The Harms of Masking - Part 1

Despite the cries that anti-maskers are ableist, mask zealots have completely ignored the harmful impact that mask mandates have had on those with hearing loss.

Ever since the Cochrane review was published on January 30, 2023, there has been much written about the ineffectiveness of masking. Or mask mandates. Or both.

We seem to be caught in a tug of war: See they don’t work! vs Yes they do! Except it’s not that nice.

Still the conversation hasn’t moved past this and on to: Are there downsides from masking that should be weighed against questionable effectiveness? This is what I’d like to spend a few posts talking about by sharing some personal stories from folks who truly struggled and were discriminated agains with mandatory masking policies. They have not been heard for the past three years. It’s well past time.

But first, the background (ICYMI) on the tug of war.

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Those of us billed as “anti-maskers” jumped on the Cochrane review. (I’d argue this label is inaccurate — we just want definitive evidence that an intervention works before we’re asked to utilize it, emphasis on “asked” vs “mandated.” But I digress . . .)

I wrote this piece for The Spectator World and, more notably, Brett Stephens wrote this opinion piece for The New York Times, which really raised some hackles from the mask enthusiasts.

In summary, Stephens wrote:

The most rigorous and comprehensive analysis of scientific studies conducted on the efficacy of masks for reducing the spread of respiratory illnesses — including Covid-19 — was published late last month. Its conclusions, said Tom Jefferson, the Oxford epidemiologist who is its lead author, were unambiguous.

“There is just no evidence that they” — masks — “make any difference,” he told the journalist Maryanne Demasi. “Full stop.”

The pro-mask establishment was not content to let the Cochrane study, or Stephens, stand as the final word. The sunk cost fallacy (the phenomenon whereby a person is reluctant to abandon a course of action because they have invested heavily in it, even when it is clear that abandonment would be more beneficial) has been hard at work.

After three years of insistence that masks were “the science” and worked to slow the spread, that 2-year-olds needed to cover their faces in pre-school and that states with strict mask mandates fared far better during covid than those without them, the mask lovers aren’t giving in without a fight. Even though reality doesn’t align with their narrative (masks are a magical life-saving tool only discovered in 2020!) they are doubling-down.

As far as reality goes: California had a longer and stricter mask mandate than Florida did. And according to the map above, California’s cumulative death rate per 100,000 people was higher than Florida’s. Even though Florida’s population is older and more at risk. No matter. According to committed maskers, I’m obviously “cherry-picking” when I cite the fact that the much maligned Florida fared better than the heralded state of California, always hyped for it’s strict covid protocols.

But examining actual facts would require far too much introspection and mea culp-ing to be acceptable for the mask-iest “experts,” proselytizers and faithful adherents. And so, two weeks after Stephens’ op-ed, we got sociologist Zeynep Tufecki’s counter-argument in The New York Times: Here’s Why The Science is Clear That Masks Work. Though her piece proves no such thing. In fact, the body of the article pretty much states the opposite of what the title claims. The piece quotes Karla Soares-Weiser, the editor-in-chief of the Cochrane Library:

“The review examined whether interventions to promote mask wearing help to slow the spread of respiratory viruses. Given the limitations in the primary evidence, the review is not able to address the question of whether mask wearing itself reduces people’s risk of contracting or spreading respiratory viruses.”

So basically what Tufecki ended up hailing as a retraction was actually more like: While we don’t have any evidence in these 78 RCTs that masks DO work, we don’t have any evidence that they don’t work either. They don’t not work. Nor do we do know that they do work. We need more studies.

A lot of double negatives. And a far cry from Here’s Why The Science is Clear That Masks Work.

But that’s all background (and probably too long of a wind-up!) for what I want to talk about here.

What about the harms?

If we are going to assess whether or not masks work, the effectiveness of mandatory masking policy needs to be weighed against the harms. Smoking promotes weight loss but I don’t see any doctors recommending it as a dieting strategy. Purging after every meal would also promote weight loss or at least weight management. But I don’t imagine any doctors are recommending vomiting after every meal as a way to lose weight without those pesky feelings of deprivation that calorie restriction can cause.

All health interventions are always weighed against possible harms. Or were. Until covid.

As I wrote in a another piece for The Spectator World:

“What remains to be studied and discussed, in detail, are the harms that masking has caused at both the individual and societal level: language and developmental delays in children; deaf people unable to participate in society, to work, to communicate with others; victims of trauma unable to mask due to PTSD, prevented from entering public spaces. The list will go on.”

That piece was centered around Colleen Flood, a victim of violent sexual assault which included choking and suffocation. Flood now suffers from PTSD (Post-Traumatic Stress Disorder). Her medical accommodation request to her employer from her doctor read:

“Because of this history, having to wear a facial mask for extended periods of time almost if not always triggers debilitating trauma-related flashbacks which make it very difficult, if not impossible, for patient to function in her full work-related capacity . . . Being unable to breathe freely and comfortably often triggers flashbacks of her terrifying past experiences of her breathing being restricted against her will.”

In what I would consider a clearly discriminatory act, Flood was fired for being unable to mask at work. Unemployment for those suffering from mental health challenges is a downside that should have been considered when implementing mandatory masking for all.

And what about the hearing impaired, the deaf, children with various disabilities? Is masking actually a low-cost mitigation strategy for these folks? It certainly wasn’t for Flood but what about children and adults with hearing loss, for whom masking interferes with their ability to function in the world?

Maybe it works, maybe it doesn’t, but worth a try, if it saves one life!! is what the mask proponents might say. After insisting “the science” is clear. But I would argue that the onus is on the interventionists to prove it works (not clear) and that the benefits are greater than the harms — especially when there are obvious and significant costs for a wide range of people.

The deaf and hard of hearing

About 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears. Approximately 15% of American adults (37.5 million) aged 18 and over report some trouble hearing. It’s not an insignificant number.

Sheryl Neumann, 58, was born hard of hearing. She is the sister of a childhood friend of mine and was kind enough to speak with me about her experience during the past three years.

Her mother had German measles while pregnant and it wasn’t until Sheryl was 4-years-old that it was known that she had hearing issues.

She told me:

“Back then as long as you came out with ten fingers and ten toes, all was considered good. No testing was available nor done after a child was born like it is today. Unfortunately, it was unidentified at an age of critical brain and learning development. Therefore, when I turned 4, I was extremely behind the average child of the same age. I was always behind in everything I did. School, socialization, understanding, emotional development, basically in all ways. The only reason I speak as well as I do today is because of the hard work and love of my mother. She worked with me every single day of my life, even up to the night before she passed away. I am forever grateful for her strength, dedication, commitment and love in always looking out for me, encouraging me to speak all words properly.”

Sheryl has profound hearing loss in her left ear and she is completely deaf in her right ear and has been since her 20s. She uses a behind-the-ear hearing aid to assist with her hearing in the left ear. She also has a hearing service dog — Pringles — who went to work with her until covid. Her dog alerts her when her cell phone is ringing, when an appliance — like a smoke detector or, less urgently, the microwave — sounds an alarm.

Sheryl with her service dog

She also relies heavily on lip reading and calls the practice her “life saving grace,” especially at work in Calabash, North Carolina. She worked on the sales floor at Home Depot for 26 years. Until mask mandates made that impossible.

Sheryl's service dog, Pringles, in his cubby at Home Depot.

When I asked her if mask mandates impacted her ability to do her job, she told me:  

“Mask mandates made it impossible for me to be able to do a job I enjoyed tremendously. However it wasn’t just the mask that made life difficult. Many people were unaware how much harder it became when all businesses added the dreaded plexiglass. That exacerbated the situation ten-fold. By putting plexiglass up it does not allow sound waves to come through the plexiglass to reach the person on the other side. It also distorts the sound because it bounces back towards the person who is talking. Now add a mask which makes it impossible for anyone to see facial expressions.”

Ultimately, Sheryl found herself completely cut off from the world:

“Since I could no longer understand anyone in public with the full covered mask mandate, I ended up being isolated. From work and socializing. It forced me to retire because there was no way I could stay out of work for 3 years [until mask mandates ended]. I became pretty depressed without any ability to be able to get out of the house. I couldn’t food shop, I couldn’t work. I became a shut-in for almost 3 years. After working so hard to break out of the isolation shell as a child to only be placed back into isolation by the government who is supposed to protect me . . . it was and sometimes is still hard.”

Since Sheryl retired far earlier than planned, she’s been living off of her investments, which are likely insufficient to get her through, since she’s only 58.

“All of my money earned through hard work is leaving me faster than planned. I have no job so I can’t input to social security so now that amount will become greatly reduced. I’ve worked for over 40 years and this is not the way I planned my retirement. Losing my job has made it a very lonely and isolating experience for me and my service dog Pringles.”

Despite the cries that anti-maskers are ableist, mask zealots have completely ignored the impact mask mandates have had on those with hearing loss. If you dared raise concerns, you might be accused of using the hard of hearing to further an anti-mask narrative, rather than simply considering — with empathy — how masking might impact those with hearing loss.

But weren’t the mask enthusiasts actually furthering a narrative — masks save lives! —without real evidence? According to the Cochrane study — yes.

Those with disabilities were ignored, even when the issues were raised, again and again.

Those who screamed the loudest about ableism were actually guilty of it. They simply refused to consider that mandatory masking had any downsides worth examining. But I think Sheryl’s story illustrates the harms of wearing a mask for far too many. So let’s start with some anecdotes. Because, as filmmaker Jen Sharp says: The plural of anecdotes are data.

I had intended to share a few more stories in this post from real people who struggled with mandatory masking. But I wanted to convey Sheryl’s full story, in her words, so at the risk of making this too long, I’m going to cut it into pieces.

Next up — the stories of two children, one with hearing loss as well as other developmental challenges, and that of a 10-year old child with Downs syndrome.