When and how should we open schools?

skatingguy

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Not sure if this info has been posted.

Mask Wearing in Children and *********-19 - What we know so far.

https://www.publichealthontario.ca/...8/wwksf-wearing-masks-children.pdf?sc_lang=en

Key Findings

 There were limited studies directly evaluating the isolated effectiveness of mask wearing in children. However, several studies found that mask mandates in schools have been associated with lower incidence of severe acute respiratory ******** 2 (SARS-CoV-2) infection. Wearing masks for outdoor sporting events is unlikely to be beneficial. Many of the studies examining *********-19 incidence in schools had layered infection prevention and control measures in place, so it was challenging to measure the independent impact of mask wearing. In addition, most of the studies examined did not consider mask wearing in settings where variants of concern (VOCs) were circulating.

 Relatively little research has been published with respect to mask wearing behaviour and compliance in children. However, from the available studies of school and community settings, adherence to mask policies was typically high in children (53–97%) and uptake increased with age.

 There were variable findings with respect to negative health impacts in children who wore masks. Further research is needed to assess potential negative impacts of mask wearing in children, especially for longer-term use of masks.
 

Louis

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OK, let's start with the World Health Organization, which says children under 5 should not wear a mask, children playing sports should not wear a mask, and "the use of masks for children of any age with developmental disorders, disabilities or other specific health conditions should not be mandatory and be assessed on a case by case basis by the child’s parent, guardian, educator and/or medical provide."
https://www.who.int/news-room/q-a-detail/q-a-children-and-masks-related-to-c*vid-19 Yet, the U.S. stubbornly advocates wearing masks at the age of two, and many places enforce mask wearing in situations against the recommendation of WHO. Prior to politics changing the narrative and groupthink replacing science, WHO cited the side effects of headache, skin lesions, dermatitis/acne, and self-contamination, but most of those have been removed as far as I can see.

The below is a meta-analysis that draws from 65 scientific papers and is a good summary of the scientific evidence against the risk of mask-wearing. Few if any of these studies would meet a "gold standard," but analysis across them lends credibility to the results (and there are absolutely zero studies showing clear and conclusive benefit to masking children). I also place more weight on pre-2020 studies because they're free of the political bias and groupthink that has infected the scientific community.
 

allezfred

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Even I think wearing masks at the age of two is completely impractical.
 

Miezekatze

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I think the US is the only country who recommends that (and maybe parts of Canada?).

In Germany it's from 6 years on.
 

missing

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Schools are seeing a major increase in the number of cases among their students.

(CNN)As school districts across the country reopen, some state officials are voicing concern about the vulnerability of children as the highly contagious ******** Delta variant takes aim at the unvaccinated.

*********-19 cases are surging among children as the school year begins -- many in districts without mask mandates -- and the ********* continues to force quarantines and other disruptions.

The latest weekly count of new pediatric cases -- 243,373 -- is about a 240% increase since July, the American Academy of Pediatrics said Monday...

So far, more than 5 million children have tested positive for *********-19 since the start of the *********, representing 15.1% of all US cases...

In the past week, Ohio saw a 44% increase in cases among school-aged children, compared to a 17% jump in the rest of the population.

The statement said school districts where masks are optional have seen a 54% week-over-week increase in cases, compared to a 34% spike in districts with mask requirements.
 
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Debdelilah2

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OK, let's start with the World Health Organization, which says children under 5 should not wear a mask, children playing sports should not wear a mask, and "the use of masks for children of any age with developmental disorders, disabilities or other specific health conditions should not be mandatory and be assessed on a case by case basis by the child’s parent, guardian, educator and/or medical provide."
https://www.who.int/news-room/q-a-detail/q-a-children-and-masks-related-to-c*vid-19 Yet, the U.S. stubbornly advocates wearing masks at the age of two, and many places enforce mask wearing in situations against the recommendation of WHO. Prior to politics changing the narrative and groupthink replacing science, WHO cited the side effects of headache, skin lesions, dermatitis/acne, and self-contamination, but most of those have been removed as far as I can see.

The below is a meta-analysis that draws from 65 scientific papers and is a good summary of the scientific evidence against the risk of mask-wearing. Few if any of these studies would meet a "gold standard," but analysis across them lends credibility to the results (and there are absolutely zero studies showing clear and conclusive benefit to masking children). I also place more weight on pre-2020 studies because they're free of the political bias and groupthink that has infected the scientific community.
I agree that 2 is probably too young. But I think you’ve been arguing against mask mandates for schools in general. Mask mandates can and do already have exceptions written in. Perhaps we should be advocating for a revision of the age rule. Here are exceptions in Virginia’s that apply to some of the criteria you mentioned.
-Any person who has a disability or meets at-risk criteria or those assisting such persons, including individuals with an Individualized Education Plan (IEP) or 504 plan under the Rehabilitation Act, where wearing a mask would inhibit communication or the receiving of services.
  • Persons with health conditions or disabilities that prohibit wearing a mask. Nothing in this Order shall require the use of a mask by any person for whom doing so would be contrary to his or her health or safety.
  • Pre-********* mask studies in schools
  • These studies were specific to influenza but they did support the use of relatively thin, non-N95 masks in schools. The studies used disposable masks, which like cloth masks would only trap large particles
  • The pre-********* mask paper contains a lot of specific data about influenza and when it is contagious and how it spreads among kids vs other groups. I don’t think the political controversy is a reason to avoid reading ********* era specifics.
 

Prancer

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OK, let's start with the World Health Organization, which says children under 5 should not wear a mask, children playing sports should not wear a mask, and "the use of masks for children of any age with developmental disorders, disabilities or other specific health conditions should not be mandatory and be assessed on a case by case basis by the child’s parent, guardian, educator and/or medical provide."
I am aware of this, which is why I didn't ask you for sources that are against mask wearing. Are my posts unclear?

The below is a meta-analysis that draws from 65 scientific papers and is a good summary of the scientific evidence against the risk of mask-wearing. Few if any of these studies would meet a "gold standard," but analysis across them lends credibility to the results (and there are absolutely zero studies showing clear and conclusive benefit to masking children). I also place more weight on pre-2020 studies because they're free of the political bias and groupthink that has infected the scientific community.
Do you think that all this loaded language aids your cause or are you just unable to resist the urge?

I haven't read your studies yet (I am about to), but I must point out that most masking studies pre-2020 (when scientists were all free thinkers) found that masks were ineffective against disease transmission and not recommended for anyone outside of the medical community because they offered no benefit. We had this discussion before, I believe, in early 2020 in a thread on PI. So if I were inclined to think that scientists cannot look at evidence and assess it objectively, I would wonder how much this influenced the results of those pre-2020 studies, before scientists apparently all melded into the Borg and lost their ability to reason. But I am sure that was not the case before.
 

Prancer

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The below is a meta-analysis that draws from 65 scientific papers
Reading along...Thirty papers referred to surgical masks (68%), 30 publications related to N95 masks (68%), and only 10 studies pertained to fabric masks (23%). Since children aren't wearing surgical or N95 masks, I think we can safely eliminate those from the discussion entirely. Or no? Is there a reason I need to look at them?

The researchers specifically looked for studies that found negative effects from wearing masks. That's what you do if you are looking at the negative effects of wearing masks. However, it also skews the results when ALL of your sources find negative effects of wearing masks. I would prefer to see something that looked at effects of mask-wearing from a more neutral stance, but moving along.

Heh. I see they reference one study that moebius cited a while back. IIRC (and I am pretty sure I do), the researchers issued a statement saying their study should not be used to discuss masking for the general public. It does not, in any case, really address negative side effects of mask wearing, only the inefficacy of cloth masks.

I am seeing a lot references to "statistically significant" results, which generally means "negligible for most intents and purposes," but I will look into what those numbers mean tomorrow or maybe Friday, as I am too tired to math right now.
 

Prancer

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Reading along...Thirty papers referred to surgical masks (68%), 30 publications related to N95 masks (68%), and only 10 studies pertained to fabric masks (23%). Since children aren't wearing surgical or N95 masks, I think we can safely eliminate those from the discussion entirely. Or no? Is there a reason I need to look at them?
I will go with yes in some cases, as the psychological and some of the physical effects of wearing masks would be similar across the board.
When I see "statistically significant" results, I immediately think p-hacking.
I don't, as statistically significant results can be genuinely significant--but they don't mean a lot without further study.

Having slogged through the entire paper, I haven't really changed my mind about anything.

Masks can cause some people problems. Those problems are nearly always mild and, given that self-reporting is usually the sole evidence offered against cloth masks, it's difficult to even demonstrate a direct connection between mask wearing and a particular problem. Correlation is not causation, after all. As Louis said, these are not gold standard tests. But getting gold standard tests isn't all that likely to happen, at least not any time soon, so we have to go with what we have. Most of the problems associated with masks would be classed by me at least as annoying more than anything else.

There are people who suffer from mask wearing, but that is what exemptions are for.

So if I'm supposed to concede here that masks can cause some people problems, sure. But I knew that already. And I don't think the evidence for children wearing masks is particularly strong (which I also said already).

But here's the thing--it is pretty well-established that children are the primary source of influenza spread in communities. I actually heard that for the first time from one of Louis' beloved Swedish epidemiologists and I've read it in a number of pieces written by health authorities who are against masking children (none of which I have seen linked here, which is kind of interesting). That is the basis, at least as I understand it, of the CDC's guidelines for masking children--that if children are the primary spreaders of influenza, it is likely that they are also going to be primary spreaders of similar respiratory diseases. A number of the anti-mask authorities I have read don't even dispute that this is likely. Their argument is, instead, that we are sacrificing children to save (unvaccinated) adults. However, it has never been established that children are spreading ********* infections through their communities.

Given the amount of reading I think Louis has done on this issue, I am sure he knows this already, but for anyone who is interested, there you are.

So again, to me it comes down to which side of caution you want to err on--should we risk making children wear masks even though there are some mostly mild issues and there could possibly be long-term side effects because it would theoretically reduce the spread of disease or should we not force children to wear masks because there are some mostly mild issues and possible (but theoretical) longterm side effects, even though having children wear masks might reduce the spread of infection in a community?

I don't see a strong case either way as far as science goes--and this paper did nothing to convince me that there is even a good basis for thinking that masks are significantly harmful to anyone beyond a select few. Louis' default position (as he has so often told us) is that unless there is strong evidence to support any restrictions, freedom should always be paramount. Well, that's an opinion. But there's not a whole lot of evidence to support it, either, and I am kinda :confused: at the idea that our laws support this. Um, our laws ARE restrictions far more than they are anything else, just like everyone else's laws. But that's an issue for a different thread.

My take, for what it's worth, is that it will be a good 10 years before we really know the answers to any of this, if we know it then. I expected from day one that we were going to have to muddle through all this and get a lot of things wrong because that's science in action. Scientists are going to disagree, sometimes vehemently, and they are going to change their minds as new evidence emerges. It's a horribly unstable way to live, but I don't see how we get around that.
 

Debdelilah2

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I will go with yes in some cases, as the psychological and some of the physical effects of wearing masks would be similar across the board.

I don't, as statistically significant results can be genuinely significant--but they don't mean a lot without further study.

Having slogged through the entire paper, I haven't really changed my mind about anything.

Masks can cause some people problems. Those problems are nearly always mild and, given that self-reporting is usually the sole evidence offered against cloth masks, it's difficult to even demonstrate a direct connection between mask wearing and a particular problem. Correlation is not causation, after all. As Louis said, these are not gold standard tests. But getting gold standard tests isn't all that likely to happen, at least not any time soon, so we have to go with what we have. Most of the problems associated with masks would be classed by me at least as annoying more than anything else.

There are people who suffer from mask wearing, but that is what exemptions are for.

So if I'm supposed to concede here that masks can cause some people problems, sure. But I knew that already. And I don't think the the evidence for children wearing masks is particularly strong (which I also said already).

But here's the thing--it is pretty well-established that children are the primary source of influenza spread in communities. I actually heard that for the first time from one of Louis' beloved Swedish epidemiologists and I've read it in a number of pieces written by health authorities who are against masking children (none of which I have seen linked here, which is kind of interesting). That is the basis, at least as I understand it, of the CDC's guidelines for masking children--that if children are the primary spreaders of influenza, it is likely that they are also going to be primary spreaders of similar respiratory diseases. A number of the anti-mask authorities I have read don't even dispute that this is likely. Their argument is, instead, that we are sacrificing children to save (unvaccinated) adults. However, it has never been established that children are spreading ********* infections through their communities.

Given the amount of reading I think Louis has done on this issue, I am sure he knows this already, but for anyone who is interested, there you are.

So again, to me it comes down to which side of caution you want to err on--should we risk making children wear masks even though there are some mostly mild issues and there could possibly be long-term side effects because it would theoretically reduce the spread of disease or should we not force children to wear masks because there are some mostly mild issues and possible (but completely theoretical) longterm side effects, even though having children wear masks might reduce the spread of infection in a community?

I don't see a strong case either way as far as science goes--and this paper did nothing to convince me that there is even a good basis for thinking that masks are significantly harmful to anyone beyond a select few. Louis' default position (as he has so often told us) is that unless there is strong evidence to support any restrictions, freedom should always be paramount. Well, that's an opinion. But there's not a whole lot of evidence to support it, either, and I am kinda :confused: at the idea that our laws support this. Um, our laws ARE restrictions far more than they are anything else, just like everyone else's laws. But that's an issue for a different thread.

My take, for what it's worth, is that it will be a good 10 years before we really know the answers to any of this, if we know it then. I expected from day one that we were going to have to muddle through all this and get a lot of things wrong because that's science in action. Scientists are going to disagree, sometimes vehemently, and they are going to change their minds as new evidence emerges. It's a horribly unstable way to live, but I don't see how we get around that.
Delta variant differences
The link above shows some of the more recent, delta-specific data as it applies to children having symptomatic disease from the delta variant vs. previously
Cloth masks are credited for helping to end the Manchurian plague of 1910, which killed over 60,000 people and had a mortality rate of near 100 percent. And they do block 51 percent of respiratory droplets, and don’t affect carbon dioxide levels, so they don’t cause headaches.
Manchurian plague
Retracted study
Pro-mask evidence review
 
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MsZem

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Reading along...Thirty papers referred to surgical masks (68%), 30 publications related to N95 masks (68%), and only 10 studies pertained to fabric masks (23%). Since children aren't wearing surgical or N95 masks, I think we can safely eliminate those from the discussion entirely. Or no? Is there a reason I need to look at them?
That would depend on where the studies were conducted. Children in Israel, for example, typically wear child-sized surgical masks.

The researchers specifically looked for studies that found negative effects from wearing masks. That's what you do if you are looking at the negative effects of wearing masks. However, it also skews the results when ALL of your sources find negative effects of wearing masks. I would prefer to see something that looked at effects of mask-wearing from a more neutral stance, but moving along.
A meta-analysis, of course, is only as good as the research that goes into it - very much a garbage in, garbage out situation. And when that happens, it can actually amplify dodgy results.

When I see "statistically significant" results, I immediately think p-hacking.
That's unfortunate, because there's plenty of sound research that's reported like this, and statistical significance does have some meaning. Also, a lot of results that haven't replicated over the years are due to reasons other than p-hacking.
 

Miezekatze

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In Germany kids also all wear kids surgical masks (or even FFP2 with older kids), since cloth masks are nearly completely banned in Germany (and Austria), at least indoors.

Generally the expert opinion here is that keeping schools open and having normalcy for kids is more important than protecting them from the *****, BUT the masks are just seen as a mild measure to achieve the goal of having open schools and normal life.

I think courts would also not consider masks a "restriction of personal freedom" (unlike more harsh ********* restrictions), after all it's more like a seatbelt or a motorcycle helmet or the rule that you can't walk around naked in public or whatever...

For example kids in Germany in many state now barely have to quarantine anymore when there's cases in their class. So they don't have to sit around at home without being allowed to leave their appartment so easily anymore. I'd guess most kids find being forced to stay at home for 14 days worse than wearing a mask at school and at some other places.
 

Susan1

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Post from a high school teacher on our chat page -
"Tales from MHS-Episode 1:
Today I received 2 emails about students that tested ********* positive in the last 24 hrs and asked to contact trace and send in the names of students that were within 3 ft for a minimum of 15 minutes. I have old school science tables in my classroom and most students share a table with another student. No students had to be quarantined because as of Monday all students were wearing masks. That’s the point/reason for the MCS mask mandate. Keep kids in school to LEARN. It worked.
Tales from MHS-Episode 2:
Last week in the Neighborhood Chat a member very clearly said that his kid WILL NOT be wearing a mask at school this week.
Update: the HS child of this individual wore a mask every day, no issues, voluntarily.
Moral of this story: the kids are fine. As a matter of fact they are great. It’s the parents that are the problems.
Tales from MHS-Episode 3:
This week I received an email from the district Superintendent that had APPROVED a mask exemption for religious reasons for a student. That student had VOLUNTARILY worn a mask EVERY DAY, all year, PRIOR to the mask mandate and continued to wear a mask all this week on their own accord. Once again…the kids are doing great!"

And there are two other women saying their kids come home with migraines. Isn't a migraine a different kind of headache? Overdramatization? Don't kids have headaches anyway - eye strain, stress, lately - cleaning products, an excuse not to do homework or chores. The parents probably tell them it's the mask giving them headaches. I haven't heard how the school board meeting went last night. I said earlier, they might end up on CNN like some of the others I've seen, because they were trying to get people with "differing opinions" to show up.
 

Prancer

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That would depend on where the studies were conducted. Children in Israel, for example, typically wear child-sized surgical masks.
There are only a few studies on children and masking and they are from Great Britain, Singapore, and Germany, I believe, along with some sources like surveys from the US, some discussion of guidelines and some sources about children that really aren't about masking specifically but about things like social development.

Most of the discussion about children, which is relatively brief, is focused on discussion of concerns extrapolated from studies on adults because "It can be assumed that the potential adverse mask effects described for adults are all the more valid for children."

I might have missed something, though; there are a lot of references.

In any case, Louis' ire is directed at US masking policies and children here are wearing cloth masks.

A meta-analysis, of course, is only as good as the research that goes into it - very much a garbage in, garbage out situation. And when that happens, it can actually amplify dodgy results.
Most people who would read this would almost certainly come away from it with some really skewed ideas about the dangers of masks, if for no other reason than there is such a litany of complaints about them, but there are so few masochists in the world who will read all of it that it shouldn't be too much of a problem :p.
 

MacMadame

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Dobre

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I believe this is the study that I've read referenced several times. (The first news cast that I saw referencing it stated that it showed 40% of the school populace would be infected in 2 months without masks):

Researchers from NC State, UNC study effectiveness of masks, random testing in schools​


*********-19 Projections for K12 Schools in Fall 2021: Significant Transmission without Interventions​


"Our analysis considers three levels of incoming protection (30%, 40%, or 50%; denoted as “low”, “mid”, or “high”). Universal mask usage decreases infectivity by 50%, and weekly testing may occur among 50% of the student population; positive tests prompt quarantine until recovery, with compliance contingent on symptom status.

Results Without masking and testing, more than 75% of susceptible students become get infected within three months in all settings. With masking, this values decreases to 50% for “low” incoming protection settings (“mid”=35%, “high”=24%). Testing half the masked population (“testing”) further drops infections to 22% (16%, 13%).

Conclusion Without interventions in place, the vast majority of susceptible students will become infected through the semester. Universal masking can reduce student infections by 26-78%, and biweekly testing along with masking reduces infections by another 50%.
 

Dobre

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I guess I misinterpreted your post. I thought we were having a discussion on studies that showed whether masks were effective at reducing spread in schools. (Rather than just on studies that Louis was bringing into the thread).
 

Prancer

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I guess I misinterpreted your post. I thought we were having a discussion on studies that showed whether masks were effective at reducing spread in schools. (Rather than just on studies that Louis was bringing into the thread).
If I did address that, it was within the context of Louis' link.

In any case, the NC study hasn't been peer reviewed yet according to what I have read, so I would advise waiting to see how well it holds up before you count it as anything other than interesting.
 

Dobre

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Yes, I know it has not been peer reviewed yet. I was just wondering if that was the reason you had not mentioned it & if all the other referenced studies above had been peer reviewed. Or if you were not mentioning it for another reason.

I assume now, based on your response, that you had not mentioned it because you were directly discussing the studies Louis was addressing.
 

Prancer

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Yes, I know it has not been peer reviewed yet. I was just wondering if that was the reason you had not mentioned it & if all the other referenced studies above had been peer reviewed. Or if you were not mentioning it for another reason.

I assume now, based on your response, that you had not mentioned it because you were directly discussing the studies Louis was addressing.
If you look at studies on children transmitting *********, most indicate that children do not spread the disease at high rates. Most of these studies were done pre-Delta, so that's a consideration. But I would not say that there is a strong case for masking kids in schools based on the evidence to date. One study isn't going to change that.

I would predict that in the long run, the evidence is going to show that children do spread ********* in schools and that masking children does prevent the spread of infections, and I think that's what is driving the CDC's position on this, but I don't think the evidence supports that now. As the CDC says, the evidence is still evolving.

I am open to changing my mind on that, but not by getting a lot of links that show only evidence that supports masking kids. If you are going to do effective research, you have to look at the best research available to date, regardless of the conclusion. There are statements in Louis' linked meta-study, for example, that strike me as overtly biased; combine that with the overtly cherry-picked studies included in the study and it's not at all persuasive.

One problem I have with a lot of this kind of research is that I don't think we have a good handle on the overall quality of these studies yet.
 

Debdelilah2

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Yes, I know it has not been peer reviewed yet. I was just wondering if that was the reason you had not mentioned it & if all the other referenced studies above had been peer reviewed. Or if you were not mentioning it for another reason.

I assume now, based on your response, that you had not mentioned it because you were directly discussing the studies Louis was addressing.
Is it cited in the meta-analysis Louis linked? Because if not, why would I "count" it in posts about the meta-analysis Louis posted? :confused:
I read Louis’s meta analysis too, and it had some studies that claim very high levels of CO2 when masking. Other studies that measure the same thing put a tube near the nose to measure the breathing zone CO2 as opposed to the total CO2 in the mask, and come up with a number that is lower by far. But both oxygen and carbon dioxide are small particles, smaller than the respiratory droplets the masks are designed to catch. And of course outside air is coming in, so a person doesn’t only inhale the contents of the mask. The CDC’s site has articles that directly address some of these claims.
CDC studies
Quote from CDC page above:
“Research supports that mask wearing has no significant adverse health effects for wearers. Studies of healthy hospital workers, older adults, and adults with COPD reported no change in oxygen or carbon dioxide levels while wearing a cloth or surgical mask either during rest or physical activity.”
But I was also trying to look for sites outside the CDC and get some more perspective.
To quote one of the sections in Louis’ meta-analysis:
“According to the latest scientific findings, blood-gas shifts towards hypoxia and hypercapnia not only have an influence on the described immediate, psychological and physiological reactions on a macroscopic and microscopic level, but additionally on gene expression and metabolism on a molecular cellular level in many different body cells. Through this, the drastic disruptive intervention of masks in the physiology of the body also becomes clear down to the cellular level, e.g., in the activation of hypoxia-induced factor (HIF) through both hypercapnia and hypoxia-like effects [160].”
The study in the link at 160 doesn’t actually say anything specific about masks. It is a pre-********* study about hypoxia.
But according to the CDC’s studies, which are also peer reviewed, masks do not cause hypoxia.
I found it interesting to read the pre-********* article about flu from 2018, because it was clear to me from that that the most troubling issues (like headaches) were reported long before ********* and by people who chose to wear masks anyway, despite the side effects(like the study in Japan). The person who wrote that article wanted to improve the design of masks, which is already happening now; there are N95 masks that allow easier breathing in use by doctors.
It was also insightful because it shows certain possible differences masks can have; for instance, is a mask scary if it has a colorful design or cartoon? Is it scary mostly if it’s seen in a culture where wearing a mask indicates you’re very sick? These are things that can change over time. Not sure what to make of psychological effects studies, except I think mask design could be better and is better than it used to be. And culture too - would ********* have spread as much as it did if people didn’t reserve mask use for “feeling extremely sick”? Thinking of the people who attended business conferences and other events a bit sick, and just the general culture. The 2018 paper talked about how some people felt uncomfortable mentally in masks even when they were wearing them to protect others from the flu, just because use of them was so uncommon at the time and people reacted negatively, but that changed when more people wore them after the swine flu *********.
 
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Prancer

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I read Louis’s meta analysis too, and it had some studies that claim very high levels of CO2 when masking.
I didn't linger on that part because I knew there were other studies that directly contradicted those findings (and also because the really high levels were for N95 masks).

Again, the researchers overtly stated that they were only looking at studies that showed negative effects of wearing masks. Their justification for this is:

Our approach with a focus on negative effects is in line with Villalonga-Olives and Kawachi [12]. With the help of such selective questioning in the sense of dialectics, new insights can be gained that might otherwise have remained hidden. Our literature search focused on adverse negative effects of masks, in particular to point out risks especially for certain patient groups. Therefore, publications presenting only positive effects of masks were not considered in this review.

Okay. There are reasons for doing a study like this. But I don't see how anyone could look at this as anything other than cherry picking. This is not to say that their studies are bad or that their evidence should be dismissed out of hand; it's just that you have to go into this recognizing that what you are reading is not a balanced view.

As I tell my students, if you are only finding research that supports your own position, you aren't doing it right.
 

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