Unmasking the Beast
The CDC and Mask Mandates
Today I am going to talk about an extremely contentious issue… mask mandates. Before we go over some of the different ethical considerations, perspectives, and blunders let’s talk about the evidence.
The Evidence for Masking
The evidence largely points in favor of masking reducing the transmission of covid-19.
Evidence from ecological, case-control studies, RCTs, and cohort studies supports the efficacy of mask-wearing. Obviously, this efficacy will depend on the type of mask used.
For instance, the N95 mask reduces the odds of testing positive for SARS-CoV-2 more so than a surgical mask and a surgical mask reduces odds more than a cloth mask. However, wearing some form of mask is better than not wearing a mask at all for reducing the odds of testing positive for SARS-COV-2.
In addition, countries that did not implement universal mask-wearing or mask mandates saw increased transmission of SARS-CoV-2 by nearly 7.5 times as much.
More locally in the United States, states that implemented a mask mandate led to an estimated 230,000–450,000 COVID-19 cases which may have been averted.
The evidence is clearly in favor of mask-wearing as a preventative measure against SARS-CoV-2, but besides the evidence, there seems to be apprehension on the part of the national government to enact a mask mandate.
Issues with the CDC
On a personal level, I truly feel bad for the CDC, having to constantly fight back against political opposition in the face of a global pandemic is tough. Let alone gathering and sharing data from the entire country with numerous entities. Data entry, cleaning, and analysis is not an easy job, as a public health student, I should know!
Nevertheless, the CDC has been under fire recently with the admission it is withholding large amounts of data. This was due to a number of reasons from outdated systems, bureaucratic delay, and political pressure.
Does this mean the CDC is some corrupt enterprise dedicated to the downfall of humanity? No not at all, if anything the CDC is victim to the fact the United States was never prepared for a global pandemic of this magnitude.
This isn’t to say the CDC is innocent either, with certain policies and remarks from the CDC director only adding to the overall confusion of the American public. Policies such as a great reduction in recommended mask-wearing.
Mask Mandates and The CDC
Keep in mind I am subscribed to The COVID Digest and Your Local Epidemiologist, both newsletters run by epidemiologists with differing perspectives on some of the same issues.
Dr. Schmidtke from The COVID Digest criticizes the CDC for its seemingly rushed and politicized recommendation to reduce masking requirements and I do not blame her.
CDC director Rochelle Walensky made this remark on a podcast:
“I know people are tired. The scarlet letter of this pandemic is the mask. It may be painless, it may be easy, but it’s inconvenient, it’s annoying and it reminds us that we’re in the middle of a pandemic.” - CDC Director, Dr. Rochelle Walensky
This remark is unprofessional and ghastly for a number of reasons including the fact we are still in a global pandemic. If the evidence is in favor of mask-wearing the worst thing the director of the CDC can do is negatively frame that behavior as a “scarlet letter”.
Easing up on mask wearing does not magically stop the pandemic, it does not mitigate the impact of the virus, it does not guarantee reduced hospitalizations, and it does not reduce mortality. But it can increase transmission of covid along with its variants to continue taking lives.
Effectively what the CDC has done was increased the threshold for “low levels of disease” turning the map from this:
To this:
We can even quote Your Local Epidemiologist who states this about the map:
Case level definition: It’s not clear to me how they arrived at their new case metric: 200 cases per 100K in the past week. (Before today masks were needed at 50 cases per 100K in the past week). No scientific justification was provided. And I’m shocked the CDC is comfortable with this high level of transmission given long COVID19 implications, given that not everyone has access to the vaccine, and given high excess death to high risk individuals (like we’re seeing in Denmark with high levels of transmission. Vaccines are great but not perfect).
Why did the CDC increase the disease threshold to something with higher levels of transmission among the populations? No scientific explanation was given even if you look at the official CDC site.
Nevertheless, Dr. Jetelina states some positives about the new recommendations such as the inclusion of cases and a clearer definition for hospitalizations. However, these positive attributes seem to be overshadowed by what the recommendations suggest.
Common Rebuttals
Here are some common rebuttals I am hearing concerning mask mandates and the CDC with my response to them.
Rebuttal #1:
“So, you expect us to wear masks for x amount of years?”
Response #1:
I am not telling you or informing you to wear a mask for x amount of time. I am merely stating the new recommendations made by the CDC are flawed. The evidence for mask-wearing tips in favor of wearing a mask to reduce the transmission of covid-19. These are the facts and they cannot be ignored.
Rebuttal #2:
“But I am tired of the pandemic and want to get back to my life mask-free.”
Response #2:
You may be tired of the pandemic, but covid is not tired of you. Besides other preventative measures, like vaccinations, mask-wearing helps reduce community spread alleviating our loved ones from this terrible virus. Wearing a mask is simple and easy to do, it can be the least we can do for our loved ones who might be immunocompromised or dealing with chronic disease.
Rebuttal #3:
“I am fully vaccinated, why do I still need to wear a mask?”
Response #3:
With the advent of variants such as delta and omicron, we have seen instances of reinfection. Getting boosted if you haven’t already should be the number 1 priority for risk reduction. However, other preventative factors such as mask-wearing obviously help the overall picture of reducing disease spread until we get covid under control. Ever heard of the swiss cheese model?
Final Thoughts
As a scientist and public health student, I have the duty to stand up for evidence-based practice. Mask-wearing is a part of evidence-based practice no matter how much it is disliked or vilified.
The CDC’s new guidelines regarding mask mandates and wearing are inherently flawed and do not seem to be based on solid scientific support.
As an individual, me as Jae, I am deeply disappointed with the CDC, Biden administration, and the United States in general.
Over 900,000 lives were lost, but it seems this country does not take the pandemic seriously and just wants it to be over with already. This is not how reality works. This is not how public health should operate.