilitarians argue that following rules that tend to lead to the greatest good will have better consequences overall than allowing exceptions to be made in individual instances, even if better consequences can be demonstrated in those instances.

We have two children. Both masked for 7 hours a day. Every day. Both schools are VERY STRICT. Everybody is vaxxed and boosted. Doesn't matter.

The TSA mandate itself. Only those under age 2 are exempt from it. This is just for the US obviously, not sure about other places. But in my experience the less you paid for your ticket the more strict the airline is. I typically don't fly budget airlines but did once during the pandemic and that's when a flight attendant shouted at me and my wife when our toddler had taken his mask off and we didn't notice.

I've flown in the past year and was annoyed that adult passengers in front of me weren't wearing their mask (or wearing it with their nose exposed). While the flight attendant told them a few times times to put their mask on correctly, the flight attendants were not going to "turn the plane around and ban [them] permanently".

It's true that a mask alone isn't enough to guarantee anyone's safety and while community spread is high sending kids into schools is pretty much asking for them to get infected, but wearing masks is still far better than doing nothing, it's just that sadly "nothing" is all some people are willing to do to prevent the spread of the virus.

https://med.stanford.edu/news/all-news/2021/09/surgical-mask...

Even cloth masks reduced transmission, and "reduce the overall likelihood of experiencing symptoms of respiratory illness during the study period."

I love this argument.

"Just imagine how much worse things could have been! The observed outcome is better than a worst case scenario I made up!"

"Just imagine if I didn't wear my lucky socks to the game. We would have lost even worse!"

The data does not bear out your position. Places with less / no mandates did not have measurably worse outcomes.

The outbreak curves and percentages are basically the same, especially when you account for the population differences in age, obeasity, diabetes, etc.

A red state might do worse at times, but is also more easily explained as a result of a more vulnerable population.

Be scientific about it rather than political. There are a lot of ways to analyze the data.

Maybe? But I already live in a place that did away with all COVID restrictions some time ago (not to mention they were never as harsh as elsewhere to begin with), and the situation here is barely worse than places with prohibitive restrictions.

As far as I'm aware, most studies, including WHO, show that lockdowns were counter productive, and could result in increased transmission.

I haven't seen a single study that showed school closures resulted in any decrease in transmission, or provided any benefit. I have seen many that showed the harms it imposed, though.

These measures were ineffective. So, how do you justify saying that a hospital's case load would increase by 2X if we got rid of them, or had never done them?

Even a year after vaccines we are still being asked to treat Covid like it is the #1 priority in our lives. More important than our well being, our mental health, our communities, our children, or anything else.

Heaven help you if your value system is incompatible with such an idea. Be prepared to be yelled at, called names, lose your career, and become marginalized.

Having different priorities than you do does not make someone "subhuman" and I would seriously reconsider the language you are using.

Honestly, I don't think it's as extreme as "if coronavirus were ten times more fatal" that would lead us to naturally take on mitigations. Instead, it would be if the death rate were evenly spread across age groups. Then, the motivation for avoiding some piano playing would be the immediate cost to self or close friends, rather than the abstract cost to some other group.

All that said I am quite sympathetic to the motivation behind your argument, but I believe you and GP are ignoring some motivations people might have for following or being 'bureaucratic automatons'.

Quick capsule hypothesis-- you tend toward thinking in a way that results in you having written the word "subhuman" on HN because an active pandemic tends to increase feelings of disgust in the affected population.

Did you consider that possibility?

Edit: wording

I'm sympathetic to your point (and I love to play piano), but I can't help but ask, if we slightly reword your claim: would you be willing to take responsibility for spreading coronavirus to n other people so you can play the piano?

Edit, to be clear: I'm not talking about the piano, or surface transmission; I'm talking about the values.

But I'd also like to downvote you for the this comment: "I tend to think that people who operate in this way are subhuman, in the genuine sense of the word" >> It's not right, not useful, and not reflective. Much better is to assume others are also smart, well-educated and well-intentioned, and then try to genuinely understand why they believe or act the way they do.

Sure, being able to go watch a family movie together used to be a big family thing, but we can't do that anymore. Our QOL has dropped in that regard, but it's far less impactful than saying to heck with it and going to the theater and having my kid or an in-law catch Covid and die. Long Covid even indicates there's a chance that surviving Covid leaves you with a long-term impact to QOL. Why take that risk over minor irritation in the near term?

Sure, masks are tedious and annoying. But to my youngest, so are shirts and shoes. If he had his choice, he'd run around all damn day in underwear or shorts. But society as a whole benefits from a general adherence to everyone wearing shirts and shoes in public. He's got the same feelings towards seatbelts. Just like masks, seatbelts are only a half-measure. They don't prevent you from dying in a car crash, but they give some modicum of benefit overall. There's a higher chance of surviving a crash with a seatbelt on, even if it's not guaranteed.

All of these "I'm done with masks/precautions" statements are made in a void while ignoring the ripple effect that stems from that.

There's a turning point where life will have to resume one way or another, but the longer we can go as a civilization with a reduced QOL the better the chances of resolving the pandemic with fewer deaths all around.

The problem comes when it's "I will take the risk of infecting others who are vulnerable, of contributing to overwhelming the already struggling healthcare system, and of damaging the economy to play the piano, because it doesn't matter how many people are infected or are dying every single day I care more about myself getting the things I want right now than I care about any of those things."

There's no need to frame the issue as if folks are being told they can't do anything they enjoy ever again and have to devote their whole lives to simply breathing and eating either. It's a false dichotomy that we have to choose between common sense measures for the good of our community and limiting ourselves to "what is the minimum possible quality of life we can have".

We can instead make smart choices based on the degree of community spread which can mean putting off certain activities, but often times just means putting on a mask and washing our hands. It's not a huge ask.

It was pretty damn fatal when we had no containment measures or vaccines. We're in a totally different situation now, and need to get out of the "minimize cases" mentality.

What if people didn’t? What then? How would that be different from today?

You can see how they got to that place, so they can control the density of visitors which is important because of COVID, but it's also something they've wanted for years.

This means people just park in the streets around the parks. What’s that supposed to achieve?

Who gets to decide what is okay and isn’t anyway? Some myopic “experts” who barely feel the negative impacts of their prognostications? What about other types of experts? What would “music experts” say about shutting down the piano?

Covid doesn’t live in a vaccum.

But you are right - singing would increase the risk of infection. Still, I think the risks from the current version of the virus to a vaccinated group of young people (who are still required to wear masks!) is small enough that the piano should be available.

> When a metric becomes a target, it ceases to be a good metric

The public health equivalent of the broken window fallacy would be maximising the spread of disease in order to boost the medical industry.

Mask mandates done poorly are pointless. Obviously. But it is completely absurd to conclude that mask mandates writ large are pointless.

https://www.poverty-action.org/publication/impact-community-...

From the paper:

    We found clear evidence that surgical masks are effective in reducing symptomatic seropreva-
    lence of SARS-CoV-2. While cloth masks clearly reduce symptoms, we find less clear evidence of
    their impact on symptomatic SARS-CoV-2 infections, with the statistical significance depending
    on whether we impute missing values for non-consenting adults. The number of cloth mask vil-
    lages (100) was half that for surgical masks (200), meaning that our results tend to be less precise.

Furthermore, they said that even without that consideration, the cloth masks still reduced symptoms of Covid, which is still a great win for masks, as it seems they reduce the viral load received by an individual enough to reduce the severity of their infection. So saying the overall advantage of masks was statistically insignificant isn't really true.

What the trial really found was indeed that masks seem to work, and surgical masks work better than cloth masks. This aligns with what many other studies have found as well. However, even though that's probably a valid inference to draw from the data collected in the trial, it's not really what the trial was designed to find, which was more specifically that if you actively distribute masks to people and encourage them to be worn, then more people will indeed wear them, and this in turn seems to have a positive effect on reducing both the transmission and severity of Covid.

I never know what to make of posts like this. It seems almost insulting to have to explicitly point out that masks are about reducing transmission, and that transmission could occur between students (not 50+) and teachers (many 50+).

Right?

So your conclusion should be that the Bangladesh study is quite relevant to schools, yet you seem to be suggesting the opposite?

Though I knew about it, I don't think I really appreciated how people could cherry-pick information to fit their preconceived ideas until covid.

The study could prove that the masks worked in 50+. And this was with a maximum of 40% of people complying.

This does NOT mean that the masks didn't work in 50-. It means that the statistical power was insufficient to prove that they worked.

It could also mean that 50- didn't comply with masks as well. It could also mean that 50- engaged in other risky behavior. etc.

Why everybody seems to think that "Provably works in 50+" and "Provably doesn't work in 50-" are completely compatible ideas is completely beyond me. "Provably works in 50+" significantly increases the Bayesian prior on "Works in 50- even if we can't prove such."

You'd be surprised how often this happens at an elementary school!

  What are they protecting against: direct sneezing into someone else's face?

I'm triple-vaccinated and absolutely sick of wearing a mask. I agreed with it for the first 18+ months of this but by now I'm just no longer in favor. I no longer believe covid will eventually "go away" and am certainly not in favor of wearing masks for years to come in the hopes that it does.

Those that remain unvaccinated by choice I don't care about. Those who have vulnerable immune systems I have sympathy for but ultimately I don't feel all of society can wear masks forever on basis of their existence. Especially now that it's such a widespread virus that it's basically unavoidable without being a hermit.

_The Unmask is not designed or intended to prevent, mitigate, treat, diagnose or cure any disease or health condition, including COVID-19/Coronavirus. Unmasks are intended for general public use only. They are non-sterile and are not intended for use in any clinical or surgical setting or where exposure to bodily or hazardous fluids may be expected, where the risk of exposure through inhalation is high, or near intense heat or flammable gas. Unmasks are not surgical masks, personal protective equipment, or filtering respirators (such as N95 masks)._

Basically, it seems like a soft, breathable mask.....but they make no claims that they will significantly reduce your chances of catching Covid from someone nearby. That said, if the only goal is to meet masking requirements in public places, then it "works".

Keep in mind that it's also pretty unclear the long term effects of contracting COVID (even with no symptoms) in the first place. What about getting COVID twice? Three times? Four times? I'd rather do what I can to ensure my kids don't get it at all, are vaccinated, social distance, etc. Hopefully we'll get to a place where vaccinations / natural immunity reduce cases to a point where masks no longer make sense, but until then...

Since this article is about children, there is a lot of evidence to show that kids are experiencing developmental delays that are likely correlated with masking. The long term effects of which is not yet well understood. I would much rather live in a country that challenges assumptions and fosters debate, instead of blindly pursuing countermeasures that may have extremely detrimental outcomes in the future.

At the beginning of pandemic, gov sends cloth mask all house. I think this was good try at the time, but finally the mask isn't used well because non-woven mask become available soon. Now gov still has huge cloth mask stocks.

After that, some research suggests that nonwoven mask is the best for protect, cloth mask isn't the best, urethane mask is relatively bad. But because the gov sends and still has cloth mask, gov don't want to say avoid using other than nonwoven masks.

Anyway over 80% (I assume) of people wear non woven mask so totally fine.

If wearing red shirts on Tuesdays gave me a 0.001% improvement in my kid not being infected, sure as shit I'd be wearing red shirts on Tuesdays and convincing everyone I could to do the same.

Are you unaware of the massive amounts of clear-cut evidence that properly worn quality masks substantially reduce the transmission of covid? Come on.

Jesus.

Sorry, but yes, arguing that away is dumb. Not just dumb, but it gets people dead. So... good for you?

Look at the way the article hand-waves away the Bangladesh study... that only makes sense if children transmit covid in a substantially different way than adults. What's the justification for that? Our model for covid transmission is by droplets, particularly from the mouth, such as when exclaiming, shouting, etc. and that masks inhibit such transmission by catching the droplets. Without some evidence it's hard to conceive of how children would be less prone to this, making mask-wearing more important for them to reduce transmission.

> unfounded inferences

What's your argument? That children probably cannot be educated to do anything whatsoever? Hey, schools are pointless in their entirety, so we can cancel all that and the mask issue goes away naturally. Dumb.

I am not saying vaccines and masks have no benefit. Vaccines have a substantial personal benefit and a more marginal communal benefit.

Mask done perfectly have a decent personal and communal benefit. However, masks are not done perfectly and never will be.

The question is should we have mandates? Should we have vaccine mandates along the lines of “get the vaccine or get fired?” for marginal and waning communal benefit. If so should we extend this marginal logic to other marginally communally beneficial prevention measures? Eg. Protests are spreader events. These hurt the community. Attend a protest and you’re fired. I don’t think either is reasonable.

In regards to mask mandates we are forcing kids to wear masks at school but we are not mandating adults wear masks at restaurants, bars, movie theatres, concerts, football games etc. It doesn’t matter if the kids had perfect mask compliance (and they dont) the exposure to adults is everywhere. Also mask mandates do not impact behavior much. So why do we have them for students? I think it is mostly because adults want security theater and are used to telling kids to do something they themselves are unwilling to do.

Eventually you will come in to contact with a virus, unless you plan to remove all contact with people and animals.

Shouldn’t we move on at this point? What is the end goal here? Why are fully vaccinated adults continuing to freak out about Covid?

Great justification for making 5 year-olds wear masks for 6+ hours 5 days a week in school. This makes even more sense for the 5 year old kids that have ESL or Speech Pathology needs.

By that reasoning you would only wear masks when rates are very high. But a lot of schools require it when case rates are very low.

The idea that somehow getting or not getting COVID is due to level of diligence is absurd on its face.

I get tested after each exposure and have yet to get it either.

Wearing masks and not catching covid is like wearing a bandana and not getting into a bike accident. It is an extremely contagious aerosolized virus that cloth masks simply aren't sufficient to stop.

Meanwhile, the effects of perpetual masking are obvious- harmful to deaf people, harmful to the development of speech and socialization in children, asthmatics and more.

The only way you're getting away with this is either by having some innate immunity, or by simply not noticing you've had it.

I wouldn't have realised if not for a friend saying "get a test", my only symptom was a purple line on a bit of paper. I actually felt better than normal because I went out drinking less.

Or you did and were asymptomatic. Something on the order of 70% of cases are largely asymptomatic IIRC. Unless you're claiming you got a PCR test every 21 days since the beginning of the pandemic?

I don't think it is possible to avoid Coronavirus at this point. Unless someone had barricaded themselves in for the past 2 years they are likely to have had contact with the virus at this point.

Our school requires masks at all times on campus, inside or outside, vaccinated or not (we're in California). However, prior to omicron we had 0 cases (school has about 500 people at it teachers+staff+kids). With Omicron we've only had 37 cases.

That was exactly the CDC’s publicly stated view at the time. Pre-Delta, it was to a first approximation true. Citing this as if it’s evidence of her spreading misinformation is exceptionally dishonest.

My daughter who is 3 and thus unvaccinated, caught Omicron at daycare. Unfortunately the parents of the child who was spreading it, neglected to inform the daycare that the child was positive. Because of this, we unknowingly spread it to my 81 year old mother in law. This was around Christmas and although she is ok, it was a little touch and go for a while.

I imagine I'm far from the only person who found themselves in this kind of situation.

Masking in restaurants for the twenty feet from entrance to table is a bit silly, though.

As for restaurants... where do you need to wear a mask in a restaurant these days? I often wear it when talking to the host, just to be polite, but that is the only moment I wear a mask in a restaurant.

As for vaccines, they are the "answer" because they dramatically reduce hospitalizations and all of the downstream catastrophes that come from overwhelmed hospitals.

What we do know - based on mountains of data - is that vaccinated people take up hospital beds far, far less often than unvaccinated people.

That's not something that is indicative of good leadership, even if supposedly done for benevolent reasons.