At this point, I think it is clear: many pandemic experts hurt children.
School closure was the greatest self inflicted wound of the pandemic. Sensible European nations did not close primary school at all, or only for 6 weeks, but places in the USA remained closed for more than a year. This was a net negative for the health and well-being of children, and will damage this nation for years to come. I am not sure we will recover.
This decision was made only in some places in the USA, and not others, and was not explained by virus specific properties— it had no correlation with cases/100k or hospitalizations per capita—but solely the political valence of a region/ strength of teachers unions. When the history books are written, school closure will be viewed, as I have said before: a massively catastrophic and harmful blunder that was fueled by mis-information from the legacy media, and many pundits who lacked experience adjudicating trade-offs.
But the experts did not stop with closure. To this day, children suffer some of the harshest restrictions. In many parts of the USA, including school districts in California, school kids must wear cloth masks inside and outside (Nov 2021). During recess, and in inclement weather (rain). In some locations, they must eat lunch outside, in a hurry (time limits), or in the cold.
Cloth masks failed to work in the Bangladesh cluster RCT in adults. Their effect size among kids is certainly less than 0% benefit seen in adults. Outdoor spread of sars-cov-2 is very low in adults, and vanishingly rare in children. For these reasons, making kids wear cloth masks outdoors is a cruel policy that may only sate adult anxieties. It is not evidence based, and, in fact, counter to evidence and common sense.
The experts in the USA pushed this issue further. Against the advice of the World Health Organization and UNICEF, our expert bodies (AAP & CDC) advocated for cloth masking (an ineffective mask per Bangladesh RCT) in kids as young as 2. This decision defied all pre-pandemic guidance, all available evidence, and basic common sense. To date, this recommendation continues, and this policy has led to mandatory masking of toddlers in many daycare settings for hours on end.
The regulatory standards for vaccine authorization were made easy for kids 5 to 11. A randomized trial was run, but underpowered to show a reduction in severe events. It was also incapable of showing rates of adverse events due to low sample size. Despite the granting of EUA however, there was no off-ramp to prolonged mask mandates for kids (indoors or outdoors), and these restrictions continued.
After we approved vaccines for adolescents (12-15) under the auspices of the EUA (emergency use authorization), school districts like Los Angeles, which were closed for a year, decided to exclude any child who did not comply in a short period of time. This coercion risked excluding poor, minority children from public education, or required them to receive 2 doses in short time interval, which increased their risk of myocarditis. The policy was needlessly cruel and regressive.
Some have claimed that our policies to children reflect “following the science.” They do not. There is no science to support primary school closure. No science supported prolonged (>1 year) closure for any age. No science supported outdoor cloth mask mandates for young kids, and no science supported deviating from the WHO guidance. These policies meanwhile have devastating consequences for the well-being of children.
Meanwhile, adult hypocrisy was rampant, as adults routinely met in bars, nightclubs, music venues, and private parties without masking. Many of the same adults who pushed strongly for draconian restrictions on kids, hypocritically violated those restrictions themselves.
If someone reads this a hundred years from now, I want to say that I am sorry. I am sorry that no organization rose to defend the interests of children. I am sorry that I personally did not do more to criticize these draconian, irrational mandates, though I did, as much as I felt I could, and as soon and as consistent as I felt I could. Many of us recognized these errors as they happened, but could not stop them, and I am sorry we failed you.
“Men, it has been well said, think in herds; it will be seen that they go mad in herds, while they only recover their senses slowly, and one by one.” – Charles Mackay
Vinay Prasad MD MPH is a hematologist-oncologist and Associate Professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco. He runs the VKPrasad lab at UCSF, which studies cancer drugs, health policy, clinical trials and better decision making. He is author of over 300 academic articles, and the books Ending Medical Reversal (2015), and Malignant (2020).