Regardless of Americans’ preference for seeing each other’s faces and breathing in fresh air, many public health officials are still fond of masks mandates. Accordingly, almost five years after Covid-19 hit our shores, a handful of counties encircling the San Francisco Bay have announced new mask mandates in various health-care facilities. San Mateo, Santa Clara, Alameda, Contra Costa, and Napa Counties have all declared mask mandates for health-care workers in hospitals, skilled nursing facilities, or both, starting the day after Halloween and extending until early spring.
San Mateo County, which borders the southern part of San Francisco, has announced that its mask mandate in skilled nursing facilities will also cover family members and friends who visit patients. The county’s health officer has asked the local sheriff and chief of police to “ensure compliance with and enforce this Order,” as a “violation of any provision of this Order constitutes an imminent threat and immediate menace to public health.” She declares that such violations are “punishable by fine, imprisonment, or both.”
One of the great lessons from the pandemic should have been that America’s founders knew what they were doing when they separated the powers of government, and when they entrusted policymaking to the legislative branch. Americans shouldn’t be put in the position of potentially being tyrannized by one kingly official wielding largely unchecked powers. Yet the source of the mandates in at least three of these counties, and likely in all five, is a lone individual: the county health officer (joined, in Alameda County, with the city of Berkeley’s acting health officer).
The health officers are dictating medical protocols to doctors. Many doctors don’t want to wear masks because they compromise interaction with patients, because they force people to breathe in unhealthy levels of their own carbon dioxide, and—most importantly—because the best scientific evidence suggests that they don’t work. But, convinced that they know better, the health officers are ordering doctors to obey their commands or else face punishment by law enforcement for being a “menace to public health.”
For the record, cloth masks won’t qualify as acceptable face coverings, at least not in San Mateo, Santa Clara (home of San Jose, Stanford, and Silicon Valley), or Napa (home of the French Laundry restaurant). The good news is that, in all three counties, masks won’t be required in the health-care facilities’ gift shops. So, even if you don’t get to smile at your loved one when you visit, you’ll still get to shop for souvenirs or knick-knacks unimpeded.
“Facial coverings are a proven method for protecting people,” proclaims Napa County Health Officer Christine Wu in her order. One wonders what sort of proof she has in mind. My deep dive into the randomized controlled trials on whether masks are effective (“Do Masks Work?”), later updated to include a subsequent study (“Masks Still Don’t Work”), found the following: the best available evidence suggests that masks do little to nothing to prevent the spread of viruses and might even be counterproductive.
While RCTs are the gold standard of medical research, Cochrane reviews are the gold standard for assessing such trials. Last year, Cochrane found that wearing a mask “probably makes little or no difference to the outcome of laboratory-confirmed influenza . . . compared to not wearing” a mask, and that using an N95 “compared to” a surgical mask “probably makes little or no difference for the . . . outcome of laboratory-confirmed influenza infection.” Cochrane used the same language, verbatim, in its 2020 review. Explaining how masks might be counterproductive, Cochrane mentioned the potential for “self-contamination of the mask by hands” and “saturation of masks with saliva from extended use (promoting virus survival in proteinaceous material).”
In all, the evidence from RCTs is so bleak for mask advocates that Scientific American was reduced to publishing an article by Harvard law professor Naomi Oreskes arguing that, when it comes to masks, scientists should start prioritizing “reality” over scientific “rigor.”
Cochrane also notes that “more attention should be paid to describing and quantifying the harms” caused by masks. In that vein, a German study found that those who wear masks for more than five minutes at a time are breathing in 35 to 80 times normal levels of carbon dioxide (that’s four to ten times “toxic” levels), with N-95 masks being even worse in this regard than cloth or surgical masks. That same study also found that mask mandates force pregnant women to breathe in higher levels of CO2 than they would be permitted to be exposed to if serving on a Navy submarine. As John Tierney writes of masks, “No drug with all these potential side effects would be recommended, much less mandated.”
Many people assume that masks must work, at least to some degree; otherwise, medical personnel wouldn’t have worn them pre-Covid. But surgical masks were designed to keep surgeons and other medical personnel from infecting patients’ open wounds, while N-95s were worn primarily to prevent the spread of tuberculosis bacteria. Neither type of mask was worn to protect against viruses. An article on the National Institutes of Health’s website, published in the less-politicized, pre-Covid days, helpfully notes, “Viruses are tiny, ranging in size from about 20 to 400 nanometers in diameter. . . . Billions can fit on the head of a pin.” More than 1,000 can generally fit on the period at the end of a sentence. Meantime, “Bacteria are 10 to 100 times larger than viruses.”
Others seem to think it’s better to err on the side of caution and wear a mask. But it’s not caution that leads one to defy medical research; it’s superstition. Besides, masks may do more harm than good from a health perspective, without even factoring in their highly adverse effects on human communication and social interaction.
When medical personnel wear masks, it suggests that they aren’t following the evidence provided by medical studies—which should give one pause—while also sending the wrong signal to the wider public. When the New York Times’s Bret Stephens wrote a column summarizing Cochrane’s findings, the former paper of record’s readers responded with thousands of comments. Among the readers’ ten favorite comments was this one: “The [Cochrane] findings are basically nonsense. Common sense prevails here. . . . I was in a hospital today. Everyone has to wear a mask.”
In that same spirit, in each of five Bay Area counties, a lone health officer has falsely claimed that masks work and mandated their usage by medical personnel. The medical personnel will therefore wear them. Seeing this, many people will conclude that masks must work. That’s how “reality” prevails over rigor.
With only about a fortnight left to go, this federal election campaign has been remarkably devoid of discussion about the major public health experiment that Americans experienced firsthand over the past Olympiad or so. That experiment involved coerced masking and vaccinations, shutdowns of stores and schools, and abridgements of free movement and even of the free exercise of religion. Perhaps these five Bay Area county health officers are doing Americans a favor by reminding everyone what we recently endured—and certainly don’t wish to go through again.
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