Zombie Healthcare Masking Policies Return to Maryland

Another guest post from Dr. Marine regarding mask mandates...in 2025!

A limited mask mandate is returning to my state this week. In 2023, the Maryland Department of Health (DOH) adopted a standard for return to universal masking in healthcare facilities when hospitalizations with respiratory viruses (covid, influenza, or RSV) reach a level of 10 cases per 100,000 population.

Maryland has a population of 6.3 million and about 10,000 licensed hospital beds, so that works out to about 6% of hospital beds. We hit the threshold in late December and the DOH sent out this letter on January 14:

I responded by writing to the DOH the following e-mail:

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I hope to receive a response, but I am not holding my breath.

One could reasonably ask: What is the big deal with masking for a few weeks or months in the winter? In my view, plenty.

Masks impede communication and dehumanize personal interaction. They are unpleasant to wear for prolonged periods of time, evidenced by the fact that most people do not wear them unless they are required to do so. They make life difficult for hearing impaired.

Most people have now recognized that, like the 6-foot distancing rule, masking was adopted empirically during the exigencies of the early covid pandemic and only later justified by weak, biased, and confounded retrospective studies. Most regard it now as an empty ritual, so that masking requirements undermine the credibility of medical authorities and thus everyone associated with the healthcare system.

The public health community has painted itself into a corner on masking. So many have staked what remains of the credibility of the field on the proposition that masking reduces the spread of respiratory viruses that they seem unable to consider the possibility that they got it wrong.

In 2023, the former CDC Director Rochelle Walensky famously testified to Congress that the CDC never ran or advocated for randomized trials of masking because there was “no equipoise.” However, in my hospital, masking has been “strongly recommended” for everyone since the last mandate was lifted last winter. The message is reinforced through cycling through all computer screen savers and plasma screen displays throughout the hospital. By my estimation, this “strong recommendation” has been ignored by > 95% of hospital staff and visitors. If 95% of health care professionals and the public are ignoring a “strong recommendation,” then do we not have equipoise?

Instead of mandating masks based on arbitrary thresholds, the Department of Health should be working with Maryland’s esteemed academic medical centers to run proper prospective trials to determine if masking is accomplishing any important goal. Until this is done, we may be stuck with this annual ritual forever.

Fortunately, we may not be masking for long this winter, as my check of the DOH website shows that hospital prevalence of respiratory viruses has been falling sharply—2 weeks before the mandate started.

No doubt our public health experts will credit masking for the rapid drop [sigh] . . .