It’s now a crime in many places in the United States not to wear a face mask. These misdemeanors, like simple assault or trespassing, are punishable by fines and even jail. At the moment, these are state and local matters, but if Joe Biden is elected president, he has promised to declare a national mask mandate.
Although such a mandate would likely be ruled unconstitutional in the courts under the 10th Amendment, which reserves such authority to states instead of the national government, the stakes are ramping up with power-hungry politicians in positions of authority. It’s more urgent than ever that mask policy be based on scientific evidence.
Scientists have long tested the value of masks for the general public. The results are not, on the whole, in favor of masks for general use because there are just too many trade-offs and exceptions. Besides, not all masks are created equal. A clean, properly-fitted N-95 respirator and face shield worn, and never touched while worn, by a trained health professional is one thing. A dirty cloth neck gaiter worn begrudgingly at the gym is quite another.
Even Dr. Anthony Fauci used to admit this. “In the United States, people should not be walking around with masks,” Fauci told “60 Minutes Overtime” back in the spring. “There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better, and it might even block a droplet. But it’s not providing the perfect protection that people think that it is.”
Mask partisans now claim this interview is “outdated.” Fauci said last week that Americans should expect these public health restrictions, such as mask requirements, to continue into 2022. He now supports a national mask mandate. The evidence about masks, however, has not changed. Recent scientific studies have simply confirmed past ones.
In 2015, for instance, the respected British Medical Journal Open published a paper that compared infection rates of those who wore cloth masks with properly worn “official” medical masks. It found that “the rates of all infection outcomes were highest in the cloth mask arm.” The paper concluded that “the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.”
Summarizing similar work, Jenny Harries, deputy chief medical officer in the U.K., said such masks could “actually trap the virus.” In other words, wearing a cloth mask could make things worse than not wearing a mask at all.
A June 2020 article in the New England Journal of Medicine concluded that although lengthy interactions in enclosed spaces increase the likelihood of viral transmission, for “passing encounters in public space,” the authors say “wearing a mask outside health care facilities offers little, if any, protection from infection.”
Questions about masks are far from new. Right after the deadly Spanish flu, the American Journal of Public Health published a study on gauze face masks. “The masks, contrary to expectation, were worn cheerfully and universally,” the authors wrote, “and also, contrary to expectation of what should follow under such circumstances, no effect on the epidemic curve was to be seen. Something was plainly wrong with our hypotheses” that masks work.
A May 2020 paper by Jingyi Xiao and others examined a collection of studies on masks. “Although mechanistic studies support the potential effect of hand hygiene or face masks,” they wrote, “evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza.”
There are dozens of similar studies. Many show plots of when masks were mandated and the subsequent later rise of positive cases. Mask mandates have had no provable effect. Meanwhile, power-hungry policymakers ignore countries like Sweden that did fine without mask mandates.
The best one could say for masks is that evidence for their general use is ambiguous. This could be because people wear them improperly or cannot resist touching them. It might also be that they give people a false sense of safety, leading them to take risks they would otherwise avoid. Or it may be that mask fabrics’ holes are too big to stop viruses.
Based on research such as that we have quoted, Danish health authorities discourage the use of facial masks outside the health-care system. Yet authorities in other places, including the United States, mandate masks. Perhaps they think any extra protection is worth the costs. Perhaps they think it will give people comfort, as Fauci suggested months ago. Or perhaps they want to see clear signs of public compliance.
In any case, there’s little scientific evidence that the various face coverings we call “masks” do much if anything to stop the spread of the coronavirus. For ordinary Americans, masks should be voluntary, not mandatory.