Two Faces of the Face-Mask Mandate

by Sidney Bostian

Governor Ralph Northam will announce tomorrow the details of a statewide mandate to wear masks in public spaces and businesses. “We are working through the policy. Obviously it’s an equity issue,” Northam said at his Friday news conference, adding that all Virginia residents would need access to face coverings and that he is examining how to enforce such a policy.

“Wearing a mask could literally save someone else’s life,” Northam said. “That is becoming clearer every day as we move further into managing this virus over the long term.”

The justification cited above — “could literally save someone’s life” — is one of the most interesting “definite maybes” uttered by a public official in recent memory. A careful observer would note that Northam failed to cite his scientific sources for that statement.

Mask wearing in the COVID-19 era has become controversial. Proponents suggest that the coronavirus can be managed only if we compel everyone to wear masks. Opponents to mandatory masks flinch as if they are being asked to wear the “mark of the beast.” Virginians seem evenly divided with about half favoring masks and about half opposing (acknowledging that there are some who don’t care and will swing like a barn door).

Given the passions of the partisans on both sides, it is reasonable to ask that the Governor’s decree meet two tests. First, that there is scientific evidence that universal mask wearing will save lives, and second, that there are few if any citizens who will be adversely affected by long-duration, long-term use of masks. One would hope that Northam, a physician, would affirm the “do no harm” principle.

A recently published meta-analysis of available randomized controlled trials evaluating the efficacy of masks to control spread of respiratory viruses (Masks Don’t Work: A review of science relevant to COVID-19 social policy by D.G Rancourt, April 2020 – accessible on reached the following conclusion:

Masks and respirators do not work. There have been extensive randomized controlled trials (RCT) studies, and meta-analysis reviews of RCT studies, which all show that masks and respirators do not work to prevent respiratory influenza-like illnesses, or respiratory illnesses believed to be transmitted by droplets and aerosol particles. Furthermore, the relevant known physics and biology, which I review, are such that masks and respirators should not work. It would be a paradox if masks and respirators worked, given what we know about viral respiratory diseases: The main transmission path is long-residence-time aerosol particles (< 2.5 μm), which are too fine to be blocked, and the minimum-infective-dose is smaller than one aerosol particle.

The present paper about masks illustrates the degree to which governments, the mainstream media, and institutional propagandists can decide to operate in a science vacuum, or select only incomplete science that serves their interests. Such recklessness is also certainly the case with the current global lockdown of over 1 billion people, an unprecedented experiment in medical and political history.

One can also find sources implying that masks, if properly fitted, might be a helpful adjunct to hand washing and extreme care in placing hands on the face. Note the qualifiers. Many studies note that absent proper hand washing and extreme care in keeping unwashed hands away from the face, masks provide considerably less protection. I cannot find RCT studies (the gold standard) which demonstrate statistically significant reduction in virus spread. It is quite difficult on the basis of available research to establish the efficacy of masks in reducing respiratory virus spread. It would seem that the governor’s impending edict would fail an efficacy test.

Long-duration, long-term mask wearing is not without cost to those wearing the masks. There are significant populations for whom wearing masks for long periods of time is harmful. Individuals with COPD, emphysema, heavy smokers, and a variety of cardiac conditions can experience negative effects when required to wear masks for extended periods. Additionally, there is considerable literature showing that mask wearing reduces blood oxygenation between 5% and 20% when worn for long periods of time. Over 30% of healthcare professionals who wear surgical masks or N95 masks for several hours at a time experience headaches, light headedness and impaired decision making.

Any reasonable review of pertinent literature would acknowledge that health costs would be imposed on many who are compelled to wear face masks. There is additional credible literature pointing to immune system impairment resulting from long-term mask usage and worsening of infections in sick people. If we apply a no-harm criterion to Northam’s proposed course of action, it would fail.

If the proposed course of action fails even rudimentary tests of efficacy and benign effect on those required to wear the masks, we are left with the question of why the governor is pursuing the mandate. Given the Governor’s appearance at Virginia Beach on Memorial Day weekend without a mask and violating his own social distancing dictates, how can we reasonably infer that he believes in his own recommendations?

Sidney Bostian lives in the Richmond area.