Wearing a mask from the age of 6 has caused a lot of excitement. This collective tries here to understand on the one hand its degree of usefulness in terms of health, following the state of scientific knowledge, and on the other hand whether this measure is proportionate to the meaning defined in the legislation.
Summary of the main points
There is no proof that masking non-sick children – sick children who stay at home – reduces transmission. Misuse of the mask, common in children, increases the risk of contamination. Guarantee the indoor air quality virtually reduces the risk of transmission to zero.
The particularity of the innate immune system of children means that Covid is a benign disease for them and that they are not very active in the chain of transmission. Infection would provide them with the benefit of broad and long-lasting immunity, effective against transmission. Serological tests also show that 40% of them are already immunized. The mask has it increased risks to the physical and mental health of children in full development, the long-term consequences of which are unknown. The best interests of the child therefore do not seem satisfied. Hiding children leads to more health problems, as well as cognitive and behavioral destruction, for illusory gain.
What is the scientific consensus on the usefulness of wearing a mask?
Scientific consensus on the usefulness of wearing a mask has not been established in all cases. That it depends on the state of health and the mode of transmission. Wearing a face mask when sick – or for healthcare workers in close contact with sick people – would reduce transmission.
The advantage of widespread wear and tear for people without symptoms of the disease is uncertain. The mask does not protect against hand contamination. It seems useful to prevent direct transmission from large droplets emitted by a coughing patient.
One study directly measured the infection rates of 17 viruses. Prove that, even with perfectly trained nursing staff, through high performance surgical masks, under optimal conditions, protection is not only about 50% (it was less than 3% for a cloth mask). One can therefore easily imagine the poor results in untrained adults, and especially in children.
To block the transmission of aerosol-like fine droplets in the air, neither the cloth mask nor the surgical mask is effective in stopping droplets smaller than a few millionths of a meter. The most efficient FFP2 type mask would stop droplets down to 300-600nm with 95% efficiency.
The finer droplets – the virus measures around 125 nm – it could still escape. In most studies, performance is established in standardized tests and does not consider escape through the edges of the mask. In real life, performance can decrease significantly: to block aerosols well, the mask must be sealed with wax for example – and the efficiency measured in stopping the aerosols varies from about 10%, for a standard mask, to a maximum of 60% with an FFP2 type mask.
For Covid-19, a patient who has symptoms can contaminate from the 3 transmission modes described over it. He should isolate himself as much as possible and wear a mask, preferably of the FFP2 type, for any essential movements.
For people who are carriers but without symptoms, a distinction must be made between:
- Asymptomatic carriers who will never develop the disease. They are hardly contagious because they have a low viral load . This is also the main reason they have no symptoms, because their body has been able to control the infection.
- Presymptomatic carriers which are potentially contagious about two days before symptoms appear [m3, m4, t1, t2, t3, t4, t7]. To contaminate, they would have to exhale a sufficient amount of viral particles, which normally occurs when symptoms such as coughing develop.
Presymptomatics mainly contaminate for aerosol. This type of transmission, which would explain the phenomenon of supercontaminators, seems to be the main mode of contagion of Covid-19. This would explain the virtual absence of external contamination, even without a mask, and the absence of clusters during large gatherings and outdoor events.
The contamination threshold for SARS-CoV-2 is around 1 million viruses per ml in our bronchi, it cannot be reached by aerosols outside. Inside, wearing a mask to filter out aerosols is probably not relevant, because there is an effective solution more than 95-99% : is aeration, ventilation or air purification.
The case of children: unfavorable risk-benefit ratio, also a non-existent advantage
In addition to what has just been stated, children very rarely develop severe forms, they are rarely symptomatic and not very active in the transmission chain of the coronavirus. It may have the most contagious delta variant increased their chance of transmitting the disease – there are few data and no consensus -, but they remain little contaminated and are no longer at risk. This would be related to their innate immune system, which is very effective against Covid.
Infection would give them the advantage of a broad immunity – therefore robust to virus mutations – and durable. The latest scientific publications estimate that it provides lifelong protection against severe forms and typically 1 to 2 years against the possibility of reinfection and transmission. Children in contact with the virus could even develop antibodies without ever testing positive and without being contagious.
The risks of wearing a mask, its difficulty and its impact on physical and mental health have been proven. First, there is the risk of increased contamination, if used improperly, through a potential increased risk of self-contamination. WHO, ECDC and Sciensano recognize that the risks of misuse are increased in children and do not recommend or advise against wearing a mask under the age of 12.
The other most common side effects are: headache and breathing difficulties; skin problems; difficulty in communicating clearly, the possible feeling of discomfort, the disadvantages and difficulties associated with wearing a mask and wearing a mask that is not well tolerated, especially by small children; communication difficulties in case of addiction to lip-reading …
On a physiological level, various studies have shown an increase in respiratory effort, a decrease in oxygen saturation and an increase in the rate of CO.2 in the blood. This would typically result tiredness, increased heart rate and blood pressure. These reactions could be related to headache, dizziness and fatigue.
At the level neuropsychological, studies reveal vegetative dystonias (intense fatigue, dizziness, anxiety), a decrease in empathy and communication disorders. Recently, many specialists and child therapists have spoken out against the use of a mask for children, believing that the risk / benefit ratio is not favorable to them. The long-term physiological and psychological impacts of wearing a mask in still developing children are not well known.
The legal aspects:
According to what has just been stated, the best interests of the child does not seem satisfied and the circular ordering the use of masks by primary school children, in our opinion, does not take into account Article 22 bis of the Constitution, Article 8 and the jurisprudence of the European Court of Human Rights. ‘man. The best interest of the child is also referred to in the International Convention on the Rights of the Child in its article 3.
he is urgent to end this measure which does not satisfy any objective and superior imperative in Public Health and which seems to us largely disproportionate. It would also be wise to adopt a policy of peaceful consultation, particularly in schools. The goal cannot be reduced at any price to reducing the transmission of the virus. It is also an impossible bet, especially when this virus is shared with many animals.
After nearly two years, improved patient care, approximately 40% of the population is found to possess antibodies due to a natural infection (according to estimates and the evolution of serological tests in Europe and the United States United States) and the majority of people at risk vaccinated, wouldn’t it be appropriate to take a step back and find more serenity?
Dr Ir Aryan Afzalian, physics and modeling
I Marie – Aurore Labonte
Dr. Kaarle Parikka, microbiology
Dr Nour de San, MD-PhD, clinical biology (immunology and microbiology)
Prof Dr Martin Zizi, Doctor of Medicine, Molecular Biophysics, Hygiene and Public Health