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Go figure: School mask requirements worked in curbing Covid-19 cases, researchers say

Boston and Chelsea managed to reduce Covid-19 rates among their public school students and staff simply by requiring them to keep wearing masks after the state lifted its requirements, researchers report in a recent New England Journal of Medicine article.

Public-health researchers from Harvard, Boston University, Mass. General, Brigham and Women's and the Boston Public Health Commission looked at reported Covid-19 rates in 72 Boston-area school districts after the state lifted its school masking requirement on Feb. 28 - Boston and Chelsea continued to require masks through the end of the school year in June while all the other districts lifted their requirements within three weeks of the state ending its mandate.

Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded. ...

Before the statewide masking policy was rescinded, the trends in the incidence of Covid-19 observed in the Boston and Chelsea districts were similar to the trends in school districts that later lifted masking requirements. However, after the statewide masking policy was rescinded, the trends in the incidence of Covid-19 diverged, with a substantially higher incidence observed in school districts that lifted masking requirements than in school districts that sustained masking requirements. These trends were observed among students and staff overall, as well as among students alone and among staff alone.

They continued:

Before masking requirements were lifted, difference-in-differences estimates were essentially zero, a finding that supports the assumption of parallel trends. After masking requirements were lifted, the lifting of masking requirements was consistently associated with additional Covid-19 cases. The effect was significant during 12 of the 15 weeks after masking requirements were lifted. Weekly estimates ranged from 1.4 additional cases per 1000 students and staff (95% confidence interval [CI], 0.6 to 2.3) in the first reporting week after masking requirements were lifted to 9.7 additional cases per 1000 students and staff (95% CI, 7.1 to 12.3) in the ninth reporting week.

The authors said the results were particularly significant because:

In our study, school districts that chose to sustain masking requirements longer tended to have school buildings in worse physical condition and more students per classroom, and these districts had higher percentages of students and staff already made vulnerable by historical and contemporary systems of oppression (e.g., racism, capitalism, xenophobia, and ableism). In Boston and Chelsea, more than 80% of the students are Black, Latinx, or people of color, and these cities were among the Massachusetts cities and towns that were hit hardest by Covid-19. Students and families in these school districts have strongly advocated and organized for governmental action to increase Covid-19 protections in schools, emphasizing their role as essential workers, the risk to vulnerable family members, and the unequal consequences of missed work and school. The decision in some school districts to sustain school masking policies longer may therefore reflect an understanding among parents and elected officials that structural racism is embedded in public policies and that policy decisions have the potential to rectify or reproduce health inequities.

They added that supposed alternatives to masking, such as good ventilation, were themselves not as effective as masking:

or example, in Lexington, MA, a comparison district approximately 10 miles from Boston, mean student and staff absences due to Covid-19 during weeks when masking was optional were 50% higher than absences during previous weeks, when masking was required.

Neighborhoods: 

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Comments

What about the huge, enormous, terrible damage done to the children because of the trauma of wearing masks?

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Higher percentage than a 4% spike in a population that’s not high risk.

I know math is hard.

"huge, enormous, terrible...."
The trauma is your absurd projection that it did any damage to the vast majority of children.

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Sarcasm is by no means hard to detect in written Internet postings. Nope, nope, it really isn’t.

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A "/s", perhaps?

I had to wear masks to school in 1980. It was weird, but not traumatizing.

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I did put in a /s, but it seems that putting a less-than symbol before it makes it invisible.

I have heard others make this same implication. But when I talked to them about it, they implied that peer pressure was the cause. As if wearing a mask or not wearing a mask was the beginning of peer pressure.

Obviously this created an additional dynamic in school peer pressure which kids needed to consider but I strongly doubt there was any additional harm caused by said pressure since the children have always experienced these types of pressures. It is a part of growing up.

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"What's a'matter? Won't your mommy let you wear a mask?"

As a Chelsea resident who is very active in working in my home community ... What in the living heck are you talking about.

My community was one of the hardest hit cities in the country early on. Our infection rates were sky high, our death rates were scary , the city was on edge. We responded by firing on all cylinders and turned that tide. We worked like crazy to get vaccines out there and continue to do what we can. We are now handing out masks and tests again ahead of the holidays to make sure people have resources. And yes our schools took extra steps. Those steps were taken because so many lives were traumatized and the kids were from backgrounds that were unevenly harmed by the pandemics affects.

With that background of people complained they were in the extreme minority. I still see people walking outside with masks. After the crest of the pandemic I felt like a crazy antimasker because I'd be walking outside in downtown and all the people around me kept their masks on.

I guess it's easy to throw the word trauma around when talking about masks but those of us who saw what happens without the precautions will consider you a fool for being so hyperbolic about it.

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Am I really the only Uhubber with a working sarcasm detector?

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That was heavy, dripping sarcasm if I've ever seen it. C'mon people, when the verbiage is that over the top, say it out loud to get the idea.

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.

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perruptor made the mistake of thinking that just because a position is self-evidently moronic it cannot be widely held. Caricature is not possible when the features of the original are too preposterous to be exaggerated. The post was (deliberately) ridiculous, but no more so than many that are monstrously sincere.

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but i would argue that nobody has ever started a comment in earnest with “but but but…”

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As another poster said, read it out loud. The phrasing was a dead giveaway.

I guess some of us have experienced enough people with "wait what????" Views we thought were jokes that it's hard to tell the difference anymore

"it's impossible for sarcasm to be over the top."

Water is wet.
Of course wearing masks helped curb the spread. And the kids really had no problem with it. Don’t come at me telling me of the exceptions; I’m aware that there were kids who couldn’t wear masks or had a hard time. Most kids did far better than adults though.

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I have a very hard time with the masks. I don't care what they say, it does restrict flow and for me I get very warm under my mask and it's miserable... Yet I believe in them. When I have to explain my mask is bothering me I always felt the need to say "it's not political, I believe this is good but I gotta step outside."

Most of the people I see and saw whining and complaining seemed perfectly fine with the masks when they did wear them. Ironically those that have a hard time with them seemed more inclined to accept them for what they were. I think for the whiners it's something to fight against, it's a mission. If you can focus on fighting the mask you don't have to confront everything else around you.

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Yes, many are uncomfortable with masks and feel restricted with breathing. A mask bracket under a regular surgical mask helps because it gives more breathing space. The most effective masks that protect against COVID and other diseases are N95 but they tend to be the most uncomfortable. However, there are exceptions. The Airgami reusable N95 mask won an innovative mask award because of its efficacy And breathability. I’m a teacher working with students, many of whom come in sick, and I travel from school to school as part of my job. The Airgami is hands down the most comfortable mask I have ever worn. I also have a protocol of supplements including quercetin and vitamin c which research shows helps prevent viruses from entering the cell wall and limits their replication if they do enter. I had a very adverse reaction to the first dose of the vaccine so I am exempt from further doses. I’ve been able to so far Not get COVID while others around me, most of whom are double vaccinated and boosted, have gotten COVID repeatedly.

Sensible Medicine's take on this study is a bit different
https://open.substack.com/pub/sensiblemed/p/nejms-disappointing-decision...

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Most kids have had Covid. Ergo, they no longer need protection from Covid...

Sensible, you betcha.
/s

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I've had a look at who runs the Substack and who wrote up the linked article and it's nutjobs backing up other nutjobs.

I then took a scroll through the author's Twitter feed and found just post after post of what-about-ism and complaints about nobody doing studies on how much harm masks do to children and how the boosters are more dangerous than the disease for kids, etc.

She's lost her perspective because she's found a hole to dig...and boy does she keep digging. And that has garnered her attention, which in turn appears to fuel her sense that she's on to something.

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I didn't have the patience.

That's the sensible way!

This substack is ripe for Bad Medical Takes.

Instead of asking for pandemic amnesty, these people are doubling down.

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Am I wrong in thinking that it's pretending there is no more Covid, so no one needs to take any precautions at all?

As an old person with health conditions that put me at elevated risk of dying from the disease, I am not declaring the pandemic over. So far, I've avoided getting it, and I plan to keep it that way.

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This is scientific analysis. Meanwhile, the quantifiable metrics also show that keeping schools remote for a year hurt intellectual and emotional growth in students. In both cases, hindsight is 20/20, but lessons can be learned going forward.

Meanwhile, the quantifiable metrics also show that keeping schools remote for a year hurt intellectual and emotional growth in students.

Care to produce some?

I mean, it's certainly plausible, but given that lives are at stake, I think at least a little intellectual lifting should be required before making such an assertion. Correlation is not causation, and it's not as if nothing else changed but remote schooling.

To be honest, I always thought of you to be well read, despite our differences from time to time. My advice to you, and to everyone, is to invest in reading a newspaper. For $3.50 a day, the Globe will give you all sorts of insights. And when you are done, there's comics, a crossword, sudoku, and even that silly little jumble crossword.

But since you missed it, here's the latest article on how keeping kids remote for a year hurt their intellectual growth.

But since you missed it, here's the latest article

"Reading and math scores on national exams for fourth and eighth grade students in Massachusetts have dropped to their lowest levels in nearly two decades." The article asserts that this is because of "a tangible result of COVID-19 pandemic related learning losses", but produces no evidence in support of this, only test score trends.

Since you missed it, correlation is not causation. Is there likely to be a connection? Sure. But it's sloppy thinking at best to say "test scores down therefore remote learning to blame".

Perhaps correlation is not causation in the case of masks.

All I know is that my son was back in school in September of 2020, with one only 2 incidents of education going remote, a week each time. At the end of the day, they did not get the same slide in test scores that BPS did. And yes, they wore masks the whole year, and into the 2021-22 school year (but not the entire year.)

Another possibility is that the very conditions that made it possible for your son's schools to have in-person instruction (i.e., a lower incidence of infection, a better compliance with vaccination and other hygiene precautions) also mean an absence of disruptions caused by death and serious illness. I don't think you'd disagree that kids whose relatives, teachers, bus drivers, etc. are hospitalized or dead are going to be significantly disrupted, for one thing.

The disruptions of unemployment, food insecurity, eviction, and differential impacts of technology access.

This Glob stuff is way too uncontrolled for social determinants of health and differentially impacted environmental justice communities as to be completely uninterpretable - particularly to the degree that they are interpreting it.

Instead of the needed citations.

I'll put my epi degree against that of some stupidass Yale econ professor sponsored by Peter Thiel and you anytime.

There is a fuckton of difference between "keeping kids remote" and "making them cover their faces".

That expertise in a subject means nothing.

Meanwhile, science morphs into the realm of religion, with rigid dogma. Just ask Dr. Leanna Wen.

And indeed, there is a big difference between keeping kids remote and having kids wear masks in person, which I noted. This brings us back to the point of "pandemic amnesty" that was referenced. Poor Emily Oster got castigated for saying that kids in person but masked was the best way forward. Read her latest on why people should be able to walk back some of their claims about the best ways to deal with Covid. Then perhaps you could go back and revisit some of your claims made about the virus and precautions against it from February 2020 (hint, it involved saying that it was crazy to wear masks.)

Any kid that was traumatized by wearing a mask was probably due to their parents screaming that the virus was a hoax and masks did nothing. People forget how resilient kids are. After a few awkward days adjusting, kids were fine. Christ, my kids adapting to the masks far quicker than i did.

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And now with no mask requirements, we have a surge of other non-covid viruses in the school-aged populations- things like flu and RSV, which can be even more dangerous for kids than covid-19.

I taught in a district that opened for masked in-person school in September 2020. Every few weeks that school year I was notified by the nurse that I had had a student with symptomatic covid in my classroom the previous week and to test and monitor for symptoms. I never came down with it, despite these couple dozen exposures, until I had unmasked Easter dinner with my family. I'm very unsurprised that science is showing masks work, my lived experience already did.