For a while it has been known that, contrary to what politicians and their friends in the health-industrial complex would have you believe, face masks do harm. In a piece published in May 2022, former clinical psychologist Dr. Gary Sidley laid out the multiple areas where masks cause trouble. These include: impairing communication; increasing risks of falls for the elderly and frail; aggravating respiratory problems; exposing the wearer to micro-plastics and other contaminants; and retraumatising those who have suffered abuse in the past.
In a wide-ranging and large list of potential pitfalls, perhaps the most worrying area for harm is that of exacerbating mental health conditions. As Dr. Sidley explains, “Many people already tormented by recurrent panic attacks, involving catastrophic thoughts of imminent death and feelings of breathlessness, will find masks very difficult to tolerate.” Mask-wearing could increase anxiety and amplify fears about the prospect of contamination, and, for those on the autistic spectrum, create an expectation and sense of pressure to conform to wearing a face covering.
With these concerns in mind, it is extraordinary to hear that an NHS mental health trust is reiterating its demands to staff, and requesting patients and visitors, to wear a piece of cloth over their mouth and nose.
Lest we forget, the national, top-down NHS directives were changed in June 2022 to remove any mandate for masks. Yet here we are, eight months later, and, as we’ve seen before – for example here and here – local masking policies continue to be made on a whim. This time it’s a provider of mental health and learning disability services – Sussex Partnership Foundation Trust (SPFT) – which remains committed to forcing mask wearing, reminding its staff of the requirements that, “In all clinical areas (including inpatient wards and in the community) all staff are to wear masks, and mask wearing for patients and visitors is to be encouraged.”
Strangely, the use of masks as prevention for the spread of COVID-19 does not appear in SPFT’s Policies for Infection Prevention & Control. The only mention in the official documentation being for “pandemic influenza and sputum-positive pulmonary TB during the first two weeks of treatment”.
Equally perplexing is the lack of any information sharing with the public about masks: the link for ‘Infection Prevention & Control for Patients’ being either broken or the page itself missing.
Framing these requirements within the context of ‘safety’ and conformance with ‘high standards’ of infection control, the SPFT’s Chief Nurse, Teresa Barker, seems to be unaware of the vast body of evidence that supports the statement that masks don’t work and have the potential to harm. Indeed, in the past few days we have seen the publication of the latest – and fifth version – of the Cochrane Review, ‘Physical interventions to interrupt or reduce the spread of respiratory viruses’. First published in 2007, the current rendition looked at 78 randomised controlled trials (RCTs) and cluster-RCTs, with over 610,000 participants, and which, in the words of its lead author, Tom Jefferson, concluded that, “There is just no evidence that they [masks] make any difference. Full stop.”
Surprising as it is that a healthcare professional, tasked with being accountable for infection control and prevention, should be so out of step with significant and up-to-date evidence in her area of expertise, even more of a head-scratcher is the practical situation as it exists ‘on the ground’. As of February 1st, SPFT were “caring for two coronavirus patients in hospital”, down from four the previous week and nine a month earlier. No new Covid patients had been admitted in the week to January 30th. This downward trend in SPFT mirrors the national picture with COVID-19 patients hospitalised nationally decreasing 35% in the past four weeks.
So, there we have it:
• Clear evidence that, especially for those dealing with mental health challenges, masks can harm;
• Clear and compelling evidence that they do nothing positive to stem the transmission of COVID-19;
• No top-down, NHS-wide directive for masking to shelter under;
• No documented public policy within the specific Trust for masking;
• No communication with the public of a need to mask;
• Decreasing numbers of patients in hospital with the virus, both nationally and locally.
Really, support for enforcing mask-wearing seems pretty weak, doesn’t it? Instead, we are left with the sense that instructions for SPFT staff to continue wearing face masks is, as Tom Jefferson observes, about satisfying the urge to “appear to do something”, a complete subversion of the ‘precautionary principle’ that “you should do nothing unless you have reasonable evidence that benefits outweigh the harms”.
Paul Stevens is a member of Smile Free, which campaigns for the end of mask mandates and masking.
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