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Re: Reopening schools is welcomed but new mitigations are unnecessary and damaging

Dear Editor,

This leading article is very timely, just as schools are about to return. But given the poor evidence for closing schools, and the known harms to children, it does beg the question why the government is introducing yet more mitigations. At a time when case numbers are now back to levels seen last September and with the added knowledge that everyone in the top 4 risk categories has been offered a vaccine which we are assured is highly effective, surely this is not only unnecessary but potentially harmful.

Firstly, the use of masks in classrooms will undoubtedly be detrimental to learning, particularly for any children with hearing impairments or any special educational needs. When the WHO first suggested masks in schools last August[1], the guidelines specifically stated that this should be accompanied by monitoring not only of any effect in reducing Sars-CoV-2 transmission but also of any harms to either mental or physical health, but this has not been done. There have been numerous publications highlighting potential risks, ranging from paradoxically increasing transmission[2], through to inhalation of microfibres[3]. A study of over 25,000 children in Germany[4] reported headache (53%), difficulty concentrating (50%), less happiness (49%), reluctance to go to school/kindergarten (44%), malaise (42%) impaired learning (38%) and drowsiness or fatigue (37%).

The second proposed mitigation is that of regular testing for secondary school pupils. Public Health England reports that lateral flow tests have around 99.7% specificity[5] which would be excellent for a test in a clinical situation. However, if testing 5 million secondary school pupils twice a week, those 10 million tests would be expected to generate 30,000 false positives. These children would presumably all be sent home from school, with their 30 classmates, leading to almost a million children incorrectly out of school each week.

Concerns have already been highlighted about children’s mental health[6], yet the combination of testing and then requiring masks in class even when tests are negative, will simply compound anxiety about Covid-19 in a population for whom the true risk is so small[7].

[1] Advice on the use of masks for children in the community in the context of COVID-19. 21/08/2021 https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC_Masks-Children...
[2] Proposed mechanisms by which masks increase risk of Covid-19. Huber C. 08/01/2021 https://pdmj.org/papers/masks_false_safety_and_real_dangers_part4/
[3] Masks_false_safety_and_real_dangers_Part_1_Friable_mask_particulate_and_lung_vulnerability? Borovoy B, Huber C, Makeeta Q. https://pdmj.org/papers/masks_false_safety_and_real_dangers_part1/
[4] Corona children studies "Co-Ki": First results of a Germany-wide registry on mouth and nose covering (mask) in children. Schwartz S, Jenetzky E, Krafft H, Maurer T, Martin D. 05/01/2021
Corona children studies "Co-Ki": First results of a Germany-wide registry on mouth and nose covering (mask) in children | Research Square
[5] Preliminary report from the Joint PHE Porton Down & University of Oxford SARS-CoV-2 test development and validation cell: Rapid evaluation of Lateral Flow Viral Antigen detection devices (LFDs) for mass community testing: 08/11/2020. UK evaluation_PHE Porton Down University of Oxford_final.pdf
[6] Teenagers' mental health under severe pressure as pandemic continues - new research. 31/01/2021. Teenagers' mental health under severe pressure as pandemic continues - news research | Mental Health Foundation
[7] Use of “normal” risk to improve understanding of dangers of covid-19. Spiegelhalter D. 09/09/2020. Use of “normal” risk to improve understanding of dangers of covid-19 | The BMJ

Competing interests: No competing interests

24 February 2021
Rosamond A K Jones
Retired consultant paediatrician
Health Advisory & Recovery Team (HART)
Slough, UK