Senior Kye Catlin wears a face covering as he studies in University of Wyoming's Coe Library in October 2020. (Jeff Victor/WyoFile)

It’s settled, according to regulators: If you mingle in public in Wyoming, you’ve got to wear a face mask to help reduce the spread of COVID-19.

Masks — “a covering made of cloth, fabric, or other soft or permeable material, without holes, that covers the nose and mouth and surrounding areas of the lower face” —  with some exceptions, are now required in businesses, healthcare facilities and on public transportation through Jan. 8, 2021. 

Yet, mask use, effectiveness and even safety remain the subject of heated debate among many skeptical Wyoming residents, many of whom claim the science doesn’t support wearing masks.

Does it? According to health officials, it does.

Wyoming Health Officer Alexia Harrist on Dec. 7 signed the order that states “the most comprehensive, systematic review” found that face coverings reduce risk of transmission by some 85%.

The CDC illustrates how to choose a mask. (CDC)

Officials based their endorsements on many scientific studies. One “natural” or real-life experiment found “mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate.” The paper, published in Health Affairs, estimated masks prevented more than 200,000 COVID-19 cases early this spring.

Masks work best when compliance is high, according to a literature review published in the Proceedings of the National Academy of Sciences. “The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low,” the paper published this spring states.

Masks provide benefits in a couple of different ways, according to the federal Centers for Disease Control and Prevention. 

First they contain some of the water droplets expelled from an infected person’s mouth and nose while breathing or speaking and limit the distance some other droplets, which could hold the novel coronavirus, spread when exhaled. By reducing the volume of potentially dangerous droplets and their distance of travel, masks reduce the opportunity for virus particles to reach and infect others. Though imperfect protection for any one individual, fewer opportunities means fewer cases in a population. 

The second benefit comes when an uninfected person wears a mask to block inhalation of the coronavirus. The smallest, aerosolized exhaled droplets can linger in the air for three hours. Masks provide “filtration for personal protection” and can block 50% of the smallest particles, according to the CDC.

Clearly far from foolproof, 50% filtration of the smallest particles not only offers some protection to the individual, it can have a significant impact on a population scale. 

See how one mask works in this video posted by the New England Journal of Medicine.

Masks should have two layers of cloth, the  CDC states. It recommends that an individual “wear the mask over your nose and mouth and secure it under your chin.”

The CDC illustrates all the wrong techniques when wearing masks. (CDC)

A mask should fit snugly and not have gaps. A good mask should have a large surface area and a pouch-like space in front of the mouth and nose to allow near-normal breathing, according to a guide in The New York Times.

The CDC offers other recommendations and tips, including which children should wear masks, how to deal with fogging glasses and the effectiveness of neck gaiters and face shields as alternatives to cloth masks. 

The living dead

Viruses are infectious packages of protein and nucleic acid — the stuff that’s in genes. They are zombies, one educator explains metaphorically, not living but not quite dead. Viruses can’t reproduce without a host but can undergo genetic variation and evolve.

Masks are one of many tools that can help slow the spread of the virus. They are not foolproof, experts say, and not a panacea. People should continue to follow the numerous other precautions, including social distancing, frequent hand washing and avoiding congregating in enclosed spaces.

CDC instructions on how to protect yourself after wearing a mask. (CDC)

Because a COVID-19 vaccine will take months to deploy and become widely effective, masks will continue to be useful and necessary to slow the disease spread and corresponding deaths.

More than three-quarters of Wyoming residents responding to a University of Wyoming survey on Dec. 7 — before Harrist’s order — said they wear masks always or often when visiting indoor public spaces. That’s up from June, when only 41% of respondents wore masks, according to the Wyoming Survey and Analysis Center.

Many public officials have stressed the importance of wearing masks to help stymie the virus. “The science tells us that the more people are wearing masks, the more effective we’ll be in limiting transmission,” Harrist said last week.

Statewide, health experts agreed. “Education and encouragement alone have not achieved desired outcomes,” Wyoming county health officers, Wyoming Medical Society and the Wyoming Hospital Association wrote Gov. Mark Gordon Nov. 12. “We feel that a statewide [mask] mandate sends a more powerful and effective message in a more timely manner.”

Gov. Gordon, in a moment of frustration, had another way to describe those who resist community safety protocols backed by scientific studies — “knuckleheads.”

Doubters

There are lots of ways to poke holes in calls for mask mandates, but most anti-mask arguments appear to lack widespread scientific support or have limited applications. 

Masks work in the laboratory setting, but “mask-wearing policies seem to have had much less impact on the community spread of COVID-19,” two Australian professors wrote.

Cloth masks are not as effective as medical masks and “should not be recommended for [health care workers], particularly in high-risk situations,” they stated in the British Medical Journal.

Editors added a long note to a commentary published in the University of Minnesota’s Center for Infectious Disease Research and Policy after readers complained it was being used by anti-maskers to thwart public policy. The editors, who agreed data was limited, refused to retract the commentary and wrote that cloth face coverings are likely to have limited impact in some instances.

“…[T]hey have minimal ability to prevent the emission of small particles, offer limited personal protection with respect to small particle inhalation, and should not be recommended as a replacement for physical distancing or reducing time in enclosed spaces with many potentially infectious people,” the editors said.

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The Minnesota editor underscored a point of many who advocate mask use by emphasizing that they are but one tool.

“We also worry that the public doesn’t understand the limitations of cloth masks and face coverings when we observe how many people wear their mask under their nose or even under their mouth, remove their masks when talking to someone nearby, or fail to practice physical distancing when wearing a mask,” the note reads.

— With staff reports

Angus M. Thuermer Jr.

Angus M. Thuermer Jr. is the natural resources reporter for WyoFile. He is a veteran Wyoming reporter and editor with more than 35 years experience in Wyoming. Contact him at angus@wyofile.com or (307)...

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  1. It’s refreshing to see an article in the press that at least attempts to provide a balanced presentation of competing data. I was hoping to see something written in a neutral voice like the Scientific American article recently published. (https://www.scientificamerican.com/article/the-covid-science-wars1/). The pro-mask bias of this article was transparent.

    There were three key studies recently published that were not included in this article:

    A study published Nov 20th by the Centre for Evidence Based Medicine, University of Oxford, Oxford, UK, also found that masks are ineffective to prevent viral infections from spreading. Here’s a link to the paper: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub5/full

    A study by the American College of Physicians published 11/18/20 finds no difference in infection rates between mask wearers and non-mask wearers in a 6,000 participant, randomized controlled trial. (https://www.acpjournals.org/doi/10.7326/M20-6817)

    Researchers at Universities of Cambridge, Oxford, Manchester, Tufts University et al., studied the effectiveness of public health policies for COVID-19 in 41 countries. Public mask mandates increased infection rates by 1%. Closing schools and universities, banning gatherings and closing high-risk businesses was effective at reducing infection rates. Here’s a link to the paper: https://www.medrxiv.org/content/10.1101/2020.05.28.20116129v4.full-text

    The findings of these recent studies are consistent with the 40 years of research conducted prior to 2020, which also finds no utility in face masks on the general public to prevent illness. The review and summary of prior research (over 50 peer reviewed papers published between 1980 and 2020) was published by The University of Minnesota Center for Infectious Disease Research and Policy (https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data)

    I would encourage those interested read the full text of the studies rather than relying on the interpretation of a journalist..

    There is currently no rigorous scientific evidence that face masks are effective. The danger in ignoring the findings of science is that face coverings become the primary line of defense rather than just another tool that might help (assuming the right type of mask is worn correctly in the right circumstances).

    This was very evident in the attempt by Natrona County Commission to request a waiver to the restrictions implemented by the governor. The justification they used was that as long as everyone wore a mask, everything would be fine.

    Rather than focusing on interventions that are shown to be ineffective or cause greater harm than they prevent, let’s focus on finding interventions that create the greatest good for the greatest number..

  2. It is so easy to support the masks and wear them – what’s the harm, no matter what your own personal opinion is? Why not give some consideration to others? Why not be polite? The radical language doesn’t help a thing. Why be so divisive – recently I saw a sign on a door that said “if you’re not feeling well, please visit our establishment some other time. Please wear a mask, and have a pleasant day with us. And please try to stay socially distanced from others, to keep people as safe.” A shame, that Wyomingites won’t look out for each other.

    1. I agree! It is very easy to wear a mask, social distance, and wash your hands more often in order to protect yourself and those you love from getting covid 19. I have been doing it since March and a few more months won’t hurt a bit. I am a strong Wyoming woman and have survived much worse. I love my family, have awesome friends, and support my community of Riverton. To me, wearing a mask is the very least I can do!

  3. Facemasks may be the elephant in the room. But there is also a rhinoceros.

    Here’s a scenario I would like explored. The nation of Taiwan is small… you could drop seven Taiwans onto Wyoming and it would be a good fit geographically . But Taiwan has 26 million people… nearly fifty times Wyoming’s population. The density of that population on the 13,000 sq. mile island is cheek to jowl.

    SInce the virus became known and the pandemic spread, Taiwan recorded only 700 actual cases of Covid-19 and only 7 deaths. Not a single case since July. That’s it. The case count and mortality is about the same as my l’il ole mask hating freedom luvvin’ Park County WY to date. ( Allow me a sideways glance to South Dakota where they experienced 92,000 Covid cases and 1300 deaths to date wrapped in the highest per capita positivity infection rate on the entire planet… our next door neighbor ). Taiwan is one of several nations of millions of people that have all but defeated the virus. new Zealand in now declared virus free. They broke the chain of transmission. Wyoming is accelerating their chain driven covid juggernaut.

    We need a broader examination of what works in slowing or stopping the pandemic, for which facemasks and distancing are the two lowest performing but readily functional public health tools. How did Taiwan and others beat the beast ? —rigid universal contact tracing. The central government and leadership took the fight straight to the virus, mano y mano , at street level.

    All the vaccine in the world won’t stop the pandemic unless a VERY high percentage of the population are immunized ( > 85 percent min. ) and all other preventions are not diminished, Plan on masking and distancing till late 2022 regardless. Forget about Herd Immunity. Ask Sweden about that ….

    I consider my native Wyoming to be deep in the hot zone of problematic pandemic prevention… the virus will be with us for a very long time here. We know what to do , we just are not doing it … because of some ridiculous bone marrow deep belief in liberty , personal freedom , antivaxx hysteria, and generalr ed state conservative disbelief in science, the public portion of public health somehow being Socialized Medicine when it’s not, and a general malaise of misonformation being the norm around here. Plus, we love money , beer in bars, food in restaurants, and fail to see further ehead than one turn of the calendar page or a sales quarter even when our life depends on some longterm thinking. Wyoming has NEVER employed long term thinking and planning for anything. Ever.

    Doesn’t sound like we’re starting down that path outta here any time soon …… regrettably so.

  4. I wear a mask, I believe there is some, albeit small, benefit to wearing the mask. How can there not be some benefit to stopping some level of air we breath in and out? But their effectiveness is questionable. I base my unscientific opinion based on the cases that have surged nationwide without regard to states/locales with a mask mandate or no mask mandate. Colorado has had “Safer at Home” since May, Montana has a mask mandate, New Mexico has a 14 day quarantine period if you stay one night in the state……..and the list goes on and all of those states struggle with similar surges in cases. If mask are so effective why are the number of cases in mandate and non-mandate states on par with each other? I could see and support a statewide mask mandate and I certainly support any business of facility that wants to implement one – that is their right – if the mandate locales had a much lower rate of transmission than the non-mandate states. But the data is supporting mask wearing as the save all much less that it is portrayed to be. It’s all about the same.

    I think the media and less so scientists have sold masks as a save all, when in reality most masks outside of N-95’s and similar devices have limited effect. As a previous comment stated, social distancing, avoiding crowds and crowded situations is probably more effective than any cloth mask will be. And even when you do practice all the protocols, you can still end up with it, luck of the draw.

    The data scientific or otherwise is not supporting a mask as the save all it is portrayed to be in our real life situation.

  5. So doubts about the effectiveness of masks is “unscientific”? The orders here in Laramie are based on a study by Chu et al from last June. A number of people have called on that work to be retracted, most particularly by a couple of researchers at the Oxford based Center for Evidence Based Medicine. However, even assuming that this piece of peer-reviewed work is unscientific, we might just see what Chu et al actually have to say. They say that N95 respirators are more effective than cloth masks with 12-16 plies. The sorts of masks worn typically are a couple of plies at most, and even 12-16 plies are not as effective as an N95 respirator. Even so, their confidence in their own recommendation about masks they, themselves, rank as low.

    Then there is the much censored Danish study with was a randomized clinical trial. It found a 95% confidence interval which included the value of zero effectiveness. And the U.S. Army conducted a non-fully randomized trial (CHAMP it think it was called), but one with highly monitored compliance with a group of thousands of volunteer recruits split into a control and treatment group. They found no significant difference in lab confirmed cases.

    Finally there was an article in the Asahi Shimbun last July by a researcher who measured particle attenuation. Cloth and gauze masks had zero effectiveness. N95 masks were as effective as their design standard, which is to say they attenuate 95% of particles 0.3 to 0.5 micrometers in size; but the viron is 5 to ten times smaller. The masks are not really designed to such a standard.

    I have a couple of dozen other studies finding the same going back decades. At one time we were curious about the effectiveness of masks against influenza and found they had no significant effectiveness. That hasn’t changed.

    Look, wear a mask if you wish. Wear the best quality one you can find, and pay attention to its specs. But don’t expect masks to do things they cannot, and haven’t been designed for. The better strategy is to avoid situations where transfer is likely — crowds, exposure to sick persons, long exposure times, etc. Just because an official says something is scientific doesn’t make it so. Our officials would have done better to work with parents around the state in late August to convince their college-bound children to stay at college once there. This would have diminished the spread of COVID-19 if anything could have.

  6. If you can buy an N95 mask from a retailer it is not available to your healthcare workers anyway. And some healthcare workers in my town won’t wear them because they are hard to breathe in. If your community is NOT protecting you, protect YOURSELF with an N95 mask. The CDC thinkks you can protect the supply to hospitals but they are already getting them. Healthcare workers will soon be vacinated before us anyway. If you have health problems or inconsiderate neighbors, IGNORE the suggestion and buy N95 masks if you need them.