Sunday, March 13, 2022

On Removing Mask Mandates

I'm gobsmacked by the recent move to remove the mask mandate for schools starting March 21st, at the start of spring. In the words of Dr. Genevieve Eastabrook, it's premature demaskulation! The Hamilton Board dared to face down the ministry, but my board only had one trustee, a former nurse, willing to go on record as voting against the new rule that students must be allowed to go to school without a mask. A few voted in favour, but most abstained. The special meeting and vote took place from the safety of their private homes, of course. Hamilton's decision, if it sticks, will provide us with an excellent control group in this macabre experiment on our children. One argument my board's trustees made in favour of following the ruling was that, since the trustees aren't medical professionals, they don't have a right to make a medical decision and therefore have to follow Dr. Moore's lead. They do, I would counter, make calls on pedagogy, ventilation, urban planning, etc. despite not being specialists in those areas because they've been voted in to make informed decisions that affect the well-being of our students. And they could have made an effort to look to other specialists' views for some advice:

IT ISN'T SAFE YET

We appear to be following behind Denmark's lead as they dropped mask mandates on February 1st. This graph shows how closely our fatalities aligned until their mandates were dropped, and then their rate of fatalities soared. Canada is bound to follow that trajectory. We're significantly less vaccinated than Denmark, so things could be even worse for us. So why are we okay with this?? 

Both the Children's Health Coalition (including SickKids Hospital) and the Science Table strongly argued against removing masks at this time, hoping we could wait at least until mid-April with a careful eye on wastewater data.


Today, Board-Certified Pediatrician in Pubic Health, Dr. Risa Hoshino (@risahoshinoMD), added,

"Been getting a lot of comments from people that this virus is 'mild' and that they want to live their lives again. I just want to talk about why doctors are so worried about this virus. I don't want you to make a decisions without the facts. There are quite a few examples of viruses that have caused long-term outcomes for patients, e.g. HPV causes cancer years down the line. We are already seeing that there doesn't seem to be a cure for Long Covid. I have some patients with Long Covid who can no longer go to school because of their cognitive dysfunction. They cannot go up a flight of stairs. They have night sweats and palpitations. They are no longer themselves. We are worried that this virus will cause problems years down the line for many people, especially children. We are especially worried about children because they have the most time left on this earth. Children don't deserve to suffer and they're not supposed to die. This is why I am in no hurry to get a 'mild' infection. A 'mild' infection for one person can mean a lifetime of disability or even death. On the other hand, shots and masks have no long-term outcomes. It's all about pros vs cons, right? Studies show that shots may be protective against Long Covid, but not foolproof. I'd recommend masking in public. These are my real concerns, and I hope it will help you see why doctors are so worried. We are not fear-mongering; we just know what viruses can do, and it's scary." 

Recent studies found Long Covid in 37% of cases, and Dr. Tara Moriarty says, "If we don't take things seriously, we will likely still see a LOT of severe outcomes in Canada: ~30K-50K deaths, and third doses are waning."

It helps to keep wearing masks because how much of a viral load you take in can make a difference in the severity of the outcome. The more masks in each room, the better, especially if they're N95s. Even if kids eat together for 15 minutes, then mask the rest of the day, it's much safer than to be maskless all day. But here we go.

BUT DOES IT NEED TO BE A RULE?

We're about to run a huge experiment to see, not if masks work, but whether or not teachers have the desire, courage, and persuasiveness to convince students to follow the science and wear masks despite it no longer being a rule. We know masks work for sure from a recent study showing a 72% reduction in areas where masks are fully mandated compared to areas with partial or no mandates. But facts aren't always enough to convince people. 

Some students have argued with me that the government shouldn't be making any laws that impose on our freedoms, and I have to explain, yet again, that all laws impose on our freedoms in some way or other: either on our freedom to do things or on our freedom to not have things done to us or in our presence. I have to stop at stop signs, and I can't drive drunk, and I'm not allowed to smoke while teaching. In the case of rescinding mask mandates, the new rule imposes on our ability to be safer in classrooms everywhere. I wish we had a law protecting everyone's freedom to go to school with a very low risk of catching this virus because masks, tests, and ventilation are all in place, but those pipe dreams are over. 

IT'S NOT OUR RESPONSIBILITY

One reason for governments to remove the mandate around masks is to skirt any responsibility for enforcement and protection of citizens. One reason for boards to follow suit is to also avoid having to take responsibility for the care and protection of children. It's no longer their fault if kids are unmasked and someone gets sick. It's about board liability, not care and safety of students.

It's the same reason they all hung on to droplet dogma long after it was confirmed that Covid is airborne (really since March 2020). As long as it's about droplets, then it's on each of us to wash the desks and wash our hands and isolate books and papers for seven full days before handling them. If we do it wrong and get sick, it's entirely our own doing. But if it's spread by aerosol transmission, then they need to provide better ventilation in the schools and ensure widespread masking. Until, that is, they found a way to insist it's all on us, again. 

This puts all the responsibility on the shoulder of children! And we're all just hoping they won't feel any subtle (or overt) pressure to take off their mask. I've already been teased by colleagues for being adamant about wearing a mask all day. On Friday I was asked out to a bar by a friend who commented that they know many triple vax'd people who have gotten Covid, and that she has to be super careful because of her elderly parents, but let's go out for a drink, maskless at a crowded bar, since our vaccinations will keep us safe! I don't have a lot of hope that teens will be much better with their own rationalizations. 

WHY REMOVE MANDATES? IT'S NOT THE ELECTION

In the U.S., the CDC changed the definition of low risk, so that Covid zones just shifted. Now 98% of the country is in a low or medium risk zone, when, with the previous definition, 64% would be in the high zone. Why is this gaslighting happening?? 

In Ontario, everyone's convinced it's about Ford's election, but other premiers are lifting mandates as well at a time when our case rates across the country are near the peak of previous waves. One article, by Walker Bragman and Alex Kotch, really hit home why so many governments are getting rid of masks: the Koch Network and privatization. At first the network saw the benefit to online learning, but then, once they realized the cost of these changes to the markets, they forced a return to normalcy. They've had their hand in running the narrative from the beginning:

"The end of school masking is also in part due to a campaign by right-wing business interests, including the dark money network of oil billionaire Charles Koch, to keep the country open for the sake of maintaining corporate profits. These interests have been meddling in the education debate, first pushing to reopen schools and then fighting in-school safety measures, even as Covid case numbers were rising and children were ending up in hospitals. . . . Koch-affiliated groups saw an opportunity to reassess American education, moving away from public schools to private and homeschool alternatives. . . spent decades fighting teachers' unions, pushing school privatization, and attacking state education funding. . . to funnel state funds into for-profit charter school companies providing virtual learning. . . . 

Closures meant a loss of childcare for many parents, which contributed to plummeting labor force participation. . . . The tight labor market changed the relationship between employers and their workers, who began demanding more flexibility and better work-life balance. Companies were forced to respond by raising wages. . . . Enterprises like Koch's were eager to force a return to the old paradigm . . . force a return to normalcy and boost corporate profits. . . . The Hoover Institution, a right-wing think tank . . . argued that remote learning was causing learning loss . . . and that the risk Covid presented to anyone under the age of 18 was incredibly low. . . . 

Business interests likely saw masks as a damper on the return to pre-pandemic economic normalcy, given that they are a reminder of the ongoing public health crisis . . . citing the potential of masks to increase anxiety. . . .  [regardless that] masking during outings or school sessions will have minimal impact on childhood development."

Now that Australia has seen business losses and cancellations and a labour shortage from illness after removing preventions in December (as well as more deaths in January and February than the two previous years), we'll see if the Koch people backtrack on this one!  

ON FALSE BALANCE:

I wrote a couple threads on Twitter yesterday that make my "bias" clear (what used to be known as a position):

"When I presented to my board on Feb. 28 [24-34 min] about keeping masks, I guessed, based on watching Kenney, that they might not be able to go beyond mandates here either, so then added at the end to please create messaging carefully that supports masks. Their message doesn't do that. Their message: 'Students, staff and visitors will no longer be required to wear a mask as of Monday March 21. We respect and support students and staff who choose to continue to wear masks because they feel more comfortable doing so.' 
Imagine if instead they said this: 'Although masks are no longer mandated by law, we are strongly encouraging all staff and students to continue wearing masks to better protect themselves and one another.' It makes a HUGE difference that they chose to imply masks are just for people who aren't 'comfortable' otherwise! I was so hoping they'd clarify how vital masks are for the continued safety of others in the classroom and their families and the entire community. So now I'm REALLY worried for our kids!"

And then this one:

"We have to quickly learn to be respectful of people's attempts to avoid the virus, like we are with people avoiding cigarette smoke. We ask the group, 'Do you mind if I smoke?' before lighting up. Maybe we should ask, 'Do you mind if I take off my mask?' before taking if off. There are places we can smoke freely without asking because people CHOOSE to go there, like some patios, and we know there are places where we can avoid masks, but that shouldn't include any building people NEED to go in (stores, schools, hospitals...). For any building that people NEED to go in (and I wish this covered restaurant employees), people should err on the side of respecting that others might really NEED to avoid Covid, and wear a mask unless everyone in the pace is cool with taking it off. This is especially true if there are kids around. 
We KNOW smoke/Covid can harm them, but we struggle with masks because we still think being vax'd means we're not carrying it. We have to accept that each of us COULD have an asymptomatic case, and keep masks on around kids. Without mandates, we need to remember to be courteous and respectful around people's NEED to stay safe. 
It's NOT the same as respecting people's choice to not wear a mask. That's like suggesting we have to respect people's choice to smoke in schools and stores. The right for some to be protected from direct harm must overrule the right for some to have the freedom to potentially cause harm. We started to figure that out in 1996 with smoking restriction We have to do the same with masks, which really work."

It's NOT the case that both sides must be respected as objectively equal choices. One choice protects people and the other endangers them. These choices have serious consequences, and there is a flat out refusal to see that wearing a mask is important to protect the lives of others. We're losing any sense of responsibility we might have had for the effect we have on other people. We seem to get it when it comes to not smoking in class, or wearing perfume, or eating peanut butter, and I think it's because the effects of these things can be seen immediately. Covid can take days to show up, and by then it's often not clear where it came from. We don't see someone start coughing and getting teary eyed as soon as smoke hits their face, or gasp for air because they touched some peanut butter carelessly left on the desk. We might just notice a series of empty desks running through the class like slow-motion dominoes. 

I was accused of suggesting, with those tweets, that people who don't wear masks are stupid. So let me be perfectly clear: I think that people who can wear a mask but refuse to wear one inside a public building either lack knowledge or compassion. Absolutely. 

Either it's the case that they don't realize that cases are still high, or that even a mild case can lead to Long Covid, a brain invasive disorder, or that even the triple vax'd can be carrying it without knowing it, or that people can die from being reinfected, or even that we can get it outdoors as well. I assume this lack of understanding is the case for most mask-less people I meet, and it can be a bit of a minefield to even gingerly explain the very real risks of not wearing a mask to some people. Some people don't want to know the facts, and others refuse to believe them. There's not much we can do with those tied to conspiracy theories.  

The alternative, though, is worse: that they know all that and recognize the effect they could have on other people, possibly causing a lifelong disability or death, and they just don't care. They find the mask too inconvenient to wear despite the protection it affords others in the room. Anyone who chooses the comfort of not wearing a mask over the potential life or livelihood of their peers is choosing their own wants over other people's needs. What is that if not selfish? 

Selfishness is enacted when we prioritize our luxuries over the necessities of others, willfully oblivious to the devastation we leave in our wake. We have to get better at recognizing desires and necessities and weighing them more appropriately. People can put themselves at risk all they want without judgment, but as soon as someone willingly and knowingly puts others at risk for their own convenience, then they should be called out as lacking moral integrity. That's how we socialize people towards good behaviour in society. Somehow we're now so worried about offending people, that we can't call them out for any offensive behaviours. Telling students that their behaviour is harmful to others is mean and bullying. Even shutting down discriminatory comments has to be done with great gentleness and understanding or risk retaliation from parents and/or admin. I can't imagine daring to tell a student that a comment or behaviour is "rude" without finding myself in the middle of an immediate inquest. We're busy protecting the feelings of those who want to be out without a mask instead of protecting lives. How did we get here?? 

Another possibility, however, is that some people can't care because they're in such profound denial in order to stave off anxiety just enough to make it through another day. Knowledge can make anxiety worse for this group, but removing masks to help feed the delusion that it's all over will backfire spectacularly.  

We're told as teachers that we have to respect people's choice to not wear a mask in class. I don't respect the choice to potentially infect others for personal convenience any more than I'd respect someone's choice to smoke in my classroom. I have to tolerate it now, like I would if suddenly smoking were allowed in schools, and I definitely understand the pressure kids will be under to conform to their peers and their parents and try to appease their teachers all at once, but the board can't make me respect this choice or the people who ignited this travesty. Removing mask mandates and effectively ignoring Covid as we're going into wave 6 will impact those we typically neglect because of their race, ability, class, age, etc., resulting in disabilities, death, and overloaded hospitals. How can anyone respect that?? Allowing some people the ability to do what they were already doing but now without a mask is going to take away the ability for many to do anything due to a lack of masks. This is the very definition of inequity. How are so many okay with not protecting our most vulnerable and our children?  


The choice that's missing in all this is the freedom to choose to AVOID being in a room full of people not wearing masks. That choice should be part of the equation. It is in my classes where I've made it clear that I'll accommodate anyone who wants to work from home - except there aren't similar accommodations in place for teachers.

MISSIONARY ZEAL

I'm at a point where I recognize how outnumbered I am, yet I feel compelled to continue spouting off studies and findings and the latest peer-reviewed data. It seems to be a compulsion at this point. I recognize I could be penalized at work for telling kids of the factual risks of Covid and why I think they should wear masks if someone thinks I'm not "respecting choices" adequately, but any fear of my own losses pale in comparison to thinking about losing one of my students to this. I just couldn't live with myself if I didn't do absolutely everything possible to protect them and then one of them were permanently disabled or died because I just relaxed about it already, as many implore me to do. It seems like many have a switch they can shut off so their effect on others and any sense of responsibility for others gets walled off and disappears from their vantage point. At time I wonder if that's the healthier option as perhaps I'm too sensitive to any potential harm to my students and to children in general. But the opposite of sensitive isn't strong or healthy; it's insensitive.

2 comments:

Anonymous said...

you are more likely to die in a car crash than from covid, should we ban cars? fun fact, more people in Canada have died from overdose than covid since the pandemic, its so sad to see paranoid people like you hide in your basement with a N-95 because your too scared of the flu and want to push your misinformation on other people, ps. masks don't work

Marie Snyder said...

Hi Anon,
In my region, the rate of deaths from Covid has far exceeded the fatalities from car accidents in the last 2 years (Covid fatalities are about 8.5x the rate of auto fatalities here). But even if cars crashes were more fatal, we've taken measures over the years to make them safer. We have lots of rules of the road, mandatory seatbelts, and most new cars come with air bags. We've recognized the risks and addressed them. Masks DO work to prevent transmission of infectious particles or else why would health care professionals wear them for so much. Here are some recent studies about mask effectiveness, but I think I'll make an entire post just devoted to how well they work! Because masks make things so much safer, I don't have to hide in my basement! But it would be even safer - and necessarily so for anyone immunocompromised - if everyone wore masks. Two-way masking cuts the risk of transmission dramatically. Here are those studies: https://jamanetwork.com/journals/jama/fullarticle/2776536 and https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0264389