Public Health of Madison and Dane County's Face Covering Emergency Order #7 declares that “mask-wearing is an important layer of protection to slow the spread of COVID.” It is reasonable to think that PHMDC must possess a great deal of evidence supporting mask use for them to be confident enough to mandate long-term mask usage for the entire population, isn't it?
In fact, in its limited communication with the public, the Board of Health for Madison and Dane County, which is meant to provide oversight to PHMDC, has claimed to possess this information. They imply, however, that they simply can't share the data because, in what they've deemed an emergency, taking time to engage further with the public would distract them, waste their resources, and result in additional loss of lives.
This excuse just doesn't make sense. Shouldn't a well-meaning science-supporting public health agency be highly motivated to educate the public about the underlying science that guides their policy-making?
Solid evidence would help to convince skeptics and improve compliance with PHMDC policy measures. Yet, when asked, Dane County health leaders have failed to provide the evidence underlying their mandates and have consistently refused to engage the public in good faith dialogue about the data they insist they have.
How long would it take to list the scientific studies they find supportive of their policy? If they have data confirming mask efficacy, why not share it with the world? Why not prove what works? Can it be that a public organization with 370 employees and a budget of nearly $20 million can’t find 90 minutes to write up the rationale for their policy decisions over the course of the past two years?
The ostensible reason for the lack of disclosure is that the preponderance of the scientific evidence does not support community mask usage for mitigation of respiratory viruses.
In fact, it was common knowledge prior to COVID that masks were unhelpful in this regard.
The potential use of masks by communities to stop respiratory viruses has been studied for generations. In early 2020 the CDC actually published a systematic review that analyzed 10 randomized controlled trials of facemask use for influenza mitigation. The studies, which spanned dates between 1946 and 2018, found no evidence that face masks limit virus transmission or clinical infection. A similar meta-analysis by the World Health Organization (WHO) in 2019 came to the same conclusion.
The best evidence across decades has shown that community mask usage has no effect in mitigating respiratory virus spread. This is why there was never advice for at-risk community-dwelling individuals to wear masks prior to COVID. It’s not that there were not viruses or that the issue had never been studied or that people didn’t care about others. It’s that the medical community had studied the issue and knew a mask would not help.
So then, how did masks suddenly become essential? Did the science change? Was there a radical new discovery that invalidated the previous studies by elucidating how decades of research was wrong? No. What changed was a media-driven political narrative where numerous low-quality studies were used to support a politically chosen opinion and create the appearance of scientific consensus.
At its January 6th meeting, the Dane County Board of Supervisors formally considered 2021 RES-157, a resolution that called for Dane County Director of Public Health Janel Heinrich to rescind her most recent emergency order and mask mandate until she could formally sound out the public on the matter. The first person called to speak against Res 157 during the public comment portion of the meeting, a UW professor and virologist, literally claimed the efficacy of masks based on a study that hung masks between hamster cages. This is the level of evidence that Dane County appears to be operating on.
There are huge differences between observing mask-walled hamster cages, monitoring people using masks in a controlled laboratory setting, and actually studying the population effects of community mask usage. This is why large randomized studies of community mask wearing were originally designed. Even if there were to be some small short-term, demonstrable filtering effect for masks, the pertinent question is: Does any such effect translate into practical community benefit?
Here again, the evidence is sorely lacking. What do your own eyes tell you? Everyone in Dane County is wearing masks, and COVID cases are higher here than ever. The practical effect of masks must be quite small indeed!
The reader may be interested to learn of one new large-scale randomized trial evaluating the efficacy of community mask wearing specifically for COVID. A group in Denmark had, by April of '20, started the DANMASK-19 study which randomized 6,024 people to mask vs not mask anytime they were out of the home. This study did not show any statistical benefit to wearing a face mask in the community. Go ahead and read this study for yourself. How would the public debate have been different if the public had been educated about this study and its findings?
In closing, here are a few questions for PHMDC:
Have you formed an opinion on mask efficacy based on your own study of the scientific literature, or are you relying on opinions of others?
Which studies of mask usage do you find most convincing?
What level of community transmission in Dane County would invalidate your opinion that mask usage was having a practical effect?
If the county would present its mask-supportive evidence in a clear and understandable way, our community could subsequently have meaningful discussion about those potential benefits in the context of the tradeoffs, which are many.
Dane Undivided invites PHMDC and the Dane County Board of Supervisors to engage the public in this dialogue by presenting the evidence they claim to have.
Cough it up! :-)
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