We are living in a modern dystopia when, in the name of science, adults enjoy life unmasked while young children are masked; adults freely go to restaurants and gyms while children have attended school mainly by remote learning. The U.S. pandemic policies have firmly placed us in this position.

The Centers for Disease Control and Prevention released updated guidance for youth camps in late May that used vague wording that could be read as recommending continued outdoor masking of children. “People who are not fully vaccinated,” it said, “are encouraged to wear a mask in crowded outdoor settings or during activities that involve sustained close contact with other people who are not fully vaccinated.” Most group camp activities will require “sustained close contact.”

Since the CDC has yet to specifically address masking of children in other settings, gaps in the guidance have led to confusion. Some are using the camp guidance to extrapolate to other settings. As of now, the CDC recommends that unvaccinated people should wear masks anywhere they will be around other people.

As pediatricians, the two questions we must ask are “what is the scientific evidence to support the outdoor masking recommendation for children?” and “how will the endpoint for the masking of American children be determined?”

To answer the first question, the risk of outdoor transmission to and from children must be assessed. Many studies have shown that few infections are transmitted outdoors, regardless of age. A conservative estimate published in February in the Journal of Infectious Diseases found that the odds of indoor transmission are 18.7 times higher than outdoors.

However, according to current scientific evidence, masks are simply not necessary in outdoor settings. As with many things COVID-related, there is no one definitive study on pediatric outdoor masking. Our opinion is based on the fact that many studies conclude that outdoor transmission is highly unlikely and that children are less likely to transmit the virus than adults.

Coupled with the low rates of community transmission, it no longer makes sense to require children to be masked outdoors, despite being unvaccinated.

Children are regarded as vectors — people who harbor infectious diseases and infect others — for some respiratory and gastrointestinal viruses. But many studies examining the ability of children to spread COVID-19 in household and daycare, school or camp settings have determined that they have not been the primary drivers of transmission. Children are not the main COVID-19 vectors. Adults are.

Children are asking “when can we stop wearing masks?,” but we cannot give them a definitive answer because there is not one in sight. An endpoint based on vaccination of children 2-11 years is not acceptable. We don’t know when an approved vaccine will be available for this age group. The key to ending the pandemic is the vaccination of adults. For instance, Israeli COVID-19 rates plummeted after those 16 years old and above were vaccinated.

The United States is an outlier in the international community regarding masking of children. Recent guidance from the CDC advises keeping children as young as 2 masked when they are outdoors, while the World Health Organization recommends not masking children age 5 and under. England has never recommended masking for children younger than 11 and, based on low community transmission, no longer requires secondary students to wear masks at school.

The U.S. should develop metrics that allow our children to go maskless indoors when community rates are low. Influenza can lead to severe illness and hospitalizations in children ages 2 to 11, and the mortality rates in children for influenza and COVID are similar, yet mask mandates surely won’t be imposed every influenza season.

Top public health officials must establish an approach to masking based on the science and pair it with strong messaging that clearly relays children can safely attend school, summer camps and recreational programs — and neither parents nor youngsters need to worry about whether they should be wearing a mask outdoors.

The prolonged school closures of the last year have led to loss of learning milestones, along with a rise in obesity and declining mental health for children and parents. In order to make informed decisions, parents, teachers and pediatricians need evidence-based risk assessments that do not inflate risk of infection, transmission or severity of COVID in children.

It is the responsibility of the CDC to counter fear about COVID with a data-driven approach. Making children wear masks outdoors during physical activity is uncomfortable and may keep them from being physically active, particularly during hot summer months. It is also unnecessary.

Dr. Mayssa Abuali is a pediatric infectious diseases specialist at Einstein Medical Center in Philadelphia. Dr. Amy Beck is an associate professor of pediatrics at UC San Francisco. Also contributing to this article are Dr. Neeti Doshi, assistant professor of pediatrics at UCSF; Dr. Roshni Mathew, clinical associate professor of pediatric infectious disease at Stanford University; and Dr. Shawn Ralston, editor in chief of Hospital Pediatrics.

(22) comments

Plumbum

Kids around here in MD have been maskless outside playing the whole time. This out of state commentary dont really apply to us.

artandarchitecture

Kids in masks, & kids shot w/ experimental, non-FDA-approved injections is child abuse imho.

Gainesville parents in Florida concerned about the harm caused to their children wearing face masks all day at school in 90 °F weather sent out six masks—five that were worn by children ages 6 to 11 for five to eight hours at school, and one worn by an adult—to be analyzed for contaminants at the University of Florida’s Mass Spectrometry Research and Education Center.

Dangerous pathogens found on children’s face masks in COVID-19, 6/16/2021

https://rationalground.com/dangerous-pathogens-found-on-childrens-face-masks/

Parents Speak Out About Their Children Dying from the Vaccines by Daily Veracity Staff, June 17, 2021

https://www.dailyveracity.com/2021/06/17/parents-speak-out-about-their-children-dying-from-the-vaccines/

gabrielshorn2013

Still with the QAnnon stuff I see, A&A? The vaccines are not experimental. They were experimental before the clinical trials, but not after that. You never answered what parts of the BLA are still missing for full FDA approval. Did it have anything to do with safety? No. Manufacturing process? No. Quality Assurance? No. You claimed to work for FDA earlier, so you should know this, unless of course, that was not true... So, any references from a peer-reviewed scientific journal, like JAMA, NEJM, The Lancet, etc? Or will you continue to scrape the bottom of the barrel on QAnon-associated websites?

shiftless88

she was probably an admin for the FDA; answering phones or something.

gabrielshorn2013

True, but she claimed to work in the VAERS system earlier, yet didn't know how it worked. Huge red flag on credibility.

Greg F

VAERS needs janitors too.

threecents

Gabe, microbiologist inside joke: I think she might have a Coxiella infection.

gabrielshorn2013

🤣🤣🤣 Yeah, too much raw milk!

threecents

[thumbup]

artandarchitecture

I worked for AERS, *not* VAERS, gabriel. I'm not a scientist, but worked as a Quality Assurance Coding team leader in the reporting of drug adverse events. (This was back before everything was required to be submitted electronically. <--Still there's stuff that the computer can't read & needs to be manually examined & then entered. Cursive images, Latin abbreviations/shorthand from pharmacists & prescribing doctors, etc.)

BUT no matter, all you need is common sense to see through this bullcrap.

Since you likely gobble up W.H.O. recommendations*, as I type this, currently at the World Health Organization website:

"The World Health Organization (WHO) has a different approach. The WHO says do not vaccinate children, at least not yet.

At its website, the WHO offers this advice regarding giving experimental coronavirus vaccines, some of which are not even vaccines under the normal meaning of the term, to children:

Children should not be vaccinated for the moment. There is not yet enough evidence on the use of vaccines against COVID-19 in children to make recommendations for children to be vaccinated against COVID-19.

*Personally, I haven't forgot the proclamation made by WHO Director-General Tedros Adhanom Ghebreyesus that "stigma" is more dangerous than the global, viral, pandemic of Covid. That's right dear, your delicate sensibilities supersede any medicine & science! There's actually video of him saying this--probably burried on page 15 of search results.

Ghebreyesus receives a LOT of Communist Chinese Party money to share his opinions. But then again, so does our press:

“In June, China Daily filed a disclosure with the Justice Department showing that, since November 2016, it had paid $19 million to U.S. media outlets, including $12 million to newspapers such as the Washington Post and New York Times.”

The article also notes: “The practice does not seem to have caused any sort of actual uproar in the media circles that engage in it…

China: Paying US Media to Publish Propaganda Av: Judith Bergman 2. januar 2021, 15:15

https://www.news.com.au/national/who-boss-suggesting-the-stigma-of-covid19-is-worse-than-the-disease-is-farcical-bolt/video/95942dc984b5da7dc637f85709a6d6aa

gabrielshorn2013

A&A, it is quite clear that you are not a scientist. I am, and know how to read and interpret the data. I do it on a regular basis. It is quite clear that you are merely repeating QAnon talking points, without the ability to understand what is being said. Why you continue to spread such BS far and wide is yet to be determined. You keep bringing up these fringe websites, and completely ignore what scientific journals are saying. Such journals are not “mainstream media” as you repeatedly claim (such as newspapers and magazines), but are peer-reviewed journals where the articles are vetted against actual scientific knowledge by actual scientists working in a given field. China is not paying the Journal of the Americal Medical Association (JAMA), New England Journal of Medicine (NEJM), The Lancet, MMWR, and many others. Oh yeah, that’s right, the entire worldwide scientific community is “in on it”, causing the world population to become controllable robots to do the bidding of the world’s elite. SMH. Try verifying what your sources are saying on your fringe websites. They feed on each other, and none of what they publish is true or factual. The one I absolutely loved was the woman that claimed the vaccine made her “magnetic” causing metal to stick to her. Did you fall for that one too? She tried using a brass key on her neck as a demonstration of her vaccine-induced “magnetism”, LOL. Hint, non-ferrous metals, such as brass, are not magnetic! As for children not yet being recommended for vaccination, there are several reasons. First, in general, the lethality of CoViD-19 is proportional to age. Look at the mortality results reported in the Morbidity and Mortality Weekly Reports (MMWR) from CDC. In general, the very young are far less susceptible to SARS-CoV-2 infection than adults. That’s a fact. Second, there were no pediatric clinical trials of the vaccines until after the adult clinical trials, for ethical reasons. Adults can give consent, while children cannot. Once the vaccine was shown to be safe in adults, it was tried in juveniles. There was a miniscule level of myocarditis found in juveniles, but that was only slightly higher than background, which you claimed was “killing millions”. Back to VAERS vs. AERS. AERS is “Adverse Event Reporting System” for all drugs, while VAERS is the “Vaccine Adverse Event Reporting System”. Both report adverse events. The VAERS system that your “sources” refer to doses not require that a medical professional do the reporting. Any event may be reported into the system, and the scientists at FDA/CDC will then analyze the data to determine if there are any correlations. Here’s another clue. Someone in a clinical trial that died in a vehicle crash did not die due to effects of a vaccine. Read the landing page of the VAERS system before you cite it.

artandarchitecture

I have to update. It looks like the WHO has done the ol' switcheroo again within the last 3 hours, for those who actually attempt to try to follow their guidelines...

WHO Stealth Edits Page Warning Against Vaccinating Children - Tyler Durden

Tuesday, Jun 22, 2021 - 06:20 PM

https://www.zerohedge.com/covid-19/world-health-organization-says-do-not-give-children-experimental-coronavirus-vaccine-shots

gabrielshorn2013

A&A, if you read the WHO report, minus Durden's inane commentary, you will see that the statements make perfect sense, and comports with what I posted above. This is also consistent with FDA and CDC recommendations. Children under 18 were not vaccinated originally because there were no clinical trials showing their safety and efficacy (children cannot give informed consent by law). There was only adult data. Once the safety in adults was demonstrated, there was evidence that administering to children 12 to 18 could be safe, which the data from the clinical trials in that age group confirmed. Therefore, it is OK to immunize that population, and is exactly what the WHO report says. There is nothing contradictory as Durden claims, nor does Durden have the credentials to make such a claim. The next group of juveniles will be under 12. When that data shows safety and efficacy, will Durden (and you) claim that "Hey, look, they changed their minds again!!!" Jeez, ignorance must truly be bliss.

Greg F

Artie, go away with your debunked nonsense. The drugs are not experimental, they are tested and proven to be compliant with FDA and are as vigorously tested as anything that came before them, with side effects known for 99.9% of what happens at specific milestones that equal or surpass anything that has come before it...and these have been in development phase for at least a decade. Take your Qanon crap elsewhere.[ban]

threecents

At this point I see nothing wrong with anyone going maskless outside in Frederick County.

shiftless88

Like so many COVID-related articles, there are caveats to everything. Quoting Israel's results from vaccination means you have to look at their country, the vaccination spread and so on. Countries and localized regions are all at different places. States like Alabama that have few people vaccinated are not the same as places that have a large percentage vaccinated. And the specific activity is important. Right now kids are playing outdoor sports without masks, which is not the same as summer camp where you sit in a group all day inside.

Greg F

Vaccines are being tested now in younger kids. Can you not sacrifice anything? Your grandparents and other ancestors who sacrificed far more would be ashamed of you. Never heard that old saying "an ounce of prevention is worth a pound of cure" at all? Kids are still vulnerable 100%. Kids can still spread it 100%. Kids don't ever do the right thing when mom and dad aren't there, especially in this day and age when mom and dad don't even do the right things and we have football players who would rather retire than get a vaccine, and a GOP and followers who are overwhelmingly anti-science and the bulk of non-vaccinated adults. You can keep your germ bomb home if they can't wear a mask indoors where they should know better and bet taught by parents who should know better.

Greg F

I should add, not wearing outdoors is fine, so long as you are distance, use your hand sanitizer and no hugs, close contact, and other practices that should be common sense, but are uncommon anyone actually practices them.

Dwasserba

Re: sacrificing, I flashed on my grandfather being the youngest of six in “Old Allegheny,” the neighborhood near the river in Pittsburgh. He never knew his sibs, they all died the year before he was born. The year he was born, his mother died. Delphine. It was in every case, typhoid. His dad and he moved. And we knew of the stepmother situation and the younger half-brother, but not of the siblings at all, ever, until my cousin retired in the eighties and researched. It explained the tall pillar memorial in the family plot. Such a tragic wound it was apparently never spoken of. To grandfather it was not even in his recall. If there had been some simple but perhaps inconvenient alleged remedy addressing the unknowns they faced, would they have passed on it. Did they attempt whatever current thinking suggested would change the course of the illness. One wonders.

gary4books

This is a good article and has much to consider. However, we should remember that with new strains of virus and different circumstances, that past studies are limited. When we make plans based on limited information we are taking chances. Always ask "Is this risk worth the cost if we are wrong?"

Likely it will be safe. But only time will tell if we are right or not.

Greg F

Yep....the one thing I keep seeing over and over....kids in malls, stores, shops, and pretty much everywhere without masks....yet we know they should wear them and they are not vaccinated, not immune and can certainly spread to others. They can't even get that part right.

marinick1

Feel free to continue wearing your face diaper, Greg F, and to continue living in fear.

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