Misinformation at the Middletown BOE Meeting

Even if one ignored the rash of prank callers, the May 13th Middletown Board of Education meeting was difficult to watch. While some pleaded for civility and consideration of all views, others raised points that are not validated by current recommendations of professional organizations. While false statements about COVID-19 aren’t new, it’s worth noting that most of the misinformation at this meeting came from people in the field of public health. As Americans, we can certainly respectfully debate when to unmask our children and forego other mitigation measures, but it’s important that we all come to the discussion with a shared set of facts. This, however, didn’t happen on May 13th. Below are six problematic assumptions and assertions made at this BOE meeting:

1) The pandemic is over and we don’t need to worry about children and COVID-19
While cases have certainly declined in NJ and across the country, it’s incorrect to definitively declare victory over the virus. Nevertheless, Jennifer Wright Brown, stated that “parents are really upset about masks, and I understand that. And the reason being is the reality that the pandemic is over” (1 hr. 56 min.). Later in the meeting, Brown reiterated this point: “The pandemic was last year” (2 hrs. 43 min.). However, a pandemic, by definition, is a global health crisis, and to claim that “the pandemic is over,” as Brown and other speakers did, is false. COVID-19 is still circulating in the US, and the situation in Brazil, India, and many other countries remains extremely dire. Perhaps Brown was being hyperbolic in her speech, but people in the field of public health must be particularly careful in their rhetorical choices, as many will interpret their statements literally. Those who are not vaccinated—which includes most children—are still at risk of infection. In fact, a comprehensive study published in the International Journal of Infectious Disease examined “42 studies . . . [finding] that severe COVID-19 was present in 5.1% of children with comorbidities” (Feb. 2021). Additionally, a recent article in MedScape asserts that “children [are] likely [to be] the leading edge in [the] spread of COVID-19 variants” (May 2021). It’s also important to understand that as COVID-19 continues to mutate, and, as people in Brazil are reinfected with a new strain of the virus, the clear caveat of virologists and epidemiologists everywhere is that “no one is safe until everyone is safe.” To declare victory over the COVID-19 pandemic, when the virus continues to spread and mutate, is premature. While kids do typically suffer fewer symptoms than adults, if they are unvaccinated they’re still at risk.

2) The CDC says kids no longer need masks
Unfortunately, most of the speakers at this meeting seemed to misinterpret the CDC’s recent recommendations regarding masking. The recommendations that were updated apply to fully vaccinated people. The CDC’s most recent recommendation for schools is as follows: “All schools should implement and layer prevention strategies and should prioritize universal and correct use of masks and physical distancing” (15 May). Right now, unmasking children while indoors, few of whom are vaccinated, is not recommended by the American Academy of Pediatrics and other professional organizations. Additionally, it should be noted that the CDC’s relaxed recommendations for fully vaccinated people are not accepted by many. For example, “The nation’s largest union of registered nurses condemned the CDC . . . for lifting mask recommendations for vaccinated people and called on the agency to ‘do the right thing’ and revise its guidance” (15 May). Even if those who spoke at the BOE meeting had applied the CDC’s guidance to the correct group of people (those who are fully vaccinated), many health professionals believe the CDC’s declaration to be premature.

3) Masks don’t work
Diane D. Grasso, also a nurse, stated that “We need to look at evidence-based practices and the evidence-based practices say to me that masks are useless” (2 hrs. 16 min.). Jeani Isaksen amplified this point when she stated that “There’s plenty of scientific information out there that shows you that masks do nothing” (2 hrs. 19 min.). Although neither Grasso nor Isaksen shared any of the "evidence" to which they were referring, Jennifer Brown did offer a comprehensive and ostensibly persuasive piece of evidence when she claimed that “there are over 2,700 studies on PubMed.gov that show you that masks are ineffective” (1 hr. 58 min.). But if you search PubMed Central using Boolean operators: (masks OR "face coverings") AND (COVID-19 OR coronavirus OR SARS-CoV-2), the database will return over 18,500 articles. If we assume that all articles were evaluated in this research, we may conclude that over 15,000 studies do not confirm this point. When judging the efficacy of masks, we should not rely on cherry-picked evidence or studies with small or unrepresentative samples. So here’s some evidence that I believe to be persuasive: In an article published in The Lancet, researchers who conducted a comprehensive meta-analysis of 172 observational studies across 16 countries and six continents found that “face mask use could result in a large reduction in risk of infection . . .” (June 2020). Additionally, The International Journal of Nursing Studies published a “systematic review of randomized controlled clinical trials on use of respiratory protection by healthcare workers, sick patients and community members . . . The study suggests that community mask use by well people could be beneficial, particularly for COVID-19, where transmission may be pre-symptomatic” (Aug 2020). In a paper published in PNAS by a multidisciplinary group of scientists, the authors state that their “analysis reveals that the difference with and without mandated face covering represents the determinant in shaping the trends of the pandemic. This protective measure significantly reduces the number of infections. Other mitigation measures, such as social distancing implemented in the United States, are insufficient by themselves in protecting the public . . .” (June 2020). There is ample peer-reviewed research to support the use of masks as a mitigation measure. It would have been different had the speakers said “most children aren’t wearing their masks properly and masks don’t work if they’re not worn properly” or “not all face coverings are highly effective at preventing the spread of COVID-19” or “community spread is very low right now, so we don’t think our kids really need to wear masks,” as these statements are all grounded in reality. But the statements of some at the BOE meeting were absolute, unqualified, and inconsistent with the larger body of scientific evidence on the subject.

4) Masks are harming children
While masks can certainly be uncomfortable for some and cause minor skin irritations in others, the vast majority of healthy children don’t have issues with masking. Yet, this didn’t stop Jeani Isaksen from stating “We have . . . to worry about whether masks are damaging their lungs and can lead to premature death” (2 hr. 36 min.). Jessica Brink also stated “When we’re putting masks on a child, we’re blocking their ability to breathe . . . It is a God-given right to be able to breathe” (2 hrs. 2 min.). But here are a handful of fact checks from credible outlets that debunk the claims that masks are dangerous: Reuters’ “False and misleading information in post listing ‘dangers’ of face masks,” BBC’s “Deadly Coronavirus Masks Claim Debunked,” USA Today’s “Study falsely claiming face masks are harmful, ineffective is not linked to Stanford,” and FactCheck.Org’s “Video Airs False, Misleading Claims About Face Masks”. Additionally, any reputable psychologist will tell you that the minor discomfort that some children experience while wearing a face mask pales in comparison to the catastrophic devastation that children face during an “Adverse Childhood Experience” (ACE). If you research ACEs, you won’t find “wearing a simple cloth face covering” listed as a form of abuse. In fact, if more people wore masks and maintained social distance, many children wouldn’t be grieving the loss of family members right now. The real problem is the death, suffering, isolation, and loss of livelihood that have been a direct result of COVID-19. Yet several at the meeting suggested that the rise in cases of distress and mental illness among our children is due to masks alone. When speaking about masks, Jennifer Brown stated that “the psychological damage that we’re doing to children right now is going to be irreversible” (1 hr. 57 min.) Jeani Isaksen concurred when she stated, “Our kids are suffering. It’s going to be horrible for them when they get older. Who’s going to pay for the psychiatrist?” (2 hr. 19 min). Statements like these about the dangers of masks minimize the real issues of poverty, neglect, and abuse that many children experience on a regular basis, and these dire circumstances have only been exacerbated by the catastrophic loss of life and livelihood in the US due to COVID-19.

5) To require vaccinations or mandate masks based on vaccinations is discriminatory
Jeani Isaksen stated, “With this whole vaccination thing coming around, oh, now you don’t have to wear your mask, isn’t that going to be discrimination? There’s no way in hell I’m giving my kids that sh*t. No way.” (2 hr. 19 min.) In her plea for civility, Jennifer Brown stated, “it has to stop . . . We’re not going to judge you if you’re not vaccinated. I’m not asking you if you had a mammogram or colonoscopy everyday. People are saying the weirdest things” (2 hrs. 43 min.). While I agree with Brown that we all must work to be less judgmental, I find fault in the comparison of cancer to a highly infectious, airborne disease. When it comes to infectious diseases, one’s personal decisions DO impact others. There are immunocompromised people whose lives depend upon us achieving herd immunity and schools in NJ have been requiring vaccinations for many years. Unfortunately, those who are anti-vax or vaccine hesitant are often the same people who are fearful of masks. I understand that it’s difficult to persuade people who are adamantly opposed to vaccines, as discussed in this article in The Lancet: “COVID-19, Cults, and the Anti-vax Movement,” so I won’t try to do that here . . .

6) My views represent those of nurses everywhere
While none of the nurses at the meeting explicitly stated that they were speaking for all nurses, this much was implied. When Michele Collins, a mother of two, called in to correctly assert that “the pandemic is not over” and “we need to follow CDC guidelines,” several audience members heckled her by saying, “three nurses, and you can say that?” and “yeah, you know more than three nurses” (2 hr. 18 min.). The tone that some speakers adopted was one of irrefutable knowledge and expertise, yet the use of blanket and absolutist statements like “masks don’t work” and “the pandemic is over” indicates a lack of respect for the scientific process and the ever-present need for qualifiers that prevent sweeping generalizations and faulty conclusions. For further verification on the professional consensus of those in the field, I reached out to my colleagues in the Health Sciences Institute at Brookdale, all of whom believe masks to be an effective mitigation measure if properly worn. Dr. Jayne Edman, Dean of the Health Sciences Institute, cautioned against unmasking unvaccinated children, stating that this move “doesn't begin to reflect any of the academic nursing or medical literature, and even the non-academic stand opposes removing the mask mandate” (15 May). Dr. Terry Konn, Professor of Public Health and Radiology, stated “Masks give children a measure of protection . . . If everyone was vaccinated then we would not need masks, but until then, masks are needed when social distancing cannot be maintained” (16 May). Helen Heinmets, Associate Professor of Nursing, stated “Masks are an effective way to prevent the spread of COVID. It is primarily spread by droplets--so even common sense dictates that this is the best way to stop transmission” (16 May). Michele Halat, Assistant Professor of Nursing, stated "As of today, the evidence offered by the CDC and the WHO supports continued use of face masks for those that are unvaccinated" (16 May). Jennifer Larsen, an Adjunct Professor of Nursing and a full-time nurse at Hackensack Meridian Health, states that her workplace “continues to advocate for wearing masks, social distancing, and handwashing--even after a person is vaccinated” (17 May). I’m sure that the nurses who spoke at the BOE have good intentions, but their views are not representative of those in the profession. Fortunately, Sue Griffin, a nurse of 33 years and former BOE member, called into the meeting to provide a more measured and nuanced perspective when she stated, “I would urge you all to look at the data . . . And when planning and intervening, please keep all kids in mind because some of them are afraid to take their masks off. Your job is to represent all kids” (2 hr. 34 min.).

Conclusion
My high esteem for nurses has motivated me to speak out against what I believe to be the unrepresentative viewpoints that were espoused at this meeting. My motive for writing is not to inflame tensions. And while I am certainly not an expert in the field of public health, my background in research writing and information literacy has given me some tools to further research and respond to some of the points that were raised at the meeting. The bottom line is that no one person is an expert on everything COVID, but I think we should all be willing to trust the expert consensus of professional organizations instead of listening to the outliers simply because their views confirm what we ourselves want to believe. Yes, we can have different opinions about the best steps to take moving forward, but there are basic facts that we must agree upon if we are to have productive debate in public forums. Right now, I think it would serve us well to recall another divisive time in US history, in which US Senator Daniel Patrick Moynihan stated his response to the excuses that some of his colleagues made for Nixon after irrefutable evidence was presented against him in the Watergate trial: “You are entitled to your opinion. But you are not entitled to your own facts.” We can respectfully disagree about when to unmask our children, as some of this will come down to our individual tolerance for risk, but we must all be grounded in a shared reality: the pandemic is not over, masks are an effective mitigation measure, and our current vaccines are far less dangerous than a bout with COVID-19. This is what the professional organizations and experts are telling us, and I think we should trust them. In the end, we must all find a way to come together and take care of each other. One person’s individual freedoms and choices should not endanger the community. As Holly Vogt eloquently stated: “When this is over, we’re going to have to look each other in the eyes. Our children are watching” (2 hrs. 28 min.).