Masks may be liberty-preserving alternative to mandatory vaccines or vax passports

There may be an alternative to mandatory vaccines and the inherent privacy and security concerns of either paper or electronic vaccine passports: allow people to opt out, but normalize the use of masks in densely populated, public, indoor settings when conditions suggest caution is demanded.

In the United States, this requirement should be tied directly to CDC reported rates of dangerous, communicable diseases with wastewater surveillance informing decisions. Medical research should be funded to track the effectiveness of masks against flu and anything else that’s feasible, not just COVID-19.

Ongoing investigation of the role aerosols—and inadequate ventilationplay in spreading common diseases demands equal attention and funding.

I, for one, would not return to an office as of May 2021 without a mask on my face if the space didn’t promise four to six air changes every hour or a fully vaccinated cohort of coworkers! This Wired story is a must read for those who’d like to understand the origins of medicine’s deeply flawed 5 μ myth defining “airborne” pathogens.

While our coronavirus memories are fresh, we owe it to future generations to prepare better for the next global outbreak. It is as inevitable as SARS-CoV-2 was. Fumbling our collective response, however, is not preordained.

We’ve learned a lot during the course of the coronavirus pandemic.

Ample real world evidence is now available suggesting that even simple homemade cloth coverings reduce the risk of infection from at least this one airborne virus. Flu also virtually disappeared during the 2020-21 season, though that could be as readily attributed to social distance and isolation as opposed to masks.

In the absence of the worldwide supply chain disruptions common early in this pandemic, more definitively effective surgical and N95 masks are easily obtained and affordable. Employers with public storefronts should have boxes of them deployed in the workplace in the same way food service companies provide gloves to their workers.

Unfolded ProGear N95 mask sitting in front box of 50 it came in

As with gloves and hairnets in restaurant kitchens, masks should be the immediate, hygienic response to entering the personal space of unknown persons with unknown vaccination status while any community is in the throes of an infectious agent.

Massachusetts’s governor is quoted in a May 7th Boston Globe opinion piece as saying, “some people have ‘very legitimate reasons to be nervous about a government-run program that’s going to put a shot in their arm.’” The same piece goes on to report, “Attorney General Maura Healey… this week repeated her call for public employees to be vaccinated as a condition of their jobs.”

Requiring every public employee in a customer facing position to wear a face mask at work unless s/he chooses to offer verifiable proof of vaccination seems like a cheap, simple, practical solution to me. As every scientifically literate, law-abiding citizen of the United States now knows, wearing a mask is no more difficult* than wearing pants.

Rome, the power house of the ancient world, believed trousers were ridiculous, barbaric garments. Quite literally, Romans, like the Greeks before them, saw pants as uncivilized clothing fit only for uncouth Goths and Vandals. The entire Western world, and most people around the globe, now don trousers without compunction. Masking one’s face requires no greater degree of adaptation!

Most of us could decide which we prefer at work: to wear a mask, or to accept vaccination. Crucially, the public at large ends up protected either way.Redacted official CDC COVID-19 Vaccination Record Card

I think it is likely that I, personally, will never want to fly again without a face covering, if only because I’m so well aware of my own tendency to touch my face and even bite my nails when experiencing anxiety. It’s a terrible habit I’ve never been able to break, but a comfortable face shield or mask would remove almost all of that risk to my health.

There will always be liars and attempted cheats, of course. Responses to those caught committing public health fraud should be proportionate and focused on preventing harm to the community.

Perhaps being fitted with a device designed like the ankle bracelets employed for house arrest for a period of time would work, offering a visible warning to strangers while broadcasting via Bluetooth? a message alerting those in the vicinity of the need to increase social distance. This could be a system that works with individual’s cell phones, or a device required for public occupancy of spaces meeting certain size or density limits rather like the requirement to install smoke alarms and fire sprinklers before opening a hotel or nightclub for business.

The primary solution is to normalize the continued use of masks in dense situations where we crowd together with unknown persons. The secondary need is for public spaces to meet reasonable, updated standards for safety in light of our current understanding of risk in the post-COVID-19 world.

Once COVID-19 vaccines are fully approved by the FDA, I do believe that employees who work specifically with the most vulnerable population should be required to accept vaccination or leave those particular roles.

Aides in nursing homes should not be able to opt out of coronavirus vaccines, nor the flu vaccine in normal years, nor should nurses serving the immune-compromised. Prison guards—who work with populations literally unable to escape from unvaccinated sources of exposure—are another obvious group whose personal choices should not be allowed to endanger the lives or health of others.

The actual conditions of employment for such positions demand a workforce that doesn’t subject other people to unnecessary risk so easily mitigated by inoculation. Case in point: the unvaccinated Kentucky health care worker who caused the death of three elderly residents of the nursing home where s/he worked. To pretend otherwise makes a mockery of both human decency and common sense.

In another example: a recent study published in JAMA showed that 46% of organ transplant patients produced zero antibodies after a complete 2 shot course of SARS-CoV-2 mRNA vaccine. It’s unreasonable that such individuals should be unknowingly subjected to the ministrations—however well-intentioned—of unvaccinated health care workers, certainly not without the immune-compromised patient’s being informed of their relative risk and given the opportunity to offer fully informed consent to taking said risk.

Face masks could also offer an effective solution for the conflict between public school vaccination requirements and anti-vaxxer parents currently allowed in some states to claim religious or other non-medical exemptions for their children.

Further research might prove that masks are not effective against every disease against which we have mandatory childhood vaccinations, but face coverings could potentially eliminate the friction between parent choice and community health in the context of the vital public good which is free, universal education.

Where freedom is the prize—and outbreaks of vaccine-preventable childhood infectious disease remain rare in America—I’d argue that the value of face masks as an alternative to mandatory injections is well worth exploring.Disposable surgical mask

Western medical science was patently wrong, before COVID-19, when it declaimed that face coverings offered no protection from infectious disease. We still aren’t sure if they protect the wearer so much as those in the vicinity of a masked, sick individual, but we do have substantial evidence that widespread adoption of masks can protect populations during a deadly outbreak.

Perhaps most importantly, where even the most well-vetted, safest vaccine or medication carries some tiny risk of harm to its recipient, wearing an appropriate, well-fitting mask correctly has virtually zero chance of injuring anyone. Low cost interventions with few side effects are ideal public health measures.

Asian nations which had internalized the historical lessons of earlier epidemics had it right; many** normalized face coverings during flu season. Now we know better, too. Science proves its inherent value when we incorporate new data into our body of knowledge, especially when we recognize data challenging existing beliefs and ingrained patterns of behavior.

This BMJ editorial (PDF) highlights the danger of clinging to false understandings. This opinion piece by Dr. Zeynep Tufekci is well worth a read on the subject of organizations lurching only slowly toward acceptance of new information challenging medical and scientific preconceptions.

Before the next pandemic, we should take great pains to study when, where, and how cheap, medically risk-free facial coverings work to effectively control the spread of disease. How many thousands fewer would have died if we’d deployed masks as a solution worldwide in days instead of months in 2020?

This is not merely a political issue. It is a matter of public health. Where solutions exist that preserve both life and liberty, we owe it to democracy—and humanity—to explore every possible compromise.

Per the CDC, roughly 1000 flu cases were diagnosed during the pandemic 2020-21 season vs. more than 65,000 cases in the more typical 2019-20 season.

* As with trousers, some are the wrong size, and some are more comfortable on a particular body than others. Trial and error may be required to find the perfect fit for a given individual. Compared with the effort necessary to remediate infecting a susceptible individual with a life-threatening disease, this process is, at worst, a trivial inconvenience.

Per the Boston Globe: One of the major senior care operators in the state of Massachusetts came to a similar conclusion before COVID-19, though the quote perversely suggests that the organization was more interested in shaming staff members as opposed to protecting elderly residents:

“A year before the pandemic, Hebrew SeniorLife required flu shots for the first time for staff. Administrators achieved 100 percent compliance by imposing what seemed at the time an onerous condition: Holdouts would be required to wear masks 24/7 during flu season.

‘That was totally embarrassing then, but not now,” Woolf said. “We don’t have that hammer anymore.’”

In my opinion, after legitimate scientific studies were conducted to confirm that mask use by unvaccinated staff protects vulnerable patients to an equivalent level as vaccinated staff with faces uncovered, this could be a sufficient and highly appropriate alternative to mandatory shots in some cases.

Voluntary residential situations for children under age 18 should probably be held to a higher standard, in my opinion, and strictly require vaccinations for all but medically exempt participants. Absent direct parental supervision, it seems unreasonable to subject anyone else’s child to unnecessary risk due to personal choices that contradict the best current medical advice.

** Routine wearing of masks was imported to Japan from Western nations who’d adopted them as one response to the influenza pandemic of 1918-19. Unlike we Americans, Japanese culture never dropped them as a reasonable personal response to being contagious after the urgency of the Great Influenza subsided.

This Huffington Post article suggests that the Chinese adopted protective face coverings even earlier: “In 1910 and 1911, citizens were encouraged to wear masks to combat the pneumonic plague outbreak in Manchuria.”

The article goes on to point out that other Asian nations picked up the habit of covering faces during outbreaks due specifically to the SARS epidemic of 2002-2003. I’ve read that Koreans, in particular, actually viewed masks in a somewhat negative light as a foreign, Japanese import before the first SARS crisis.

4 tips to help kids wear masks safely at school

I’m a volunteer safety monitor during lunch and free time a.k.a. recess at a school serving grades 1 – 8. Aside from keeping the usual eye on the kids, during COVID-19, this job also emphasizes maintaining social distance and wearing face coverings properly.

With a few weeks of the school year under my belt, here are my top tips for parents who hope to help their kids keep their masks in place while they play.

Disposable surgical maskMy top four playground observations regarding children and masks:

  1. Fit matters
  2. Fabric matters
  3. Washing matters for re-usable fabric masks
  4. Instruct kids on how to sneeze before they need to know

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Wear a mask, people of faith, or live in sin

Wearing a mask or other face covering to reduce the spread of coronavirus should not be a political issue because protecting members of our own communities is so obviously the right thing to do.

Safety goggles, cloth face mask, and disposable glovesThis partisanship doesn’t even make rational sense in the context of America’s “culture wars.” Republican party members often proclaim themselves pro-life,º yet many refuse to don protective gear during a pandemic, callously risking the lives of others because the price of a few dollars and mild inconvenience is too high.

GOP.com suggests that Republicans believe Culture should respect and protect life.

You should wear a mask—and follow government mandates ordering you to do so—for the same reason you shouldn’t drive while intoxicated: these rules are enacted to save human lives. We have always limited some freedoms via the common law when one person’s actions infringe upon the rights of others’ lives or property.

It’s none of my business if you are an adult who chooses to get drunk; it is anyone’s business to intervene if you callously murder other people by operating a motor vehicle in that condition. I make no moral or ethical distinction between that action and firing a gun with a bullet in its chamber into a crowd, nor should the law. Mask directives land squarely in this legal territory.

I’m not making accusations from a place of partisanship, either. Objective evidence suggests that Republicans are those least likely to wear masks. A New York Times article from June 2, 2020, referenced a Gallup poll showing fewer than half of Republicans had donned a mask in public. In the same poll, 75% of Democrats had worn one, as had 58% of my fellow independents.

While this inaction flies in the face of the GOP’s pro-life position, it also repudiates the Christian faith of the majority of its members. A 2017 Washington Post article gave me the figure that “73% of the Republican party is white Christian.”Jewish Torah, Good News Bible, and cloth face mask

The 6th Commandment: Thou shalt not kill

I grew up attending a United Methodist Church, though I converted to Judaism as an adult. My daily life is enriched by living amongst observant Christians. While I won’t pretend to be any kind of theological scholar and I personally believe much of the revealed truth of Torah/the Bible to be allegorical, I find the Ten Commandments clear and straightforward, especially this one:

Thou shalt not kill.

There are variations in understanding the Ten Commandments depending upon whether you ask a Jew, Protestant, or Catholic. Thou shalt not kill is usually cited as the 6th*.

Wearing a mask definitively reduces the chances that the wearer will infect someone else with COVID-19. Doctors and scientists are still working to unravel the many mysteries of this novel coronavirus, but there is solid evidence that many cases are transmitted by asymptomatic or pre-symptomatic individuals, i.e., people who don’t think they are sick. If you wait to wear a mask until you are sick with COVID-19, you may well have already infected another innocent victim.

COVID-19 has killed over half a million people around the world already, and it is especially lethal when it infects the elderly. I can’t help but leap from this fact to another of the Ten Commandments, number five:

Honor thy father and thy mother; in order that thy days may be prolonged upon the land which the Lord thy God giveth thee.

Excerpt of page of Torah/Bible showing Exodus 20:12-13From my again, admittedly, allegorical interpretation of this commandment, wantonly endangering the lives of any elderly person is quite literally a sin. Even according to a strict interpretation of the words, not wearing a mask to protect your own parents would be the sin. Taking part in a culture of resistance to protective measures makes you complicit in endangering this vulnerable population whether you’re the one who infects your mom or a member of her church does.

Refusing to wear a mask while a virus ravages the weak is an indefensible position for anyone purporting to ascribe to Judeo-Christian values.

The author wearing an improvised home-made face coveringI didn’t need more reasons to cover my face in public during a pandemic, but, upon reflection, I found two more in my faith.

º The Republican party website, on its Platform page, has a poll “Why Are You A Republican?: Tell Us Which Principles Are Most Important To You.” The choices are compiled from previous visitors feedback, and include the option: “Culture should respect and protect life.”

Dated September 6, 2017, but behind a paywall. You could try searching for “The stark racial and religious divide between democrats and republicans in one chart.” Please note that the racial aspect of this chart had nothing to do with my point, but this was the first recent and reliable source I found for statistics on the religious makeup of the Republican party. Presumably there are Christian people of color in the Republican party as well, so it is likely that more than 73% of party members consider themselves to be followers of Jesus Christ.

* Catholic interpretation would say this is the 5th, not 6th, commandment.

Catholics omit the second clause, but the shared portion makes my point. For them, it is commandment number four.

Note: The author’s improvised face covering shown in the last photo is not ideal COVID-19 protection for others as it fits too loosely around the face. See the CDC for further advice. This hat+mask combination was my first attempt when PPE was still scarce for health care workers, but the idea of home-made cloth masks was introduced as a reasonable alternative for civilian wear in daily life. It was comprised of a napkin and pipe cleaners and designed to be worn on local walks where social distancing could usually be expected. A loose mask like this is still better than no face covering, however, and it is much easier to breathe in during socially distanced exercise.

Teen wearing medieval plague doctor mask leaving house for a walkMy teen opted for a rather more historical mask that he happened to have lying about the house. My claustrophobia would make this style very difficult for me to wear, but we did get some great photos that day.