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.

Elite public schools SHOULD consider zip code + academic performance

Fourteen families in Boston recently brought suit against the Boston Public School district, alleging that the COVID-19 era adoption of zip code as a determining factor for admission to the city’s elite “exam schools” was a proxy for race.

I’m delighted that these parents lost their suit in federal court, though I’m sorry that the young scholars represented fear for their futures due to the state’s failure to supply appropriate educational opportunities.Boston Globe online edition with Civil Rights suit article circled

My reasoning? Human beings may tend to sort themselves by distinguishing characteristics—skin color or “race” amongst them—but, in spite of its history as a racist city, there are no formal color-based barriers to residence in any Boston neighborhood today. People who would like to improve their children’s odds of admission to the exam schools are free to live in neighborhoods with larger quotas assigned to them.

Even at the height of segregation, I’m not aware of any rule that ever prevented wealthier, more powerful groups from moving to areas with lower median income. Most efforts prevented the richest “undesirables” from inhabiting homes viewed as the exclusive domain of the then current “better classes” such as White Anglo-Saxon Protestants (WASPs.)NZ Botanic Garden Curator's House - 1

According to the Boston Globe, when the traditional entrance examinations were deemed unsafe due to the pandemic, BPS adopted the following policy for admission to its three elite institutions including the storied Boston Latin:

“…students will be admitted to the exam schools based largely on their grades and in some cases MCAS scores. Seats will also be allocated by ZIP code, giving top priority to areas with the lowest median household income. The number of seats per ZIP code will be proportionate to the share of school-age children living there.”

Quoted from article by James Vaznis updated April 15, 2021, 10:21 p.m. (emphasis mine)

Pardon me for pointing out the obvious, but nothing prevents families from moving to the suddenly more advantageous zip codes. Given that these people must live somewhere with a higher median income, affordability—by definition—can’t be a barrier. Preferring to live in a racially, ethnically, or fiscally homogeneous enclave is a choice; sometimes our choices have consequences we may not enjoy.

Richer families can afford private schools. The least well off families in higher income zip codes have the most reason to dislike the change in admissions criteria. Frankly, though, the truly objectionable reality of this case is that all students aren’t equally able to access high quality classrooms. Now that’s a worthy reason to bring a lawsuit. Backpack with textbooks and school supplies spilling out

But because of the tight link in the United States between home-ownership and wealth, those lower-middle income families are more likely to be renters. Renters can move more readily than people who own their own home. I’d call that yet another benefit to factoring zip code into BPS’ admissions criteria.

The fact that lower median household wealth correlates directly with skin color in America is an embarrassment to our nation. There is no evidence save the easily debunked rantings of white supremacists for any rational basis to this truth; it’s wholly a byproduct of long-standing cronyism and widespread, systemic bias on the part of both individuals and institutions.

In spite of the fairly obvious reality of systemic racism, the BPS admissions policy in question does not in any explicit way prefer to admit children with more, larger, and more pigmented melanosomes* over those with less. It does explicitly tie income to admission, but offering enhanced opportunities to the brightest, hardest working children in a city because they were born with the extra burden of poverty seems eminently reasonable to me.

According to the Census.gov analysis I pointed to earlier regarding household wealth, education is firmly linked to better financial outcomes.

“Higher education is associated with more wealth. Households in which the most educated member held a bachelor’s degree had a median wealth of $163,700, compared with $38,900 for households where the most educated member had a high school diploma.”

—2019 analysis of U.S. Census Bureau report and detailed tables on household wealth in 2015

I say, let’s give more children from our poorest districts the chance to prove their mettle. Let’s offer better tools to help our least advantaged young people outgrow poverty, for their own benefit, and for the benefit of our society as whole. There’s no evidence that education is a zero sum game though admission to Harvard may be.

This new—and, remember, temporary!—policy is admitting the best students from Boston’s public elementary schools into their best public high schools at a rate proportionate to how many children live in given neighborhoods. Those kids may not perform better than the second or third best students at another school in more expensive zones of the district, but so what? They remain kids who show up to class, work hard to please their teachers, and follow the rules. Great students are gaining those coveted admission slots.Binder page listing high school courses for grade 10

BPS is hardly admitting disinterested, failing students from poor schools at the expense of dutiful scholars from richer ones. The real issue is that a few kids enjoy exceptionally excellent free public education while the rest are left to endure in lower quality institutions due to the vagaries of circumstance.

Without extra household funds, the poorest kids in Boston can’t afford private tutoring. Their parents—the financial data from the Census suggests—are less likely to have been highly educated; they’re likely less able to assist their kids with their toughest assignments. In spite of that, these children excel academically at the school their limited circumstances proscribed prescribed for them. I’d argue that their success is the most deserving of acknowledgement and reward on the part of the school system because of how hard won it is.

Policies such as this one finally offer an incentive to encourage our cities to integrate. Integration benefits all of us, not just poor children or students of color. The wildly uneven quality of public schools has driven real estate bubbles and worsened multiple types of segregation, directly leading to many of the upheavals and protests that roiled America over the past year.

I applaud Boston Public Schools for taking this step toward becoming an agent of change in this dynamic. Now they—and the rest of us—should work on offering an equivalent caliber of education to those rarefied, elite “exam schools” to every child who wants it.

* Melanin is responsible for pigmentation of human skin, hair, and eyes; melanosomes are the cells in the body that synthesize the melanin responsible for darker skin tones

Seeking only perfect role models means failing to learn from history

Like many others—including the city’s mayor—I find the choice by the San Francisco Board of Education to spend its time focused on name changes for 1/3 of its public schools in the midst of a pandemic quite shocking. It strikes me as a misuse of resources when the children the Board is commissioned to serve are struggling to learn remotely with no* firm re-opening plans in place.

Binder page listing high school courses for grade 10Contrary to the far right, white supremacist commentators who unilaterally dismiss that Board of Education’s actions as essentially foolish, I’d like to make clear that I support discussion of social justice issues in this context. The feelings of enrolled students about the namesake of their institution deserve to be recognized, though, crucially in my opinion, not catered to by default, and never without extensive study and careful reflection when a preponderance of reasonable people hold differing opinions.

Talking about thorny questions is helpful, even vital to each pupil’s education. Confronting difficult episodes in our shared history enables us to be better as a nation and to become better individual human beings. I disagree with some of the ultimate decisions made by the San Francisco Board of Education about striking particular names from schools, but it’s not because I am unaware of mistakes made by leaders in earlier eras.

By my reckoning, the great hubristic error shown by that Board is the futile quest to pretend any perfect role model exists, unblemished enough to “deserve” to have a school named for him or her.back side of Christopher Columbus monument in Barcelona, Spain

No man or woman can be held up as a paragon of all virtues for all times. All of us fail; the very best of us will lead a life full of foibles. Some of us succeed handsomely in our own time, but later run afoul of changing notions of decency in another era.

The greater the risks taken in life, the more likely we are to make at least one real doozy of an error. People who devote lives to public service will fail with an audience, by definition. Should we teach our children to avoid any action to circumvent the possibility of failure? Do we want tomorrow’s adults to be more afraid of being judged by history than they are of taking part in—and becoming leaders of—public life?

Speaking for myself: no, I would not choose to teach that lesson to my kids or anyone else’s. I think the San Francisco Board of Education is doing a grave disservice to the children it serves by wielding nuanced history as a blunt instrument. Ironically, time is unlikely to be kind to its members. If they are remembered at all, it may well be for presumption and self-righteousness.

There is evidence that children allowed to fail, shown how to learn from their mistakes, then given opportunities to try again to find success grow into healthier, more productive adults. Given the 100% probability that a human being will screw up, a focus on incremental improvement seems like the wisest approach to raising and teaching young ones.

Christen your institutions with improper nouns defining high ideals if you still demand perfection: Liberté, égalité, fraternité, perhaps? Freedom? Justice? Unity? My personal favorite is Integrity.

Statue of LibertyIrreproachable individuals don’t exist, San Francisco Board of Education, but I’m curious to see who you believe holds up better to scrutiny than yesterday’s heroes with their feet of clay.

The social justice warriors on San Francisco’s Board of Education might not like being compared to fascists, but, to me, the parallels are obvious. People in power are attempting to strong-arm the world into abiding by their own narrow standards, ignoring complex reality in favor of pat party lines and simplifications that cast “the other” as willfully evil. Without a doubt, extremist elements on the left are also prone to seeking economic and social regimentation with forcible suppression of opposition.

Our young people didn’t invent cancel culture. Students of history will recognize the eradication of the names of pharaohs such as Akhenaten and Hatshepsut as a similar insult to non-conformists. The term damnatio memoriae may be modern**, but the concept is not.

Let’s teach our children to honor what’s good in our history while recognizing errors for what they were: human failings. Then, we learn what we can from those past mistakes, incorporating their lessons into our own pursuit of a better future. Isn’t that the ultimate point of public education?

* As of January 29, 2021, as I write these words, only one school’s re-opening plan has reached the Site Assesment stage and zero (0) applications to re-open have been accepted.

Presenting a role model as too perfect actually prevents teens from seeing a path to similar success for him- or herself. According to the linked study, kids benefit more from learning about Thomas Edison who worked very hard to achieve success (in spite of his reputation as a real jerk) vs. Albert Einstein whom most regard as a born genius with preternatural intellectual abilities.

On a television show I watched recently, the teens attended a school called Excellence. That’s a fine paradigm for which to aim.

Too bad one of the hyper-pressured teen characters felt compelled to abuse drugs to keep up and cope with the stress, and an otherwise ethical teacher on the show guides a young child toward cheating on high stakes exams to chase the academy’s pursuit of excellence in its reputation over the needs of that pupil.

** 17th century