A man holds a sign during a protest of city COVID restrictions outside San Francisco Mayor London Breed's home in the Lower Haight on Sunday Dec. 13, 2020. (Photo by Ekevara Kitpowsong/Special to S.F. Examiner)

Medical experts weigh in on protesters’ anti-mask claims

Public confused by ‘arbitrary nature’ of guidelines

By Brian Howey

Special to the S.F. Examiner

When a small group of anti-lockdown protesters gathered in front of Mayor London Breed’s house Dec. 13, they said San Francisco’s shelter-in-place measures were too strict and mask mandates had gone too far.

Demonstrators, many of whom did not wear masks, carried signs that likened the recent shelter-in-place order to “voodoo science” and chanted slogans like, “Open S.F. now!”

“Our group is strongly opposed to masking children at any time,” protest organizer Daniel Kotzin said. “We are opposed to anyone wearing masks outside. We’re also against masks for anyone while they are exercising.”

Some protesters carried signs with the website of a group called We Have Rights, a right-wing, Southern California non-profit with ties to anti-vaxxer groups responsible for multiple anti-lockdown protests across the state last summer.

Kotzin and fellow organizer Jennifer Raub denied association with We Have Rights and claimed not to be anti-vaxxers, though Kotzin said he does not plan to vaccinate his children against coronavirus and probably won’t get it himself.

Kotzin, Raub, and other protesters made many claims about coronavirus and public health guidelines. The Examiner fact-checked several of them.

(Photo by Ekevara Kitpowsong/Special to S.F. Examiner)

(Photo by Ekevara Kitpowsong/Special to S.F. Examiner)

Claim: Children are not at risk of contracting coronavirus

Many of the protesters’ claims centered on children and the effects of public health orders on their mental and physical health, a common concern for parents across the country.

Protester Cameron Mobasser attended the demonstration with his four-year-old son and carried a sign that read “Masking preschoolers is child abuse.”

“I think that it is absolutely wrong” to mask children, he said in a phone interview. “Risk factors to them are extremely low.”

Several studies have shown that prepubescent children are far less likely to contract the virus than teenagers and adults, but kids aren’t immune to the virus.

As of Dec. 10, more than 1.6 million children had tested positive for COVID-19 in the United States, according to the American Academy of Pediatrics.

And while coronavirus deaths are very rare among kids, they happen. This is particularly true among communities of color, which saw 78% of child coronavirus deaths from February to July, according to a study by the Federal Centers for Disease Control.

Claim: ‘Masking children is child abuse’

Mobasser also claimed that masking children can lead to psychological and developmental harm, which, if proven, “would constitute child abuse.” Experts disagree.

“In Japan, and sometimes in China, kids wear a mask from a young age,” a practice that predates the pandemic by nearly a century, said Dr. Kang Lee, a professor of developmental psychology at the University of Toronto, in a phone interview.

“There is no evidence whatsoever that wearing a mask is going to stunt your development,” he said.

Wearing masks can present a speedbump for young children learning language and emotional expression, Lee said. “But these are very temporary changes and children are able to overcome them.”

Some signs at the protest outside Breed’s home referenced the web site “We Have Rights,” which has ties to the Southern California group Advocates for Citizens Righs and the anti-vaccination group Advocates for Physicians Rights. (Ekevara Kitpowsong/Special to S.F. Examiner)

Some signs at the protest outside Breed’s home referenced the web site “We Have Rights,” which has ties to the Southern California group Advocates for Citizens Righs and the anti-vaccination group Advocates for Physicians Rights. (Ekevara Kitpowsong/Special to S.F. Examiner)

Claim: Wearing masks causes oxygen deprivation

Another reason some of the protesters believe masking children is abusive is because they think it starves the wearer of oxygen.

Several studies have found that wearing a cloth or surgical mask does not affect oxygen levels in healthy people, even while exercising.

Dr. Julie Ann Sosa, chair of the department of surgery at UC San Francisco said masks have been part of her work uniform for more than 25 years.

“Surgeons pretty much wear masks every work day — and many days, pretty much all day,” she said.

On Thursday, Sosa anticipated wearing a mask throughout a complicated, 12-hour-long surgery. She has never experienced symptoms related to oxygen deprivation while wearing one or even two masks, she said.

People without respiratory illnesses who feel breathless while wearing a mask may be experiencing something akin to claustrophobia rather than oxygen deprivation, Sosa said.

Claim: ‘There is basically no spread of COVID outside’

The truth behind this claim from protest organizer Daniel Kotzin is a little more nuanced, experts say.

Inconsistent contact tracing coupled with how widespread the virus is often makes it impossible to determine exactly where someone contracted it, said Dr. Monica Gandhi, an infectious disease physician at UCSF.

She pointed to a recent study published in the Journal of Infectious Diseases that shows the risk of spreading COVID-19 indoors is nearly 19 times more likely than outdoors — but it still happens.

“The spread is much reduced, but it isn’t zero,” Gandhi said. “Because transmission could happen outside, to say to not wear a mask isn’t accurate.”

In a separate action, a group of restaurant workers demonstrated outside City Hall on Dec. 11 to protest the closure of outdoor dining and its economic impact. (Kevin N. Hume/S.F. Examiner)

In a separate action, a group of restaurant workers demonstrated outside City Hall on Dec. 11 to protest the closure of outdoor dining and its economic impact. (Kevin N. Hume/S.F. Examiner)

Claim: Restaurants and other businesses are only minor sources of viral spread compared to other places

Protest organizer Jennifer Raub’s biggest beef with the shelter-in-place order is the shutdown of local businesses.

Over the past year, she’s watched her business-owning friends’ lives turn upside down, she said, leading her to question the City’s decisions.

“I’m not sure at this point that closing their business is fair unless it’s contributing significantly to the cause of spread,” she said.

Studies suggest that there is a stronger chance of contracting coronavirus at home than in other places, but the virus has been proven to spread in restaurants and other indoor spaces, too.

Several studies have discovered that shutting down restaurants has a strong correlation to reducing COVID-19 transmission, that the virus can coast on air flows from air conditioners in restaurants, infecting diners more than 20 feet away, and that restaurants, gyms, and places of worship present the highest risk of transmission of public spaces.

But it’s San Francisco’s decision to shut down outdoor dining, specifically, that has raised the hackles of some, even public officials and experts.

Gandhi has been critical of San Francisco’s decision to shutter outdoor dining, pointing to the lack of evidence that outdoor dining leads to significant spread of the virus.

The confusing and often contradictory messaging from public health authorities at the local, state, federal, and international level don’t help, either, she said.

For instance, in defense of his decision to not mask his toddler, Cameron Mobasser cited the World Health Organization’s guidance discouraging masking children younger than five. But local, state, and federal guidelines call for masking anyone older than two.

Masking children older than two is perfectly safe, Gandhi said, but she also understands Mobasser’s frustration.

Public health authorities have done a poor job of synchronizing their guidance, sowing distrust and allowing misinformation to fester, she said.

“It’s fair for people to be confused on the arbitrary nature of these guidelines.,” she said. “After nine months, I think people are getting tired.”

The good news is, with two vaccines competing to reach everyone in the country as fast as possible, Gandhi is optimistic the U.S. can achieve herd immunity soon.

“If you’re canceling your Christmas plans, make plans with your family for your summer trip,” she said.

Learn more about San Francisco’s COVID-19 guidelines here.

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