This week a handful of American schools, businesses and healthcare facilities re-imposed mask mandates and other Covid safety policies. This provided an opportunity for lobby groups and our new Covid safety subculture to advocate for the return of the “new normal” media narrative: a “surging” virus is meeting a “complacent” population that will need to be “nudged” to do the “right thing”.
This included a small college in Atlanta with 400 students, elementary schools in Texas and Kentucky, an LA Hollywood film studio (responsible for The Hunger Games) and some Kaiser Permanente health facilities in California. Pro-mask mandate scientists and doctors, such as Independent SAGE member Trish Greenhalgh of the University of Oxford and former US surgeon general Jerome Adams took the opportunity to model “good” mask behaviour.
According to CNN, a number of “experts” continue to claim that it “may be time to break out the masks again” since “the virus is always lurking, waiting for openings,” and “Covid is just going to be a bit of a roller coaster, probably forever.” The US and UK have seen medical advocacy groups recently call, in the BMJ and Annals of Internal Medicine, for the return of permanent or seasonal medical mask mandates in all healthcare facilities, which has continued in some states and clinics.
Media articles have mostly focused on advocating for high-risk groups to “return” to masking as a personal decision. Yet the mandate debate in healthcare facilities does threaten to fundamentally (and literally) change the face of healthcare for years to come. The public is being reintroduced to the moralisation and virtue-signalling of collectivist masking. The risk-framing narrative, use of selective experts and social marketing techniques are all reminiscent of 2020-21 nudge strategies. Yet the exaggerated poetic licence and double-think of the “long masker” subculture ignores some key facts.
Before Covid, population-wide medical masks were not viewed as a particularly effective tool for respiratory viruses. In a 2018 address at the National Academy of Medicine, science writer Laurie Garrett stated that “the major efficacy of a mask is that it causes alarm in a person and so you stay away from each other.” This is roughly consistent with the updated 2023 Cochrane review, which found that mask-wearing made little difference in a community setting. More recent RCT studies of community masking during Covid in Bangladesh and Guinea-Bissau (America forgot to run RCTs on masks) found little to no benefit of community-wide cloth masking, too.
Pro-mask groups will argue that the Cochrane review did not account for the many observational studies that appear to support mask mandates. But there are major flaws with such studies. The results from a recent high-profile evaluation that found lifting mask mandates at Massachusetts schools was associated with increased Covid cases could also be explained by uncontrolled confounders. Other observational studies in Spanish and American schools show no effect from mandatory mask policies.
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