Fauci Is Dead Wrong About Indefinitely Needing Face Masks on Airplanes

Dr. Anthony Fauci, who has been the Director of the National Institute of Allergies and Infectious Diseases (NIAID) since 1984, has played a major role in advising the U.S. public on pandemic measures. He has also been off the mark on numerous occasions. Here are but a few:

• In February 2020, Fauci wrongly predicted that COVID would most probably have a fatality rate of 0.15 percent, which would have been on par with the common flu. In a matter of a few weeks, Fauci went from thinking the risk was minuscule to being supportive of lockdowns, albeit only for two weeks. It ceases to shock me how quickly "two weeks to flatten the curve" turned into months. He continued to push for strict lockdowns in the latter half of 2020. He was continually critical of states on multiple occasions that decided to open "too early." The scientific evidence ended up vindicating those states by showing that lockdowns are ineffective and harmful.
• Fauci was wrong when he thought that schools should be shut down because he went under the erroneous assumption that allowing children to go to school would be superspreader events. It turns out that the science showed that COVID is a minuscule risk to children. 
• Fauci admitted openly that his goalposts of herd immunity were not based on science, but "what the public was ready to hear." 
• His flip-flopping on masks has been astounding. In February 2020, Fauci said "there is no reason whatsoever to wear a mask." He changed his mind in April 2020 supposedly because he was worried about the supply of face masks. Fast-forward to January 2021 where he went as far as saying that even the vaccinated should wear two masks, even though Fauci admitted in May 2021 that a vaccinated person wearing two masks was tantamount to pandemic theatre. 

I could list more not-so-endearing Fauci moments, but I want to move on to Fauci's latest faux pas. This one took place on a December 19, 2021 airing of ABC's This Week (transcript here). When asked if we will reach a point where we do not have to wear face masks on airplanes, Fauci's response was "I don't think so." In Fauci's mind, those who travel on airplanes will be wearing face masks for the foreseeable future. This response is problematic for a number of reasons. 

Let's begin with the efficacy of face masks generally. The pre-pandemic understanding behind face masks was that "face masks should not be worn by healthy individuals to protect themselves from acquiring respiratory infection because there is no evidence to suggest that face masks worn by healthy individuals are effective in preventing people from becoming ill (Desai and Mehrotra, 2020)."

At the beginning of the pandemic (i.e., May 2020), I was mildly supportive of a temporary face mask mandate. In spite of the mixed evidence that we had at the time, I figured a temporary measure that had low costs and potentially high benefits was good advice at the beginning of the pandemic when we had less understanding of face masks in the context of COVID. I started to change my mind as the pandemic progressed. 

About one year into the pandemic, the World Health Organization (WHO) said in December 2020 that "there was only limited and inconsistent scientific evidence to support the effectiveness of masking healthy people (WHO, 2020, p. 8)." A month earlier, the revered Cochrane examined multiple studies on the transmission of influenza-like diseases and found "there is low certainty evidence from nine trials that wearing a mask may make little to no difference to the outcome of influenza-like illness (Jefferson et al., 2020)." The WHO and Cochrane findings began my process of truly questioning face masks.

I continued to be begrudgingly supportive of face masks, but then came accessible vaccines. Looking at the vaccine process and the clinical data, I found that vaccines were safe and effective. Vaccines are much less riskier than contracting COVID. By the time we reached August 2021, I wrote a piece illustrating why we do not need face mask mandates. Aside from not being significantly responsible for lower case rates, I also argued that vaccines are a way more effective tool in fighting this pandemic than face masks. We also have to factor in that vaccines greatly reduce severe COVID cases, COVID-related hospitalizations, and COVID-related deaths (Scobie et al., 2021). It makes less sense to talk about COVID cases when vaccines have further severed the relationship between cases and disease severity. 

If that were not enough, a literature review from the Cato Institute shows that, as of November 2021, the available evidence of face mask efficacy is of low quality (Liu et al., 2021a). While masks are shown to reduce some measure of droplet transmission, what has not been demonstrated with available clinical data is a correlation with infection outcomes (Liu et al., 2021b). As a fun side note, CNN medical analyst Dr. Leana Wen said earlier this week that cloth masks are little more than face decorations in the face of a variant as contagious as omicron.

More specifically, the evidence for face mask usage in airplanes is even more scant than face masks generally. The 2020 Harvard study is not based on the gold standard of randomized controlled trials, but was done through modeling. An Irish case study of an international flight to Ireland suggests that in-flight transmission was the only possible solution (Murphy et al., 2020). Here is another case study, this one being a two-hour, domestic Japanese flight (Toyokawa et al., 2020). In spite of these studies, the evidence base is still that of low certainty. The evidence base for face masks slowing COVID transmission, whether in the general sense or specifically on airplanes, is weak.

I would like to talk about the risk of contracting COVID while on an airplane. What is the risk of flying the friendly skies during this pandemic? To quote the medical journal JAMA Network from October 2020, "the risk of contracting coronavirus disease 2019 (COVID-19) during air travel is lower than an office building, classroom, supermarket, or commuter train." Southwest Airlines CEO Gary Kelly testified in front of Congress saying that high-efficiency particulate air (HEPA) filtration systems capture well over 99% of airborne pathogens and converts the air every two to three minutes. The aforementioned comes from a finding in a 2020 Department of Defense study showing how low-risk riding in an airplane is. How low-risk? How good of a job are HEPA filtration systems on a plane? According to the DOD study, the HEPA filtration systems do such a good job that the risk of COVID is lower than being in one's private home or being in an operating room (see Figure below). Out of all of the indoor places one can be, being inside an airplane is actually one of the safest. 

Fauci does not care about how low the risk is on an airplane. He said as much in the ABC interview by stating that "Even though you have a good filtration system, I still believe masks are a prudent thing to do." Fauci is an eighty-year-old man for whom the only level of risk that is acceptable appears to be zero risk. After all, Fauci did say in that ABC interview that we cannot return back to normal until we finish this. 

Fauci does not care about how little evidence exists to support or refute mask-wearing. Fauci does not care about how mass vaccination has made COVID more manageable. He does not care that air filtration in an airplane is so high-quality that in terms of COVID-related risk, it is safer to be in in airplane than it is in an operating room. It does not matter that flying in an airplane without a mask is a low-risk activity. Fauci does not want us to go back to something resembling a pre-pandemic normal. What he cares about is fear of COVID and that we share his fear until the day we die.

Risk is a part of life. We do not have the luxury of living in a bubble and eliminating risk. Fauci analogizing the fight against COVID to fighting the Axis powers in WWII is another example of showing how out of touch he is. The U.S. government has declared a War on Terror, War on Drugs, and War on Poverty. Remind me again how well those "wars" are going. COVID is not going to go away. As I brought up in October, this pandemic will not truly end until we as a society can accept risk once more. If we cannot let up on pandemic regulations in the safest of conditions, such as wearing face masks on airplanes, what hope do we have of leaving the pandemic behind us? 

We should not give into fear. We should also not continue to push health regulations that have little to no evidence to support it, as is the case with face mask mandates. We cannot mask our way out of the pandemic. As the Cato Institute brings up, since the effectiveness of masks is uncertain, we should focus on practices that we know to be effective: vaccines, better ventilation systems, and discouraging crowding in closed areas (also see University of Minnesota review of masks here). I do not know whether President Biden will extend the face mask mandate on airplanes beyond the current mid-March expiration date. I certainly hope not. What I do know is that when government bureaucracy is entrenched with hypochondriacs, fear-mongers, and the most risk-averse who claim to follow science but effectively ignore the science, we end up in a dystopian society that values fear above else. This mentality that leads so-called experts to say we need to indefinitely wear face masks on planes to avoid the smallest of risks is no way to move forward and sure is no way to live.