We’re now one year into this pandemic, and we have mountains of evidence on COVID and kids. Two things are clear: children are very unlikely to become infected with, become seriously ill, or suffer death from COVID-19. There is also large amounts of research available showing that young children are not significant drivers of the spread of COVID-19, including at school and at home.

Based on this evidence, it appears that there is no logical reason to subject children to adult-level mitigation and controls, particularly face-covering mandates in daycares, preschools, and schools, retail establishments, airplanes, and especially on public playgrounds.

At the very least, this practice should be seriously reevaluated, to come into alignment with the World Health Organization (WHO) recommendations, which encourages consideration for the “potential impact of wearing a mask on learning and psychosocial development, in consultation with teachers, parents/caregivers and/or medical providers.” The WHO states recommendations, which are followed worldwide except here in the United States, where the CDC makes recommendations, note that no child under age five should be put in a mask, and children aged 6-11 should be masked only under certain circumstances. This is why, when children fly on foreign airlines, they aren’t forced to mask until age six, and yet, in America, they are expected to do so from age two and up, due to guidance from the CDC.

It is time to balance any public health requirements with the medical necessity for children, as well as the impact on their overall wellbeing, psyche, and development, particularly because they lack the sovereignty to advocate for themselves. It is our duty as adults to not only protect the younger generation, but also do as much as possible to ensure they thrive.

There are real costs when it comes to masks and children. The first results of a German study of ~26,000 children and adolescents are clear on the impact of masks on kids: 68% of parents reported impairments in their children as a result of mask-wearing, including irritability (60%), headache (53%), difficulty concentrating (50%), decreased happiness (49%), malaise (42%), impaired learning (38%), fatigue (37%).

Writing for the Hill, a professor for special education at Towson University argued that masks for children in schools are needed or ethical. It’s worth quoting the piece at length, where she laid out a coherent argument against masking children,

It appears asymptomatic adults and, especially, children do not seem to have a substantial role in coronavirus spread. Experts have pointed out asymptomatic spread, while possible, seems uncommon in childcare settings, useful proxies for schools, particularly for younger grades. Despite sensationalized headlines on children’s viral load, multiple reviews and contact-tracing studies have failed to find instances of children infecting teachers and a German well-publicized survey (where most states do not require student masks) hypothesized that keeping schools open slowed transmission. One recent Norwegian study estimated that, with low community transmission, 200,000 people would need to wear facemasks to prevent one new infection per week; even with the elevated transmission, the number is 70,000. These figures suggest that if Philadelphia or Washington, DC, respectively, opened their public schools, having every student wear a mask would prevent one infection (not one hospitalization or death) per week. While other studies postulate greater benefits from masks for healthy people, they are not conducted on children and typically assume high asymptomatic transmission, a finding less relevant for pediatric populations. Further, children are unlikely to wear masks with the degree of compliance found in adult studies, leading to reduced benefits.

We must also consider potential adverse outcomes; children at low risk for COVID-19 complications and transmission are also less likely to have effective coping strategies, and their brains are still developing. Thus, the debate over students wearing masks in school all day is fundamentally different from the debate over masks for adults running errands at CVS. Pediatric mask-wearing has been found to have discernible effects on fear, anxiety, and language development. The author of one review on the topic recommended limiting the populations of children required to wear masks, the duration of mask-wearing, and the settings in which masks were required — advice that most states and schools have disregarded. In one survey of Polish young adults wearing masks due to COVID-19, 97 percent perceived inconvenience or adverse effects; 35 percent of those reported difficulty breathing. Mask-wearing at longer durations can impact thermoregulation and thermal stress. A recent German study found masks to have a “negative impact on cardiopulmonary capacity…and quality of life” and recommended these effects be balanced against potential reductions in viral transmission. It’s important to remember when we consider children that adverse effects are not merely “inconveniences” but, by increasing anxiety and physical stress, can materially impact their short and long-term health, well-being, and potential for school success.

Mask-wearing can be especially challenging for students with disabilities, including sensory processing disorder, Autism Spectrum Disorder, and mental health or intellectual disabilities. The World Health Organization states that mask-wearing should “not be mandatory” for children “of any age” who have “developmental disorders, disabilities or… health conditions”.

Covering children’s faces has the potential to impede verbal and nonverbal communication and, by extension, language development, and social skills — among the very things we send children to school to learn. It is near-impossible to imagine effective phonics instruction with everyone masked, especially for a phonetic (not pictographic) language such as English, which has a highly irregular system.

And is requiring masks in schools even effective? The evidence from Florida points to no.

What can we do about it? Unfortunately, the CDC is an unelected group of bureaucrats, unaccountable to the general public. They have a history of making ridiculous recommendations, from advising four-year-olds to rear face in car seats, to abstaining from eating raw cookie dough, to telling seniors not to drive at night. But now, their overly cautious, completely unrealistic recommendations have real-life consequences for families with young children who would like to go out in public. The CDC recommendations impact children on airplanes, in schools, in stores, and everywhere else. We have to make them accountable, for the sake of our children.

I’ve decided to start contacting our elected representatives, on the local and federal level, to advocate for children, and I hope you’ll join me. This is a copy of an email I sent to my Congressional representative yesterday:

My name is Bethany Mandel and I’m a constituent living in Silver Spring, Maryland. I’m writing you today about our federal policy regarding children and masks. The CDC recommendations, which are followed by retail establishments, daycares, schools, and the feds, require children aged two and over to wear masks. There is no epidemiological reason for this, and as such, the WHO has their policy set that children five and under are not required to be in masks, and that discretion should be used in children aged 6-11.

This policy is an undue burden on families with young children. It means we cannot bring children developmentally unable to wear masks into stores or on planes; basically anywhere in public. A child with autism was recently kicked off a Spirit Airlines flight because his autism made wearing masks impossible. His father had to pay $1,000 to fly home at their own expenses. There are stories along these lines from every major airline; parents removed from flights because their children are developmentally unable to wear a mask.

I would like you to advocate for families of young children and children with special needs and ask the CDC what reasoning they have for the guidance they’ve set and why it differs so drastically from that of the WHO.