The United States’ decision to mask children as young as two for COVID-19 has been extended into 2023 and beyond: The implications of this policy

Høeg, Tracy Beth; González‐Dambrauskas, Sebastián; Prasad, Vinay

doi:10.1016/j.prrv.2023.04.004

Cited by 4 publications

(8 citation statements)

References 5 publications

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“…However, the presence of widespread disagreement among experts, remaining ambiguity of evidence, with pooled randomized trials being negative, and the presence of recent and ongoing randomized investigations all support the presence of equipoise. At the same time, weighing the current high-quality evidence with known and potential harms [ 11 ], recommending masking for children goes against basic medical ethics. Currently, the onus lies with the public health agencies that continue to recommend masking children, especially when this can lead to mandates, to produce high-quality data to guide their recommendations rather than rely on low-quality observational data as if it were settled science.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple international experts have argued against masking children citing both a lack of high-quality evidence of benefit and concerns about harms to learning and development [ [8] , [9] , [10] ], especially among pre-school age children [ 10 ]. One review by physicians from Uruguay and the United States pointed to a long list of studies documenting harms associated with masking children including increased anxiety, physical discomfort, decreased learning ability and recognition of emotion and sound [ 11 ]. On the other hand, some experts from the United States [ 12 , 13 ] have pointed to the substantial effectiveness of masks noted in some observational studies against SARS-CoV-2 transmission as evidence masking children may even play a role in reducing systemic racism [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does equipoise exist for masking children for COVID-19?

Høeg,

González-Dambrauskas,

Prasad

2023

Public Health in Practice

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does equipoise exist for masking children for COVID-19?

Høeg,

González-Dambrauskas,

Prasad

2023

Public Health in Practice

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“…An extensive body of research has found harms associated with mask wearing or mask requirements in children. 56 These associated harms include negative impacts on speech, language and learning. Mask wearing causes reduced word identification 57–59 and impedes the ability to teach and evaluate speech.…”

Section: Discussionmentioning

confidence: 99%

Child mask mandates for COVID-19: a systematic review

Sandlund,

Duriseti,

Ladhani

et al. 2023

Arch Dis Child

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BackgroundMask mandates for children during the COVID-19 pandemic varied in different locations. A risk-benefit analysis of this intervention has not yet been performed. In this study, we performed a systematic review to assess research on the effectiveness of mask wearing in children.MethodsWe performed database searches up to February 2023. The studies were screened by title and abstract, and included studies were further screened as full-text references. A risk-of-bias analysis was performed by two independent reviewers and adjudicated by a third reviewer.ResultsWe screened 597 studies and included 22 in the final analysis. There were no randomised controlled trials in children assessing the benefits of mask wearing to reduce SARS-CoV-2 infection or transmission. The six observational studies reporting an association between child masking and lower infection rate or antibody seropositivity had critical (n=5) or serious (n=1) risk of bias; all six were potentially confounded by important differences between masked and unmasked groups and two were shown to have non-significant results when reanalysed. Sixteen other observational studies found no association between mask wearing and infection or transmission.ConclusionsReal-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.

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“…5 Ultimately the United States became an international outlier with the CDC recommending masks for anyone over two-years of age, and some states requiring school children to mask well into 2022. 6…”

Section: Introductionmentioning

confidence: 99%

“…10 The ongoing implementation of mask mandates continues to prompt debate as to whether these policies are supported by evidence. 6, 11, 12, 13…”

Section: Introductionmentioning

confidence: 99%

Face masks to control the source of respiratory infections: A systematic review of the scientific literature before and after COVID-19

Brown,

Haslam,

Prasad

2023

Preprint

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ObjectiveTo examine the scientific literature on mask-use as source control to protect others from respiratory infections before and after the onset of the COVID-19 pandemic.DesignSystematic review.MethodsWe examined primary research on mask usage as a means of source control to protect others by reducing the spread of respiratory diseases and contrasted the literature published before the onset of the COVID-19 pandemic with that published afterward. Articles were obtained through a search of PubMed and a review of article references. March 1, 2020 was selected as the cutoff date to distinguish between the pre-COVID-19 and post-COVID-19 periods.Results195 articles met our inclusion criteria. The sample included 55 articles on source control published before the start of the COVID-19 pandemic, and 140 articles published after the pandemic began, representing a 154.5% increase. The percentage of randomized control trials (RCT) and cluster RCTs declined by 94.9% (p<0.001), representing only 1.4% of the post-pandemic literature. The percentage of studies conducted on human subjects declined by 48.8% (p<0.001), and the percentage of studies in healthcare facilities declined by 64.5% (p=0.019). One in 5 post-pandemic studies (21.4%) were conducted in “real world” settings; 1 in 10 post-pandemic studies (10.0%) were done with computer modeling. Study authors were significantly more supportive of masks as source control in the post-pandemic literature.ConclusionsThe quality of evidence in the published literature on masks as source control is lower after the start of the COVID-19 pandemic, with notable shifts in methodologies, research subjects, setting, and author tone.

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The United States’ decision to mask children as young as two for COVID-19 has been extended into 2023 and beyond: The implications of this policy

Cited by 4 publications

References 5 publications

Does equipoise exist for masking children for COVID-19?

Does equipoise exist for masking children for COVID-19?

Child mask mandates for COVID-19: a systematic review

Face masks to control the source of respiratory infections: A systematic review of the scientific literature before and after COVID-19

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