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Brian Lehrer: Brian Lehrer on WNYC. Good morning again, everyone. It's been a minute since we did a COVID trends check-in on this show. As of yesterday's New York Times COVID Tracker, the news is pretty good, though not a cause for complacency. In New York State, the average for the last week is that around 4,000 people are hospitalized with COVID and 80 people per day died of it.

The good news is that those numbers are around 50% lower than two weeks ago. Similar in New Jersey, hospitalizations, ICU beds, and daily deaths down around 40% compared to two weeks ago. Smaller improvements nationally, there are still more than 2,000 people a day dying of COVID in the United States, down just 13% from two weeks ago, according to that New York Times tracker, but hospitalizations and ICU bed use were down by more than a third. It seems like Omicron is fading, but by no means gone.

What are the right policies to address a moment like this? Democratic governors are joining Republican ones now to loosen mask mandates in some places. For kids in schools, it remains a patchwork of policies, protests, and politics, but also for adults. What kinds of public spaces should require masks and/or proof of vaccines? The New York Stock Exchange, did this you know? Just lifted its masking requirements for those shouting traders on the stock exchange floor, but only if you're vaccinated.

Of course, those resistant to public health requirements for the good of the community, resist vaccines, not just masks. Hello, Sarah Palin, Kyrie Irving, and a small but disruptive to the supply chain number of truckers in Canada.

Even as mask mandates come off, the CDC is recommending that you upgrade the quality of the mask you use. The CDC says booster shots begin to wane after about four months, but it's too soon to know when and if a next round of immunity refreshers will be recommended. As you probably heard this week, the government has delayed for now approving a vaccine for children under five.

What is necessary, and what might come next? With us now, WNYC and Gothamist health and science editor, Nsikan Akpan. His latest article is called "Masks work, even for kids. But sometimes science isn't enough." Hi, Nsikan. Welcome back to the show.

Nsikan Akpan: Hi, Brian. Thanks for having me.

Brian Lehrer: Your article begins with a confluence of interests now among vaxxed and boosted and regularly masked Democrats and COVID safety resistant Republicans. Where's this common ground?

Nsikan Akpan: Yes, that's right. I spoke with Jay Van Bavel, who is a social psychologist and neuroscientist who studies how partisanship influences our emotions, or our decision making, like really looking at the neuroscience of how our identities split our views. He's conducted a bunch of studies during the pandemic, looking at how social identities correspond to following precautions.

On the one hand, right now, there's this hardcore group of mostly conservative, typically Trump supporters who haven't wanted to follow any of the rules since the beginning of the pandemic. There's actually a group at Syracuse University that has a really great study about this. Those conservatives are looking around right now, these masks going away, and are like, "That's what I'm talking about." They're very vocal about taking these mandates and requirements away.

Then I think at the same time, there's a growing group, there's a larger group of people who've been following the rules the whole time, they're liberal, they're moderate, they're also conservative, and they're just emotionally done with the pandemic. Those two camps I think are just creating a ton of political pressure right now to remove these COVID protocols.

Brian Lehrer: To the headline of your article "Masks work, even for kids," we know many people want the mask requirements lifted in schools because they believe the social and mental health risks are higher than the COVID health benefits but are some of those people claiming that masks don't even work on kids?

Nsikan Akpan: Yes, I think that's right. What they're saying is objectively incorrect. We know that masks can block airborne particles like the ones that carry the coronavirus. We've also seen that if you put a mask in a situation such as a super spreader event in schools or outside of schools, that the mask can reduce COVID rates there. We've shown this over and over and over again.

You do have some parents claiming that masks cause mental harm, but the science doesn't really support this idea. Studies show that along with masks not impairing the physical ability to breathe, kids wearing masks can still read emotional cues. I think like another story that I really want people to check out is by a science journalist named Melody Schreiber. She wrote a story for the New Republic that really laid out what masks can and can't do to kids.

She makes some really interesting points around, what do we know about whether masks can cause mental harm? Can they influence, for example, a child's ability to learn how to speak? She says, seeing actually isn't a prerequisite for learning to speak. We know that kids with visual impairments don't have social delays, they don't have language delays.

I think the other thing that is-- and I might just read this passage from her story. "The argument for school masking affecting children's language development is particularly puzzling because the majority of language development usually happens before the age of two, and masks aren't recommended for children under that age. Even among young kids at preschools and daycares who regularly interact with masked adults, no delays have been discovered."

I think there's a desire to get kids out of masks. I think for some parents when you put a mask on a kid in the morning and send them out to go to school, there's probably a feeling of like, "Am I sending them into a risky situation?" And they don't want that visual reminder because they can't see the coronavirus, but they can see that mask that they're putting on their kid. They kind of wonder if they're attaching those ill feelings to the masks rather than really looking at the science and really assessing the risk.

Brian Lehrer: Yes. You're saying it reminds them that they're putting their kids into a risky situation with respect to COVID, but I have a feeling it's other things too like you don't have to be a MAGA disinformation junkie to be a parent who gets your heartstrings tugged at when you see your kid covering up half their face. Even if the science, which most people don't know, is accurate that you cite that it doesn't prevent the kids from reading emotional cues from other people and other people from reading emotional cues from them.

Nsikan Akpan: Yes, and I don't want people to get me wrong. Children have obviously struggled during the pandemic with remote learning, I think the emotional toll of not being able to socialize with friends in person has obviously been a real struggle, but those things are separate, again, just from the mask itself and what the mask can do for us.

If we're not seeing deficits with children wearing masks in terms of their emotional learning, their social learning, but we are in a situation where I think only a quarter of kids, 5 to 11, are vaccinated nationwide, I think in-- are fully vaccinated I should say, and I think in New York State, it's like 1 in 3, it's about 30%. We still have the Omicron rates that we have, I think there is room for a discussion about, "Okay, do we need to set up protections to make sure that these unvaccinated people don't deal with very severe risks from COVID?"

Brian Lehrer: Right. After all, at the adult level, as I mentioned in the intro, a lot of the withdrawal of masking requirements are only if you're vaccinated.

Nsikan Akpan: That's right. I think going back to last year in the very beginning of the vaccine rollout, the Democratic-Republican leaders, they all pitted masks versus vaccines. Like, "You take that vaccine and you can take off your mask." I think that bargain led to sort of a distaste with masks in a way. Like, "Why can I not be free of this thing? I've done everything that I was told to do." I understand the frustration and I understand the mental thinking that's going into people wanting to take off their mask, especially if they're fully vaccinated and boosted.

Brian Lehrer: Listeners, your COVID masks and vaccine science and politics questions or how your school district or other workplace is adjusting to the latest COVID transition period, or you as an individual. 212-433-WNYC, 212-433-9692, or tweet @BrianLehrer for our Health and Science Editor, Nsikan Akpan.

Before we leave masks, what's your take on different kinds of masks? Have you been looking at the science on this like single-layer cloth, multilayer cloth, surgical masks, or the N-95s and KN95s? How much of a difference is there, because the thinking on this seems to have changed recently?

Nsikan Akpan: I think much of the recent changes are around the fact that Omicron is so contagious and so people really do need to lean towards the upper end of quality when it comes to masks, so that's your N95s, your KN95s, but I think access still remains an issue. I think some people just can't get to those masks and so it's frustrating. I think the federal government has just launched this program to hand out free masks at pharmacies, but we're almost at March 2022, like, "Where was this program this whole time?"

Brian Lehrer: Do you see--? Well, let me take a phone call and I think that'll lead us into the question that I wanted to ask next. Jim on Staten Island, you're on WNYC. Hi, Jim.

Jim: Hey, I was just wondering, is there any studies that show that masks actually do have a negative effect on children? Because, first of all, we're not built for it. That's the first thing. Second of all, it seems like your guest has an agenda almost and is a little bit more hysterics.

Brian Lehrer: Hysterics? Do you listen to the tone of Nsikan's voice? He is our Health and Science Editor reporting on studies, and I recommend you to his Gothamist webpage to see this science reporter who has a PhD in immunobiology reporting on scientific uncertainties all the time. I don't know where you get agenda. Nsikan, I will ask, are there competing studies?

Nsikan Akpan: This guy sounds like maybe he's been in my Twitter mentions this week too. I know that people have really strong opinions about this, but the studies really aren't showing us much of effect when it comes to emotional learning and social learning and masks. I think what the caller is trying to get to is the risk of death for kids overall is obviously much lower than it is for adults. Nobody doubts that, but over the past two to three months, we've also seen more pediatric COVID deaths than we've seen throughout the entire pandemic. In part, it's because we've reopened schools, we've reopened the economy, there's a lot more people mixing. There's a lot more virus out there.

There's a lot of talk about COVID transitioning into becoming an endemic. Which is similar to what we have with influenza. Influenza is endemic. We deal with it every single year and influenza before this pandemic began and before people started wearing masks and social distancing, it used to kill a lot of kids which we're talking about maybe a few thousand per year. I think COVID is heading in that direction too.

Overall, that's a small number, but if it's your kid, it's devastating, it's life-altering. It completely changes the direction of your life and so I get it, people don't want to wear masks. I get it. You don't like masks. You could just say that but the science doesn't necessarily support doing that.

Brian Lehrer: By the way, is the CDC still recommending masking in schools? I think as of last week, they were at odds with the governors of New York and New Jersey on that.

Nsikan Akpan: It looks like director Rochelle Walensky, it looks like she's going to probably keep masks in place for schools. Although, it sounds like she's signaling that masks could come off for other situations like other indoor settings. Governor Hochul has actually said that she's going to wait until March 4th to decide whether or not to take off masks for New York schools.

The New Jersey governor Phil Murphy is the one who's like, "I'm leaving it up to the individual districts to decide whether or not they want to keep masking in schools." It's all kind of like a bit jumbled up. I think a lot of our leaders are just trying to decide what's the best move right now.

I think the thing that would also probably help the situation, and deal with a lot of the uncertainty that people are feeling around the situation is just setting really specific on ramps and off ramps for COVID protocols. We still don't really know what is the case level that leads to the state taking away certain requirements. What's the hospitalization level that leads to the state taking away certain requirements?

I think if they would just say that, or somebody like New York Mayor, Eric Adams, would just say, "Hey, when we reach a thousand cases per day, 600 cases per day, you can go back to just doing what you normally do and then if it seems like we're moving back to that, like a new variant has emerged, we reach that 600 cases per day, then we're putting this stuff back on." It's like they're creating problems for themselves by not dealing with that uncertainty.

Brian Lehrer: This is WNYC FMHDNAM, New York, WNJTFM 88.1 Trenton, WNJP 88.5 Sussex, WNJY 89.3 Netcong, and WNJO 90.3 Toms River. We are in New York and New Jersey public radio at eleven o'clock. A few more minutes with our health and science editor, Nsikan Akpan, on some of the latest COVID news and Missy in Manhattan, you're on WNYC. Hi, Missy.

Missy: Hi, how are you?

Brian Lehrer: Good. I see you're a speech pathologist.

Missy: Yes, I am a pathologist. I was calling in to just talk about how we've seen in our practice how mostly five and under kids we feel are being affected by the masks. Now, to be clear, I am all for masks and science and my kids are older and they wear masks in high school, but what we have found since we reopened our office in August of 2020, is that our practice has tripled in the amount of mostly preschoolers who have come in as late talkers, pretty much.

My partner and I are really attributing that to masks in school. The preschoolers are seeing their teachers in masks and they're really only exposed to their families in their home without masks. It's interesting to see how it's just across the board, the case. Even speech pathologists who work in the public school systems are wearing masks while they're treating kids. That's just unfortunate. In our private practice, we don't wear masks, but we are just slammed with kids and are having to start turning away families.

Brian Lehrer: Missy, hang on one second, because we have another speech pathologist calling in. Irene in Cold Spring, you're on WNYC. Hi, Irene. Did you hear Missy there, and do you have the same experience in your practice?

Irene: Yes. Thank you for taking my call. Yes. Just to, again, support what Missy was saying, five and under definitively, anybody who needed speech pathology services and probably occupational therapy and physical therapy, they missed early intervention essentially because people were not going to the homes, everything was being done over Zoom.

It's incredible, I was doing early intervention with an 18-months-old over Zoom. It's a joke and it's embarrassing. The standard of your own therapeutic standard of excellence got reduced to "It's better than nothing. It's just on paper."

Brian Lehrer: Are you bringing up the same issue that Missy did with respect to masks, or are you bringing up a separate issue with respect to Zoom versus in person?

Irene: It's combined because when those children were-- so now the three and five year. Two years ago, they would've been birthed to two. Maybe they would've been getting early intervention. They lost that, so now three to five they're in preschool, thankfully. However, they might be masked and the teachers are masked. We're talking-- again, I was just in a preschool just now and nobody can really hear each other, it is amazing. If you actually go and experience it, you feel it, you feel this is inappropriate, it is wrong or something. Just like what Missy--

Brian Lehrer: I'm putting Missy back on here. Missy in Manhattan, you're on with Irene in Cold Spring.

Missy: Hi, Irene.

Brian Lehrer: Irene, meet Missy.

Irene: Hi.

Missy: Hi, Irene.

Brian Lehrer: Do you have a little speech pathologists' group therapy session here, or not really group therapy but strategization session? How did the two of you compensate or recommend compensating for what you're observing and experiencing? Missy, you want to start?

Irene: Why don't you go first?

Missy: Sure. I think it really depends on what you're dealing with. If you're dealing with just really what Irene is talking about, these late talkers who missed out on the early intervention when they were really young, we do a lot of educating the parents. We talk about what they can do to bring home the language that we're facilitating in the therapy session because that's really the only place that kids are exposed to maskless speech.

One thing I just, as an aside, want to say. Irene, you said you were just in a preschool, we see pictures of the kids in preschools all the time, and the masks are around their chins, they're half on their face. It just seemed like such a wasted effort on these two, three, and four-year-olds. I understand why. I mean they're not vaccinated, and it's a protocol. Some families want the masks to stay forever, and some families want the masks to go yesterday.

I understand that it's really like a political and a science and a political thing, but they're just missing out. It's very hard to say, and Irene I don't know if you agree, what our recommendations are outside of the home, it's really impossible, because even if you go to the market, you want to have like a little language play with the child in the shopping cart, and talk about what you're shopping for, you're masked. It's muffled, but you can't see.

Brian Lehrer: Irene, go ahead.

Irene: Again, just to support what Missy was saying, everything, there is a barrier. It is obviously not organic. It's not how human beings live or wish to live. Everyone's hair is on fire because again, if you suggest, you know what, maybe these little kids don't need to wear a mask, the people who are very anxious, whatever their reasons are, and I'm not going to dismiss their reasons, what I'm saying, but the people who are very anxious, you're attacked for wanting to kill people. You're equivalent to just a QAnon person.

However, when you are in this situation, and you're looking at it, you see, you actually see. I'm really very curious, in two years, what the expanded rate of speech services in schools, special instruction in school, everybody's going to have an IEP in first, third grades. I wonder what the ripple effect is going to be, because, again-- Yes?

Brian Lehrer: Irene, here's a question, a follow-up question from a listener who's listening to the two of you have, by the way, the first-ever Brian Lehrer Show speech pathologist industry trade association meeting off the air.

Irene: I'm so thrilled.

Brian Lehrer: A listener on Twitter asks, "If it takes visual cues to learn how to speak, how do blind people learn to speak?"

Irene: That's a good question. It also seems like it's a challenge because if you are blind, and we're going to just-- again, we're going to infer the person, the child who's blind, can hear. If you muffled someone's voice, and the person was blind, I'm not sure how well they would learn. Again, I'm not arguing, there are lots of ways people obviously learn language. It's not just language, though, it is play, it is cognition, it is attention. It is multiple things when you're that young. If you want to have a genuine idea, then you need to go and work with children. Again, I don't want-- [crosstalk]

Brian Lehrer: Irene in Cold Spring-- I know you don't want to be the QAnon person denouncing the feelings-

Irene: Right, I'm not.

Brian Lehrer: -of parents, and we hear you.

Irene: Right, I'm vaccinated. Again, people need it.

Brian Lehrer: Irene in Cold Spring and Missy in Manhattan, thank you both very much for sharing with us. Good luck out there. The world is so indebted more than a lot of families know to speech pathologists like you. Thank you both very much.

Irene: Thank you so much. This was wonderful.

Missy: Thank you. Have a good day.

Irene: Everyone, have a good weekend. Bye.

Missy: Bye.

Brian Lehrer: Nsikan Akpan, our health and science editor, as we start to run out of time in the segment, what were you thinking listening to that exchange?

Nsikan Akpan: Yes, it's interesting because it's a lot of the stuff that I hear in general. I think they're making really good points. If you look at what happened during the first year of COVID, like complete lockdown, kids really weren't interacting with each other, they were pretty much only exposed just to their families. They weren't even really exposed to grandparents and people like me on the street, on the bus. I think that, for sure, had an impact on their ability to socialize.

I think one of the speech pathologists that were just on, they mentioned, they were like, "Oh, I think it's the masks. I think it's also the remote learning via Zoom." The first thing I ask is like, "Okay, so which one is it?" Then like, "Can we design a study to tease apart those two things?" I just want to see some evidence. I want to see some evidence that the masks, in particular, are causing these issues. I think that because there were so many other interruptions to socializing and our ability to communicate with each other, that you have to keep those in mind as well.

Brian Lehrer: Yes, we have some anecdotal evidence as they call it there and people have to do the real studies.

Nsikan Akpan: Yes, exactly.

Brian Lehrer: To wrap this all up, and to put a period or an exclamation point on this conversation about little kids, what about the FDA delaying approval of a vaccine for kids under five, which, once they have it, if they're vaccinated in large enough numbers, that would reduce the pressure by some parents to keep the masking on. Why did they delay it?

Nsikan Akpan: It sounded like they want to collect more evidence before they have this review with the FDA, which is like a completely normal thing to want. I think while they were conducting the study for the youngest individuals, cases were going down. If your cases are going down, like last fall, you're going to struggle to collect enough evidence to show that your vaccine is working.

I think with the Omicron wave, they probably were able to get a better sense of whether or not the vaccine was working. I think they want to just collect more evidence in that regard. It's also really frustrating for parents because I think some parents were looking forward to vaccinating their youngest kids.

That said, we are seeing pretty slow uptake of the vaccines with teens, with kids 5 to 11, ones that are already authorized. I don't know if we can bank on everyone just going out to get their kids vaccinated because it seems like they're not doing it, but if adults got vaccinated, we might be able to drop case levels in a way that we could really reduce the risk to kids.

Brian Lehrer: More of that, perhaps, in our next conversation with Nsikan Akpan, Health and Science Editor for WNYC and Gothamist. Thanks as always.

Nsikan Akpan: Thanks, Brian.

 

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