Shoppers wear masks inside the Coronado mall in Albuquerque in late August. (Photo by Shelby Kleinhans for Source NM)
The state of New Mexico lifted its indoor mask mandate on Feb. 17, and the state’s top public health official says he doesn’t need a scientific rationale for doing so.
“I don’t know that I agree that you need scientific evidence to remove a mandate,” Acting Cabinet Secretary of the New Mexico Department of Health Secretary Dr. David Scrase told reporters Wednesday. “I think the role of government is to step in when necessary, in critical situations, and also to step back when you’re out of that difficult period.”
Scrase repeatedly said that masking is a matter of individual choice and individual responsibility.
“In my view, and in the view of many, many strongly worded emails I get, people feel like the state is in a position now to transfer the responsibility for decision making about personal interventions and protections for one’s own self, family and community, to individuals, families and communities, and away from the state,” Scrase said. “While I’m not a particularly political person, I actually agree with that perspective.”
Scrase said the reason the state implemented mask mandates in the first place was to try to protect and preserve hospital resources.
“And when we saw that basically drop off of a cliff, in cases and hospitalizations, and hospitals confirmed that with their own self-evaluations, we decided that it was time to remove the mandate,” Scrase said.
Scrase said masks are just as effective now as they were two weeks prior, and most people should consider how careful they need to be based on their family and context.
“I’m not really changing my mask routine at all yet,” Scrase said.
A mask mandate remains in place for hospitals and congregate settings including nursing homes and state prisons, Scrase said.
Individual responsibility does not work
Elizabeth Jacobs is a professor of epidemiology at the Mel & Enid Zuckerman College of Public Health at the University of Arizona. This month she signed an open letter encouraging elected officials to reevaluate ending mask mandates for schools. She was joined by three University of New Mexico professors and 400 public health researchers, practitioners, physicians, and educators.
In her view, individual responsibility has nothing to do with public health. The whole point of public health is trying to build a healthy community together and to provide the necessary infrastructure in order for all citizens to equally access lives and livelihoods, she said.
We have been shown clearly in the United States that individual responsibility does not work, Jacobs said, and is “a complete failure.”
“We’re nowhere near where we need to be as a country in terms of vaccination,” she said. “We have mask mandates that are being rolled back with absolutely no scientific evidence.”
Jacobs’ criticism is not directed only at Scrase, she said, but rather at the overarching drumbeat in the United States to reduce masking.
Jacobs appreciates that Scrase acknowledges what’s happening with people with immunosuppression, and the fact that he contacted people who registered as immunosuppressed to tell them about treatments, and that at least New Mexico officials have given some thought to the issue.
But Jacobs says those things should be used in concert with mask mandates, because immunocompromised people’s risk doesn’t just magically go away with medication.
“While I do appreciate that strategy, I do think that there’s going to be a lot of challenges with regard to these schools deciding whether to mask or not, because when your health department tells you that it’s not necessary, you get a situation like what we had in Arizona, it was literally the Wild Wild West again, with masking and school board meetings and people bringing zip ties and threatening school principals over mask mandates,” Jacobs said.
State mandates are important because they clearly demonstrate the most appropriate course of action, she said, which in this case is retaining mask mandates.
“You can hope all you want that it’s going to go well, but it’s not,” Jacobs said.
She said Scrase provided no evidence as to why having a mask mandate remain in effect is not the most beneficial policy for New Mexicans.
“How can it not be?” she asked. “It protects not just from COVID, but from flu and from other pathogens. I just don’t understand that. If you really want to do the thing that’s the best for the health of all New Mexicans, then a mask mandate remaining is that thing.”
Why is it acceptable for children to be hospitalized and to die from this disease, when the risk could be substantially reduced by wearing a high-quality mask?
– Elizabeth Jacobs, professor of epidemiology, Mel & Enid Zuckerman College of Public Health at the University of Arizona
To Jacobs, the bottom line is: are we safer with or without mask mandates?
“The answer is we are safer with mask mandates,” she said. “We know that mask mandates in schools are effective at reducing transmission. That has been demonstrated in multiple peer-reviewed studies.”
She said if we can protect children, why wouldn’t we?
“Why is it acceptable for children to be hospitalized and to die from this disease, when the risk could be substantially reduced by wearing a high-quality mask?” she asked. “I don’t understand it.”
Jacobs says the same argument applies to statewide mask mandates.
Emily Bates, an associate professor in pediatrics at the University of Colorado, said wearing a mask cuts down on rates of infection by about half, it reduces the number of outbreaks in schools by about half. She also signed the open letter.
“Why not do this easy thing, to protect people who have no means of protection?” she asked. That includes the millions of children who do not have access to vaccines, people who are immune compromised because of medications for auto-immune diseases, pregnancy, or chemotherapy patients.
“I care about these people, I don’t know why none of the rest of us can’t wear a simple mask to protect people,” she said.
Masking is more effective if everyone is doing it, rather than if just one or two people are doing it, Bates said, because the most effective means of protecting against spread is making sure an unknowingly infected person happens to be wearing a mask. But they’re not necessarily going to be wearing a mask if it’s not the normal thing to do, she said.
She agrees that it is reasonable to assume that at a broad level, when a statewide mask mandate is removed, it is easy to predict that you will see more cases, hospitalizations, and death.
Bates said there is no scientific justification for lifting a mask mandate right now.
“I think people are just sick of it, and I think it’s just a political move,” she said. “I don’t see any justification for doing it, myself.”
Bates has two children who are 2 and 5 years old. The lifting of mask mandates makes her feel abandoned as a parent of children under 5. She cried when the schools in Colorado decided to lift their mandates.
“I just feel like no one cares about us anymore,” she said.
It’s a political move. It’s not a public health move.
– Emily Bates, associate professor of pediatrics, Anschutz Medical Campus at the University of Colorado
Children under 5 don’t have access to vaccines yet in any legal way in the United States, Bates said, so there’s no means of protecting them, for most parents.
“I feel very strongly that we shouldn’t lift the mask mandates until everyone can be protected, and cases can be dramatically reduced,” she said. “That’s just not the case at this point. The cases are still very high.”
She said she has friends who work in the emergency room who have intubated 2-year-olds, and those children did not have a choice.
“So we’re saying, yeah it’s fine to increase the risk that kids get put on ventilators? I don’t think that’s OK,” Bates said.
When the mask mandate was lifted, New Mexico Public Education Secretary Kurt Steinhaus said it is important that the decision on masking be made at the school level. That same day, Albuquerque Public Schools, the largest district in the state, announced that it was following the state’s lead.
Bates said no single school district is going to fight with parents and others, and try to be different than everyone else.
“They’re just not going to do it,” she said. “They’ve already had to deal with so much. I think it’s just passing the buck, basically, and saying, ‘Hey, blame them, instead of me.’ It’s a political move. It’s not a public health move.”
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