Can the Gray Lady’s COVID Pope restore some common sense at the White House and the CDC? While Joe Biden and the Department of Justice plot to appeal the ruling striking down the transit mask mandate, David Leonhardt reminds us that it never did work well in practice — and likely not even in theory. Not only is the science lacking in real-world results from mask mandates, everyone who endured them recognized the silliness of their implementation:
A central lesson of public health is that people have a limited capacity to change their routine. They’re not machines. For that reason, the best responses to health crises depend on triage, with political leaders prioritizing the most valuable steps that people can take. Whenever politicians impose rules that are obviously ineffective, they undermine the credibility of the effective steps.
The transportation mandate had so many exceptions that many Americans understandably questioned its worth. Travelers took off their masks to eat and drink. Some flight attendants removed their masks to make announcements. Some passengers wore their masks on their chins. The mandate also did not require N95 and KN95 masks, which are more effective against the virus than cloth masks or standard medical masks.
As for “following the science,” well …
Rigorous laboratory tests show that masks reduce Covid transmission, but supporting real-world evidence tends to be much weaker.
The most glaring example in the U.S. is that liberal communities, where masks are a cherished symbol of solidarity, have experienced nearly as much Covid spread as conservative communities, where masks are a hated symbol of oppression. Another example is school mask mandates, which don’t seem to have had much effect. A third example is Hong Kong, where mask wearing is very popular (although often not with N95 or KN95 masks, Osterholm notes); Hong Kong has just endured a horrific Covid wave, among the world’s worst since the pandemic began.
Osterholm, who spent 15 years as Minnesota’s state epidemiologist and has advised both Democratic and Republican administrations in Washington, argues that much of the U.S. public health community has exaggerated the value of broad mask mandates. KN95 and N95 masks reduce the virus’s spread, he believes, but mandates like the one on airlines do little good.
“Public health advice has been way off the mark, all along, about mask protection,” he told me. “We have given the public a sense of a level of protection that is just not warranted.”
So if the idea is to prevent massive increases in community transmission, mask mandates turn out to be ineffective policy. That’s especially true in schools, where children are neither at substantial risk of severely acute infections nor are vectors for community transmission. But as Leonhardt notes, it’s also true in transit systems and in cities with indoor mask mandates. The scientific argument for mask effectiveness, as Leonhardt states, is entirely academic and not real-world.
In fact, American Commitment did a real-world study on the impact of mask mandates in school districts over this winter to determine whether they performed better at keeping classrooms open. In fact, they did four times worse than districts without mask mandates:
The new analysis finds:
“One of the reasons we were told masks were essential for school kids this year was that masks would reduce the likelihood of school closures, by reducing disease incidence. Unfortunately, like so much the CDC has promised, the opposite turns out to be true….Children in masked districts experienced, on average, 4-times the number of disrupted learning days as those in mask-optional districts (Figure 1). The same districts also had 2.5 times higher case rates during the same period as we demonstrated in analysis published on March 9th, 2022.”
The report continues:
“This result is as important as it was expected. The CDC promised that whatever potential (and willfully ignored) harms might come to children from two full years of forced masking, they must be risked, due to the added safety and schooling that masking would ensure. Neither claim ended up being true. As we demonstrated in our analysis of March 9th, during the January peak of the omicron wave, masked districts had 2.5-fold higher case rates than un-masked districts. Yet, during the same period, as we saw in Figure 1 above, those same schools experienced more than 4-fold higher rates of school disruptions—significantly higher rates of disruption even than their increases in case rates.”
Phil Kerpen and I discussed the study on my latest podcast. The increase in disruptions could have a number of causes, not the least of which is the kind of knee-jerk reaction to community case figures that one would expect from governments imposing these mandates in the first place. Still, the important part to note is that non-mandate districts performed substantially better rather than worse, and without impacting community transmission to boot.
Are there any applications for mask mandates? Yes, Leonhardt writes, but only when narrowly tailored and provably necessary. Those who fear the end of masking, however, can still protect themselves through one-way masking, he argues:
“One-way masking works,” as @AmeshAA, an infectious-disease specialist at Johns Hopkins University, says. When Dr. Adalja is treating tuberculosis patients, they are typically maskless, and he wears an N95 mask to protect himself.
— David Leonhardt (@DLeonhardt) April 22, 2022
If Covid surges again and there is reason to impose more mandates, they’ll be far more effective if they’re stricter and narrower, rather than broad and lenient.
It’s a basic principle of public health. People should asked to make changes that matter. https://t.co/cgfJi5LjcN
— David Leonhardt (@DLeonhardt) April 22, 2022
Indeed. And if the CDC based its policy on actual science, the mask mandates would have been discarded long before a legal challenge put an end to them. Even now, the only argument for those who want to see the ruling by Judge Kathryn Kimball Mizelle appealed is to protect the CDC’s ability to arbitrarily impose policies on the basis of politics. Small wonder these health experts have lost so much credibility over the last couple of years, and small wonder why Biden’s losing voters across the board.
— Kasie Hunt (@kasie) April 21, 2022
It was a court issue because the CDC exceeded its statutory authority and failed to follow the law in issuing its regulation. Fauci’s arguing for a scientocracy rather than a republic, and an incompetent scientocracy at that.