“In this review, I, as a specialist in pediatrics and adolescent medicine, summarize my thoughts and observations on the use of an oral-nasal protection (MNS) for children. These are the findings of a single physician.
We physicians, in particular, have a responsibility in these days of an epidemic situation of national scope declared by our government to recognize dangers and keep harm away from our patients. This, of course, includes the preventive measures that have been ordered.
From a medical perspective, there is a lot of conflicting information circulating, which I will highlight here. In addition, I present here the examination and measurement results of clinical observation, blood gas analyses and stress hormones in urine on me and about 20 children in the condition without and with mask. Unfortunately, the results have confirmed my suspicion that wearing masks is anything but harmless for children. In light of my findings, maintaining the general mask requirement for children is medically irresponsible. Masks are likely to cause severe, persistent, and possibly irreversible harm to children.
I invite my medical colleagues to critically review my statements and to correct or confirm me where necessary.
I also call on all those in positions of responsibility in politics and in the educational environment to stop looking the other way and to take a critical look at the results of my investigations.
For months I have been calling for a comprehensive clinical study on the tolerability and side effects of the mask in children. Such a study has already been prepared in October and, for reasons that are unclear to me, is not being continued, at least for the time being. Until a large study is completed, the mask in children must remain a voluntary decision of the children and the parents. A new assessment of the risk-benefit ratio of the mask requirement is, in my view, urgently indicated.
Of course, I am aware that no clinical relevance can be derived from the observations in a single practice and the significance of 10 to 20 measurements, but to conduct a study with 100 to 200 children single-handedly in addition to my practice activities and obligations to my family is unfortunately impossible. Nevertheless, I consider it necessary to objectify my basic clinical assumptions as well as my measurement results and to have them checked for their plausibility.
In May 2020, a general mask obligation was introduced here in North Rhine-Westphalia, also in school lessons. As a result, many children and some parents increasingly complained of similar complaints when visiting my practice, such as headaches, shortness of breath, heart palpitations, panic attacks, sweating, lack of concentration and “fatigue”.
Since then, I too have been wearing a mask at least eight hours a day, an FFP2 mask for infectious patients and a surgical mask for non-infectious patients. In emergency services in our region, doctors are supposed to wear an FFP2 mask for more than 12 hours. I also observed symptoms in myself, such as eye dryness and headaches, which I did not know before or hardly knew; I had headaches at most two or three times a year. So I began researching for studies on the use of face masks in everyday life. My research included English, German, and Russian sources, but other than a few minor papers on adult use, I didn’t find anything. But now for the details:
Dead space volume in the mouth-nose protection
In a first step, I collected a wide variety of mask types and determined their dead space volume.
The determined dead space volume was between 40 ml for a surgical mask and 120 ml for a FFP2 mask (white-blue) with valve, as they were provided to us doctors by the Association of Statutory Health Insurance Physicians in the 1st aid package. In my practice, I see 30 to 50 families every day with a wide variety of masks, and some parents left me a mask to measure the dead space volume. In total, I determined the dead space volume for over 20 different mask types. I proceeded as follows:
Method 1 The masks were sealed on the inside with liquid silicone, filled with water, and the remaining water volume was determined, see below.
Method 2 Filling up a mask put on the child with foam balls (styrofoam balls also work) of approx. 1 cm diameter (these are not inhaled because of the size), until the dead space volume of the mask was realistically filled, and then putting the same amount of foam into a measuring glass and reading off the result.
Method 3 Application of plasticine on the face of a child resuscitation manikin until the dead space of a mask was realistically filled (alone paranasal already approx. 20-30 ml plasticine could be applied). The volume of the plasticine used was then determined.
A general compulsion to wear a mask without considering possible physical and/or psychological effects on the individual child is unjustifiable from a medical point of view and the question whether a mask can be worn or not can only be an individual case decision.
A general compulsion by teachers, principals or politicians to wear a mask, regardless of whether the child suffers from it or not, must therefore finally stop! We are also damaging the psyche of many children. Parents and siblings also suffer from this, and so do we pediatricians. Many people see this compulsion as an attack on the psychological and physical integrity of children, and many even develop symptoms of depression.
They are children after all! No mask muffle!! No matter why a child with a mask feels uncomfortable, whether it is purely psychological or due to high sensitivity to adrenaline or pCo2 fluctuations, every child must be allowed to breathe clean air without a mask and participate in school without any restrictions. Anything else, in my view, is tantamount to a crime.
To critics of my publication, I offer the following: The health of an entire generation of children and possibly a great many adults is at stake here. Since May, I have tried to appeal to government officials to initiate or support clinical studies on my theses and observations. I have also asked many colleagues from university hospitals to share my concerns about children’s health. After many weeks and months of unsuccessful requests, I am now at a loss and in despair.
I see it as my duty as a father as well as a doctor to raise my voice to what is happening and not to remain silent.
Especially in times of crisis, we need the open scientific, critical-rational debate space.
Any reasoned assessment of the risk-benefit ratio of wearing masks is welcome. There are now many clinical studies and observations that qualify or even refute the benefits of masks as virus protection.
Isn’t it remarkable that the countries in Europe where mask wearing was least common had the lowest lethality and infectivity associated with Covid-19? Compare for yourself the numbers from Norway, Finland, Denmark, Belarus, etc. with the numbers from France, Italy, Spain, and Germany. If the use of masks was efficient in viral infections, it would be the other way around with the infection numbers in Europe.
So I ask all physicians and experts for an open and critical reflection of my thoughts and I am glad about every factual or professional hint, which brings us all further in our ability to understand.”