The Centers for Disease Control and Prevention says wearing masks is a good way to prevent a trifecta of respiratory illnesses, prompting outrage among Americans who feel the agency is deploying a polarizing COVID-19 tool against viruses that have been circulating for decades but never triggered similar guidance.
CDC Director Rochelle Walensky recommends a “high-quality, well-fitting mask to prevent the spread of respiratory illnesses,” namely COVID-19, the flu and disease caused by a virus known as RSV.
The CDC also is considering whether it should take into account flu, RSV or other viruses when it determines the “community level” of COVID-19 risk. Health officials use the system to determine how much damage the coronavirus is causing in a given area and whether to advise wearing masks.
“One need not wait on CDC action in order to put a mask on,” Dr. Walensky recently told reporters.
During the height of the COVID-19 crisis, critics of the CDC warned that federal officials would pressure Americans into using masks as a tool against a never-ending array of pathogens.
Some say those predictions are coming true.
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“Now, some people will sentence themselves to masking annually forever just because some bureaucrat in Atlanta refuses to say they made a mistake,” said Phil Kerpen, a free market advocate at American Commitment and a vocal critic of COVID-19 rules. He said masks didn’t work in corralling the coronavirus.
Mr. Kerpen pointed to a May 2020 study on the CDC’s Emerging Infectious Diseases page that said a pooled analysis of studies from 1946 to 2018 “found no significant reduction in influenza transmission with the use of face masks.”
In a phone interview, he said it’s too early to predict whether some places will turn this week’s verbal CDC recommendation into mandates.
“We’ll have to see if some more liberal places adopt it,” he said.
They might.
Los Angeles County officials said last week that they will consider mandates if hospitalizations spike, raising the prospect of more masking wars as most places try to move on from onerous pandemic rules.
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Public Health Director Barbara Ferrer said her department would consider a mandate if Los Angeles County tips into the CDC’s “high” community level of COVID-19 transmission and if the daily average hospital admission rate reaches more than 10 per 100,000 residents and more than 10% of staffed inpatient beds are occupied by COVID-19 patients.
“L.A. County will follow the CDC guidance for communities designated at the high community level, including universal indoor masking,” she said.
Her comments focused on COVID-19, but, like the CDC, she said the presence of other viruses is a factor in voluntary mask-wearing.
“I’ve personally been pleased. I’ve seen a lot more people wearing their masks. I think people are scared of RSV and influenza as well,” she said at a press conference.
Masking is one of the most polarizing symbols of the COVID-19 crisis.
Confusion was swirling at the federal level in early 2020 about whether masks would prevent the spread of the coronavirus or whether enough masks were available. The CDC endorsed masks as a valuable tool, and their use became ubiquitous.
Mask proponents pointed to side-by-side studies in Kansas that found counties with mask mandates had less coronavirus transmission than counties that did not. A randomized trial of 350,000 people in Bangladesh found that surgical masks, though not cloth masks, reduced transmission.
Federal scientists started to recommend KN95 and N95 masks later in the pandemic instead of cloth masks that had been in frequent use, especially in schools. Some people said the fluctuation undermined their trust in official guidance.
Mask-wearing is far less common in the U.S. than it was at this time last year, during the crushing omicron wave, though some people still choose to wear them in public indoor settings. As of the start of this month, only 5% of counties were in places where the CDC recommended masking because of high COVID-19 rates.
Dr. Walensky said the CDC continues to advise wearing masks on public transportation, although a federal mandate requiring face coverings fell away in the spring.
Analysts said some liberal jurisdictions might bring back mandates, though likely as a temporary measure strictly to preserve hospital capacity, given the extent of mask fatigue and public backlash.
“Certainly, COVID socialized some Americans into donning masks, and that behavior will continue long after the COVID emergency ends,” said Lawrence Gostin, a global health law professor at Georgetown University. “But for the majority of Americans, they will use masks strategically. For example, when they are in a crowded airplane, but not in everyday life. And there will still be a sizable chunk of society that simply refuses to mask, even if they are infectious, which is discourteous to others.”
The flu studies cited on the May 2020 CDC page found no significant difference between masked and control groups among pilgrims from Australia during the hajj and among university dormitory residents. The literature focused mainly on disposable masks and surgical masks and not high-quality respirator masks.
A review of studies by The Cochrane Library in 2020 found the use of an “N95/P2 respirator compared to a medical/surgical mask probably makes little or no difference for the objective and more precise outcome of laboratory‐confirmed influenza infection.”
“The truth is that we aren’t sure the extent to which masks prevent flu. CDC recommends well-fitted N95 masks, which are likely to be significantly more effective than surgical masks,” Mr. Gostin said. “The problem is that most people don’t wear well-fitted N95 masks consistently and properly. This is a major flaw with mask-wearing, which is it requires a level of behavior that the average American will find hard to achieve.”
Mr. Kerpen said flu hit the U.S. early, so he is hopeful that it will peak and recede before the “forces of mandates” coalesce behind mask rules for flu.
“The evidence-free public health cult seems to be trending in that direction,” he said.
For more information, visit The Washington Times COVID-19 resource page.
• Tom Howell Jr. can be reached at thowell@washingtontimes.com.
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