Covid, Masks, Evidence and Ideology

The Panhandle Health District board of health serves the five northern counties of Idaho: Boundary, Bonner, Kootenai, Benewah, and Shoshone. The first four of those counties make up about 3/5ths of the Idaho border with eastern Washington. As Covid-19 cases rose precipitously in Coeur d’Alene over the last few weeks, the Panhandle Health District’s six member board of health finally voted for a mask mandate–but only for Kootenai County–by a vote of four to two. The no votes were cast by two men from Bonner County (which includes Sandpoint and the otherwise mostly rural territory represented in the Idaho State legislature by Heather Scott). Here is their reasoning as quoted from the Bonner County Daily Bee on July 24th:

Board member Glen Bailey, a former Bonner County commissioner, one of the two no votes, said masks would not be effective, comparing wearing the masks in preventing the spread of COVID-19 to “trying to stop a mosquito with a chain-link fence.”

“It’s a threat to us as a community,” Bailey said. “I have observed the rise in case numbers. But at the same time, I have not seen a commensurate rise in the death rate.”

Allen Banks, the at-large member of the board and also a Bonner County resident, voted no.

“Masks do not work,” Banks said.

“The latest CDC publication in emerging and infectious disease … (shows) no benefit to the rate of influenza infection from wearing masks.”

Both these men claim university level educations that include the word “science,” that is, education that ought spur them to read more widely than their statements suggest. 

Bailey’s mosquito/chainlink fence analogy is cute and easy to understand–and wrong. Based solely on the size of a single virus particle and the spaces in cloth mesh it makes appealing and superficial sense, but it totally ignores a large body of bench science on droplet spread, electrostatic capture, and the physics of aerosols–as well as a growing body of epidemiological investigations on the spread of Covid-19.

Allen Banks’ “Masks don’t work” is based on a single CDC publication, a meta-analysis, not of studies of Covid-19, but of a series of studies of influenza transmission. Mr. Banks kindly provided a link to the article. It was written by a postgraduate student at the University of Hong Kong, Jingyi Xiao. In the part of her analysis regarding facemask efficacy, Ms. Xiao writes, “Most studies [that she analyzed] were underpowered because of limited sample size, and some studies also reported suboptimal adherence in the face mask group.” Running statistical analysis (meta-analysis) of underpowered and suboptimal studies does not yield a greater truth. Mr. Banks focuses on this publication because it suits his confirmation bias. To accept this meta-analysis as conclusive is to ignore an increasing body of observational evidence in the real world, including two referenced below. (See also The Face Mask Debate Reveals a Scientific Double Standard.) 

Who of us (prior to the Covid-19 pandemic) knew anything about local boards of health? It is time we pay attention. Each of these civic boards has its own bylaws and composition, including volunteer positions increasingly occupied by people with an ideology and an axe to grind. (We have our own eastern Washington example. Jason Kinley, a friend of Matt Shea, was recently appointed to the Spokane Regional Health District board of health.) 

While people like Glen Bailey and Allen Banks speak from their ideological biases and blinkered fact bases, evidence continues to mount that face masks are, indeed, very effective. Here are some real world examples:

In Switzerland where the Covid-19 outbreak is at a point where contact tracing is still practical, a recent report of a Covid-19 cluster among hotel employees not only attests to the utility of face masks, but also contrasts face mask effectiveness to the lack of effectiveness of face shields. An article from July 15 entitled ‘Only those with plastic visors were infected’: Swiss government warns against face shields, suggests that not only have the Swiss gotten beyond Bailey’s and Banks’ misinformation but have moved on the next level of analysis. (Of course, accepting such data as this would require Republicans to acknowledge people other that U.S. citizens are capable of performing credible research.)

This Missouri hair stylist case study, now complete and published by the CDC, stands in direct contraction to Allen Banks’ bald statement that “Masks don’t work.” Not one of 139 people (all wearing various masks) exposed to two Covid-19 positive, mildly symptomatic hair stylists (wearing cloth masks) came down with the disease. 

Keep to the high ground,

P.S. A free article from the Wall Street Journal (not exactly a left wing newspaper ;-), Covid-19 Measures Have All but Wiped Out the Flu in the Southern Hemisphere, strongly suggests that the measures used in southern countries to combat the spread of Covid-19 curb the spread of influenza as well. Obviously, this isn’t just the use of masks, but also a host of other measures that vary from country to country. Both diseases are predominantly spread by respiratory means. It’s just that Covid-19 spreads more efficiently, spreads from asymptomatic and pre-symptomatic people, and is spreading in a population with little resistance and no vaccine. 

P.P.S. The Bonner County Daily Bee on July 28, reports “Push on to replace pro-mask PHD board members.” The headline is deceptive. The most quoted man in the article, Bill Brooks, one of three Kootenai County Commissioners, says, “I got about 125 -130 emails: 70 want a replacement, and the rest of them want to award a medal of honor” in reference to the M.D. and R.N., both from Coeur d’Alene, who serve on the Panhandle Board of Health. It is ironic that the only two members of the six member board who actually have experience in clinical medicine are the ones that “seventy” emailers want to kick off the board. It is editorial sensationalism to characterize this as a “Push on to replace…” It sounds more to me like a well organized vocal minority of ideologues and ignoramuses, the like of which we have in Spokane in the form of the Matt Shea/Covenant Church cluster. 

The article did provide an explanation of how people come to serve on the Panhandle Board of Health: 

“Fillios [another Kootenai County Commissioner] then cited Idaho code 39-411, which requires that one member of the board should be a physician, that there be no more than one member in the same professional or interest group, and that all members should demonstrate either an education or interest in the field of health. He then specified the process for appointing or removing a board member, which requires a vote.

“It takes the majority vote of the 15 county commissioners, three from each county,” he said. “This is state law, folks. We don’t write these. These are the laws as prescribed and voted on and passed by your Legislature.”

Citizens of each county need to pay attention to how all this all works. Observe, for example, the power that the fifteen commissioners (three from each county) wield in determining the composition of such boards. John Roskelley, former Spokane County Commissioner and current candidate for WA State Senator from LD4 (Spokane Valley north to Mt. Spokane) correctly observed that county commissioners wield extraodinary power–and most voters know very little about the commissioners that are supposed to represent them.