Last week, United States District Judge Kathryn Kimball Mizelle struck down the federal mask mandate for airplanes and other modes of public transit in her ruling, which you can read here. I use public transit to get from place to place. It was the last COVID regulation affecting my daily life. The timing of the Jewish holiday of Passover could not be more spot-on. While I do not equate mask-wearing with the grinding and grueling slavery that the Israelites underwent, I felt a comparable sense of liberation. Not only did it mean a sense of bodily autonomy, but more importantly, I could put the pandemic behind me. Call it a 21st-century application of the Exodus story to my personal life. I was hardly the only one that felt that feeling of liberation.
There were airline passengers that took off their masks mid-flight because they were so sick of the mask-wearing, as well as cheering in airports. The Transportation Security Administration announced that very day that they would no longer enforce the mask mandate. The airlines immediately went from a mask mandate to being mask-optional. Even such transit authorities as Amtrak and the Washington Metropolitan Area Transit Authority (WMATA) removed the mask mandate. Keep in mind that the change did not happen in days or weeks. It only took hours or minutes for these entities to remove the mask mandate.
Not everyone shares my enthusiasm. White House Press Secretary Jen Psaki called the ruling disappointing. NIAID Director Anthony Fauci said that the ruling should not have been a court issue, but a public health issue. As we will cover later in this piece, either Fauci does not understand the concept of rule of law or does not have respect for rule of law. Economist Paul Krugman is worried that those who still decide to wear masks will face masks will face harassment, if not violence, because "this was never about freedom." I am curious if Krugman is shares the same concern about all the instances that people were harassed throughout the pandemic for not wearing a mask.
What those like Krugman do not understand is that many people do not want to wear masks. While an AP-NORC poll from last week shows that 56 percent of people want mask mandates on planes, that means the other 44 percent either do not want them or do not care either way. Left-leaning commentator Matthew Yglesias recognizes that airlines immediately switching to mask-optional signals that the airlines do not see a significant preference for masked flying.
The same AP-NORC poll also shows declining support for mask mandates in other social settings; it also shows a decline in people "very worried" or "extremely worried" about COVID, a figure that is at a pandemic low of 20 percent. An April 2022 poll from market research firm Ipsos found that 9 percent think we should be in crisis mode over COVID, as opposed to 17 percent who could not care less (the remaining 73 percent view COVID as a manageable problem, which should tell you something right there).
Thankfully, the trend is moving away from the heightened risk aversion that has been so prevalent throughout the pandemic. We are reaching a stage in the pandemic where the perceived relevance of face masks and mask mandates is waning. As the divide over mask mandates illustrates, there is a desire to get back to normal. 27 percent believe we should open everything up, and an additional 44 percent believe that we should open but with precautions (Ipsos). That is 71 percent of Americans ready to get back to normal.
If you are one of those who either want continued restrictions or are on the fence about going back to living normal, then hopefully this piece could help you out. I am going to provide my take on the federal public mask mandate ruling and masking generally in four sections. First, I will cover why the science behind masks does not merit mask mandates. Second, I will show how we have reached a stage in the pandemic where we no longer need to be in panic mode. Third, I will cover the legal argument against a federal public transit mask mandate. Finally, I will cover the social costs and moral implications behind mask mandates and masking generally. The amount of information I covered regarding the face mask debate was so extensive that for the first time in my blogging, I had to divide a blog entry into two separate entries. The first part will include Sections I and II. I plan on releasing the analyses for Sections III and IV next week.
Section I: Scientific Evidence Does Not Justify Mask Mandates
It is understandable if you were confused about masks. Public health messaging was mixed and incoherent at the beginning of the pandemic, nothing to say of dealing with mixed evidence (see my May 2020 analysis here). In spite of the mixed evidence, I thought at the beginning of the pandemic that in spite of the decidedly mixed evidence, the relatively low economic cost combined with what the World Health Organization (WHO) phrased it in its 2019 pandemic guidance as "mechanistic plausibility for the potential effectiveness of the measure (WHO, 2019, p. 14)" overrode the inconvenience of masking. As such, I was begrudgingly in support of a temporary, limited face mask mandate.
As the pandemic progressed, my support for a temporary, limited face mask mandate got weaker and weaker. About one year into the pandemic, the WHO stated that the evidence for healthy people wearing face masks was "limited and inconsistent (WHO, 2020, p. 8)." The highly revered Cochrane, which is a global network of health researchers and professionals, released a meta-analysis of randomized control trials (RTC) and cluster-RTCs, which is as good as it gets in the world of empirical evidence in the medical field (see below). Cochrane concluded that "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 compared to not wearing a mask (Johnson et al., 2020)." If you want more detail on how RTCs show that masks are ineffective, I recommend this piece from the Manhattan Institute.
After the findings from these venerable institutions came out, vaccines became more readily available. Vaccines should have been the beginning of normalcy, but we know how well that one turned out. In the meantime, the Delta variant came along. At this point of the pandemic, my view on face masks went from "skeptical about the evidence but still in favor" to "skeptical about the evidence but against mandates." By August 2021, I wrote on how the mask mandates, as opposed to voluntarily masking, does not provide additional, statistically significant benefit. In December 2021, I became more frustrated because I came across a Cato Institute literature review showing that a) the available clinical evidence of face masks is of low quality, and b) the best available evidence failed to show efficacy.
(5-2-2022 Addendum: In case the randomized control trials were not enough, here is a peer-review observational study from the Cureus Journal of Medical Science [Spira, 2022]. This study looked at 35 European countries from October 2020 to March 2021, which was during peak COVID time. As the study found, "These findings indicate that countries with high levels of mask compliance did not perform better than those with low mask usage." Although cause-effect conclusions could not be inferred there was still a lack of correlation. After all, you cannot have causation with correlation.)
I also come across this piece from the University of Minnesota's Center for Infectious Disease Research and Policy, which had the following to say in October 2021:
"It should be well-known by now that wearing cloth face coverings or surgical masks, universal or otherwise, has a very minor role to play in preventing person-to-person transmission. It is time to stop overselling their efficacy and unrealistic expectations about their ability to end the pandemic."
At best, face masks have minimal impact. At worst, we went around for two years covering our faces for nothing. Keep in mind that the aforementioned studies were released during the Delta variant or earlier. If the low-certainty evidence that pointed to little to no benefit during the Delta variant, one could a fortiori assume they did even less to prevent the more transmissible Omicron variant.
Section II: Threat Level of COVID Presently Too Low to Justify Mask Mandates
To recap Section I, the evidence base for mandating that healthy people wear face masks is weak. The evidence we do have shows that face masks make minimal to no difference in terms of transmission. But let's assume for argument's sake that the evidence was less ambiguous. If the evidence were stronger or more conclusive, would that help out the argument for mask mandates? No, and I will tell you why. Although some people react to the threat of COVID as if it were still 2020, the problem with that mindset is that this is 2022. We have dealt with this pandemic for over two years now. As of April 22, 88.9 percent of adults have received at least one vaccine dose (CDC). On top of that, the CDC estimated in February that 43 percent of Americans have had COVID (4-26 addendum: The CDC now estimates that the percentage of U.S. citizens with antibodies due to being infected from COVID is now at approximately 60 percent).
In addition to vaccine immunity and herd immunity, our access to COVID treatments has improved. The Omicron BA.2 subvariant became the dominant strain a month ago, which is significant in that Omicron is a milder variant than previous strains. The argument goes that "hospitalizations come a few weeks after cases," but how have hospitalizations fared? The "we need to flatten the curve" justification that was initially used for such measures is surely unjustifiable now because we are nowhere near the hospitals being overwhelmed. As a matter of fact, COVID hospitalizations in the U.S. in recent weeks have been at an all-time low since this pandemic began. That might have something to do with the fact that vaccines did a good job at decoupling cases from hospitalizations and deaths, not to mention COVID evolving into a less virulent strain.
Additionally, Philadelphia was the first major U.S. city to reinstate its mask mandate but removed it in a matter of days. I have been primarily focused on the United States because I live here. At the same time, other countries are removing their travel restrictions. As of April 22, 2022, there are 34 countries that have completely removed COVID-related travel restrictions, nothing to say of the countries that are repealing their COVID restrictions more gradually. Local U.S. government agencies and federal government agencies in other countries are realizing that it is time to remove the face masks and other restrictions.
If the public health concern was so overriding, why did the Department of Justice not immediately file to appeal the ruling from Judge Mizelle? Why didn't the DOJ put the ruling on hold and reinstate the mask mandate pending the appeals process? Why is the CDC still arbitrarily recommending face masks on public transit while it is recommending against mask mandates in almost every other indoor setting, most of which do not have as good of filtration as an airplane or even public trains? Also, if things were that bad, why did the CDC drop all of the countries from its highest-risk category of "Do Not Travel" on its COVID-19 travel advisory system earlier this month? Because there is no clear, overriding public health emergency to justify a mask mandate. The CDC recognizes that reality, even if it does so inconsistently and arbitrarily.
CNN admitted this appeal is not driven by public health when it stated the purpose of the Department of Justice's appeal of Judge Mizelle's ruling is "less about the current COVID-19 conditions and more about trying to preserve the CDC's authority in the future." The CDC statement in response to Judge Mizelle's first and foremost voiced concern about its authority, not public health concerns. It has become abundantly clear that this mask mandate is no longer about promoting public welfare, if it ever was. This is about the CDC maintaining control over the populace and keeping hold of its emergency powers as long as possible.
To be continued...
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