On February 25, the day Brazil recorded the highest number of deaths from COVID-19 to date – close to 1,600 – President Jair Bolsonaro said that “studies have started to appear” about the harmful effects mask wearing has on children.
“A German university says that [masks] are harmful to children, and show several aspects like irritability, headache, difficulty concentrating, decreased perception of happiness, refusal to go to school or daycare, discouragement, impaired learning ability, dizziness, fatigue,” he said.
Bolsonaro, who has repeatedly minimized the risks of COVID-19 and derided protective masks, added that he would “not go into details because everything flows into criticism over me, and I have my opinion about masks, and each one has his own. But we are waiting for a more in-depth study on this by competent people.”
Bolsonaro’s statements are misleading.
Although he did not name the German study, Bolsonaro was clearly referring to a report titled "Corona children studies 'Co-Ki': First results of a Germany-wide registry on mouth and nose covering (mask) in children," first published in December and updated this month, examining 26,000 children's reactions to wearing masks in the country. The study is based on results posted to an online registry; it was not peer reviewed.
According to the authors, the most common reported adverse reactions among children to wearing a mask were “irritability (60%), headache (53%), difficulty concentrating (50%), less happiness (49%), reluctance to go to school/kindergarten (44%), malaise (42%) impaired learning (38%) and drowsiness or fatigue (37%).”
Those are the same reactions cited by Bolsonaro, in the same order. However, his characterization leaves out some important qualifiers reported in an editorial note attached to the study. The appended note states that “due to multiple limitations, this study cannot demonstrate a causal relationship between mask wearing and the reported adverse effects in children … The limitations of the study include sampling bias, reporting bias, and confounding bias as well as lack of a control group.”
Regarding bias, the note states that “the survey was distributed preferentially in social media forums that, according to the authors, ‘criticize the government's corona protection measures in principle.’ ”
While documenting complaints about masks, the study’s authors themselves note that “other participants reported that their children had no complaints. Furthermore, there is no control group. The data relate to suspected cases of adverse reactions, i.e., medical events observed by parents in the context of mask use in children, but not necessarily related to or caused by the mask.”
So, the symptoms cited by Bolsonaro might not be attributable to masks, as he claims.
Bolsonaro is not the first to misinterpret this report. On January 26, the fact-checking site PolitiFact reported on an Instagram post by the operator of a website selling supplements, which claimed that masks have “major negative impacts” on children, and cited the German study.
Bolsonaro has criticized wearing masks and social distancing measures since the start of the pandemic. He often did not wear masks during public events or while greeting supporters. Bolsonaro eventually contracted the virus and recovered.
In June 2020, a federal judge ordered Bolsonaro to wear a mask in public spaces in Brasilia, in response to a public civil suit filed by a lawyer in the capital.
In November 2020, Bolsonaro said during a livestream that “there will still be a serious study talking about the effectiveness of the mask … it will be the last taboo to fall.”
Brazil’s government has been criticized internationally for how it has handled the coronavirus pandemic. Besides the disinformation surrounding masks, Bolsonaro’s government has pushed for the use of unproven medications – like the anti-malaria drug hydroxychloroquine and ivermectin, an anti-parasite medication – undermined lockdown orders and minimized the seriousness of the pandemic.
These actions have contributed to making Brazil's response to the pandemic among the world’s worst. The country currently has the third-highest number of cases – 10.6 million – after the United States and India, respectively, and the second highest number of deaths – more than 257,000. On March 2, Brazil's daily death toll hit a new peak, with 1,726 recorded deaths.