This past week our province, British Columbia, announced the dropping of mask mandates, as of Friday, March 11. Masks will still be required in medical facilities.

On Friday my husband suggested we go to a mall to see how people were responding to the lifting of mask mandates. About 65% of the people we saw were not wearing masks. I entered two business with staff who were not wearing masks. Most staff were still wearing masks.

Last year BC briefly dropped the mask mandate but then re-instated it to coincide with a surge in the Delta variant.

During the early months of the pandemic B.C.’s Public Health Officer, Dr. Bonnie Henry, held back on mandating and encouraging mask wearing. We found comfort in Bonnie Henry’s daily, almost motherly, encouragement and admonition at the beginning of the pandemic as we sat isolated in our homes. It was reassuring to learn she has a background working with pandemics. When her approach differed slightly from that of other provinces we concluded that she was looking at the bigger picture and was in particular concerned about the psychological impact of a pandemic. She knew how important it was for us to remain calm and hopeful. She knew the necessity of health officials being able to maintain the trust of the public. And she knew it was crucial for people to be a support to one another during these trying times.

So much has changed since then. 

Two specific decisions eroded my trust in Dr. Henry. Both exhibited a change in what were once her strongly held beliefs. The first was implementing mask mandates after repeatedly telling us for weeks that masks did not offer significant protection against covid-19. The second was bringing in vaccine passports after saying on May 25, 2021 that “there is no way that we will recommend inequities be increased by the use of things like vaccine passports for services with public access here in British Columbia.” I wrote a letter to her, asking for an explanation, and received no response.

Not everyone is happy with the lifting of mask mandates. This is how the World Socialist Web Site news media and other sites responded to her decision:

“Thursday’s announcement is just the latest in a crush of decisions by provinces from coast-to-coast over the past five weeks that effectively implement the far-right Freedom Convoy’s demand that all anti-COVID public health measures be rescinded and the potentially deadly virus be allowed to run rampant.” (Note “far-right” is an opinion and does not accurately describe the truckers. Note also that the government-funded Canadian Broadcasting Company recently retracted two articles, one with a false claim that the Freedom Convoy had Russian influence and the other claiming that hefty donations to the truckers GoFundMe came from foreign sources. Both false insinuations originated with our Prime Minister, Justin Trudeau, and served as his justification for employing the Emergencies Act against the truckers protest.)

In Burnaby Now you can read a similar opinion article that voices the fear that Henry is not “following the science” by lifting mask mandates.

The trouble is that we don’t know where to find the truth about the science anymore. It may not be so far-fetched to think that our governments and health officials are actually following opinion polls and have been doing so for some time.

Another question I have concerns the science. Is the science being communicated faithfully? This week I read an article referencing five instances of wrong conclusions being reported in “the science.” What led me to the article was my own observation when I decided to look for scientific research and scholarly reporting on the efficacy of masks.

I first went to the Mayo Clinic website where I found a recommendation that a cloth mask have multiple layers and is tight–fitting in order to prevent “droplets” from escaping. Initially we were told that the virus was spread by droplets but a few months later scientists informed us that the virus was in fact spread by aerosol particles. This changed the whole mask-wearing paradigm since evaporated respiratory particles can get through a porous surface. Note, if we want to inhale air, we will have to use a mask with a porous surface.

On the Mayo Clinic website I read, “Can face masks help slow the spread of the virus that causes coronavirus disease 2019 (COVID-19)? Yes. Face masks combined with other preventive measures, such as getting vaccinated, frequent hand-washing and physical distancing, can help slow the spread of the virus that causes COVID-19.”

My search for data on the protectiveness of masks alone against the spread of the coronavirus was unsuccessful. I found a lot of discussion on comparisons between masks. I found studies done in labs, but no assurance that lab results translated to effective protection by masks worn by the general public. In fact there was evidence to the contrary.

I went to the CDC website where I read, “Masking is a critical public health tool for preventing spread of COVID-19, and it is important to remember that any mask is better than no mask.”

OK, that is like saying, “any condom is better than no condom.” Would you say a leaky condom is a “critical public health tool” in the prevention of transmissible disease? Because masks are “leaky.” There is scientific evidence for that. Hence the insistence on “layers” and “tight fitting.”

But how many layers of a “leaky” mask are enough? The Mayo Clinic website also says, “Don’t add layers if they make it hard to breathe.” So, added layers can make it hard to breathe and when a child says, “I can’t breathe,” we should listen. I have low blood pressure and a low oxygen level and sometimes I find I am just not getting enough air with a mask. But that is another issue.

The CDC advises us to “Wear the most protective mask you can that fits well and that you will wear consistently.” And it further states, “Wearing a well-fitted mask along with vaccination, self-testing, and physical distancing, helps protect you and others by reducing the chance of spreading COVID-19.”

Wherever we read of the effectiveness of masks, note that it is always mentioned in conjunction with other protective measures. That is because, masks, on their own, are not sufficient protection. It has never been proven that masks are effective to prevent infection. Every reference to masks has a qualifier such as “tightly fitting”or a comparison of the fabric or weave or construction (N95 KN95 medical masks). One of the most troubling pieces of guidance offered is for people with hearing disabilities to wear a “clear mask.” We’ve always been warned not to put plastic over our heads. This is the same, unless there are breathable parts of the mask where air can enter. But do they not get the point that it is not the hearing challenged person who needs to wear a clear mask? They need to lip read others and they cannot do this if other people are wearing masks.

The CDC website goes on to say, “Masks and respirators are effective at reducing transmission of SARS-CoV-2, the virus that causes COVID-19, when worn consistently and correctly.” Medical staff have to be trained to put on their masks, and they have masks that are rated for higher protectiveness. Masks prevent droplets from escaping, so, in the case of surgery, I would want my surgeon to wear a high quality mask.

I looked at an article referenced on the CDC site entitled, An evidence review of face masks against COVID-19. The authors claim to have synthesized the relevant information and conclude that “The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts.” Preponderance of evidence in a court of law means that there is a greater than 50% chance that the claim is true. Another research article referenced on the site states this result: A total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%).

Another article listed on the CDC site concerning masks states, There is moderate certainty evidence that wearing a mask probably makes little or no difference to the outcome of laboratory-confirmed influenza compared to not wearing a mask (RR 0.91, 95% CI 0.66 to 1.26; 6 trials; 3005 participants). This is the “preponderous” evidence we have. It makes little or no difference. The “little” might tip us above the 50% threshold of evidence of truth.

Here is something more of interest I discovered. “While laboratory tests generally suggest that N95 masks are superior in performance to surgical masks, population studies in healthcare workers have not documented significant differences. This discrepancy may be due to the lack of proper fit when using N95s. Conversely, cloth masks generally perform poorly compared to N95 and surgical masks in laboratory tests. However, in part because of the global PPE shortage, cloth masks have become the most commonly used PPE by the general public. Despite their shortcomings, community-based research has demonstrated the efficacy of cloth masks in slowing down the spread of COVID-19.”

Do you want to hear about the community-based research on which mask wearing has been based? Here it is, from the same article:

As of July 2020, the CDC recommended that all Americans wear masks in public settings [20]. This recommendation was made, at least in part, due to a report from a hair salon in Missouri that demonstrated the efficacy of wearing masks [21]. In May 2020, two hairstylists in Springfield, Missouri received positive test results for SARS-CoV-2 and were exposed to 139 clients in total since the onset of their symptoms [21]. Both stylists, as well as all 139 clients, wore some kind of facial covering while in the salon, with the stylists wearing either a double-layered cotton face covering or a surgical mask. Despite their proximity to the infected stylists, for appointments ranging from 15 to 45 min in duration, it was found that none of the 139 clients developed COVID-19 symptoms within the two-week quarantine period. Furthermore, of the 67 clients tested, all results were negative. Interestingly, the type of face mask worn by the 139 clients varied, with only two clients wearing N95 masks, 46% wearing surgical masks and 47% wearing cloth masks [21]. Although anecdotal, this incident suggests that consistent and proper usage of facial coverings can help minimize symptomatic transmission of SARS-CoV-2 during close contact, as at a hair salon. In fact, it appears that COVID-19 transmission rates are generally lower in countries and regions where citizens are accustomed or required to adopt universal masking, such as many parts of Asia [22,23]. Simulations and mathematical models have also predicted that the adoption of universal masking would substantially curtail the spread of COVID-19 [24].

Yes, it is as a result of an anecdotal survey done by two hairstylists and because it “appears” that COVID-19 transmission rates are lower in regions like Asia…. This is the science behind mask wearing. Then, again, the article says, “Although there is a lack of published work evaluating the efficacy of universal masking by healthcare workers to prevent spread of SARS-CoV-2, the continuous use of masks by healthcare workers in clinical settings is widely supported.”

We wear masks because the continuous use of masks is “widely supported.”

It is important to take careful note of wording when you read anything. It is, after all, the truth we want, is it not? And, as I have discovered, truth can be misrepresented rather easily. There is sufficient evidence for that.