For some time now, the Smile Free team have been highlighting the reality of face mask coercion varying from hospital to hospital, with whether you have to wear one or not depending entirely on the people setting the rules locally. COVID-19 infection rates are irrelevant: it all comes down to the views of individuals who have managed to get their hands on the levers of power. For those folk who are true believers in ‘The Science’, masks were – and are – a critically important weapon in the arsenal of non-pharmaceutical interventions. Blind to the realities of historical precedent, objective evidence and common sense, masks ‘work’, they claim, and we all have to get with the programme and strap them on.
Unlike the rest of the post-COVID-19 world where we are ‘learning to live’ with the respiratory infection, in some parts of the NHS masks are still required. Notwithstanding the directives issued from the very top of the Health Service to ‘step down’ COVID-19 measures, in some healthcare settings, often driven by the head of an individual trust’s infection prevention and control (IPC) function, what are still in effect mask mandates have not gone away. How individual trusts can maintain these controls is to be found buried in the small print of the reissued National Infection Prevention and Control manual (p.36) where a get-out clause comes down to those weasel words beloved by Health and Safety bureaucrats, ‘local risk assessment’. In short, if the head of IPC in Trust A wants to dispense with masks, he or she can; if the head of Trust B’s IPC wants to keep them, then they can be kept.
If this sounds a bit bonkers, well, that’s because it is. In a world where we’ve moved on from the constant news-bombing of stats for positive test ‘cases’, hospitalisations and deaths with COVID-19, we still can find ourselves being told that we are ‘expected’ to wear a mask. Why? Just because one person, with the lucky position from which to exercise their authority and masking peccadillos, says so.
So how does this random exercise in magical thinking show itself in its least rational light? When we compare health settings from neighbouring trusts. Recently, I needed to attend the Essex Cardiothoracic Centre for an outpatient procedure. Based at Basildon University Hospital, all cardio-related procedures undertaken in Essex have been consolidated at the Centre. Which means that patients come from across the entire county, from different areas served by different trusts.
Part of the Mid and South Essex NHS Foundation Trust (MSEFT), the trust’s website advises service-users and visitors that “there is no longer the need to wear masks” in any of their health settings. And when looking at the website overall, one is struck by the absence of any images in which people, be they staff, patients or visitors, are wearing a face covering. The Cardiothoracic Centre’s website goes even further, making no mention of masks whatsoever. Indeed, throughout my time at the Centre I saw not one single mask being worn; not in the general areas, the ward or even the operating theatre in which my procedure was done. Everything was normal, so much so that it was only after I got home that I realised what I had experienced. Saying it was ‘blissful’ didn’t do my feelings justice.
In contrast, just 40 miles away from Basildon, in Colchester General Hospital, things are different. Part of the East Suffolk and North Essex NHS Foundation Trust (ESNEFT), the spectre of face masks continues to lurk ominously. The home page of the parent trust’s website, on the frame advertising ‘Latest Visiting Information’, continues to display a prominent photo of a masked nurse. Regarding guidance for visiting the hospital, the general message is that COVID-19 is still ‘a thing’, the web page headline stating that, “We continue to care for patients with a number of transmissible infections”. Further, visitors are told that they are “required to wear surgical face masks covering their nose and mouth where there is a high-risk of transmission of contagious respiratory infection”. In addition to a list of specific conditions and scenarios in which masks should be worn, the instructions are that those attending A&E will be “asked to wear a surgical mask”. Masks are available at all hospital entrances or by asking staff for one.
As if these general diktats weren’t enough, in communications with patients ESNEFT exposes an even darker core to its mask mania. Ahead of an outpatient appointment – scheduled for July18th(!) – a friend received a standard letter from it, which stated:
The staff caring for you will be using personal protective equipment such as face masks, gloves and aprons…. Please change your face mask/covering on arrival to a new surgical face mask provided at our entrances.
Should we be surprised that, even when an adjacent trust takes a sensible and relaxed view of masking, ESNEFT ignores directives coming from the very top of the management tree and deploys a stronger message about masking? Not really. As a previous Smile Free investigation into ESNEFT revealed, the fearful and authoritarian inclinations of ESNEFT management have been a feature of its IPC protocols. The man behind the mask, so to speak, is Chief Nurse and Director of IPC Dr. Giles Thorpe, pictured below in his mask and visor, and a committed devotee of covering one’s face.
Why then are people like Dr. Thorpe so evangelical about masks? What special insights do they possess that allows them to impose different rules than those in similar positions of authority and qualification just a few miles down the road? (One of MSEFT’s hospitals, Braintree, is just 23 miles from Colchester General.) After all, it can’t be that COVID-19 threat levels are different between bordering neighbourhoods and in such close proximity. Nor can it be that ‘the Science’ of masking is different between these adjacent places. So, what is it?
Perhaps we can find some clues to this riddle when we look at another neighbouring trust, Norwich and North Norfolk University Hospitals NHS Foundation Trust (NNUH). Here we find the Integrated Care System within which NNUH sits has, in line with national NHS guidance, determined that “individual healthcare providers” can “decide upon their own guidelines regarding mask use, based on the level of risk in their local setting” (emphasis mine). Based on these parameters NNUH has decided to go further than ESNEFT – but not as far as MSEFT – throw caution to the wind and ‘relax’ the mask measures so that, “instead of face masks being universally worn, they will be required in certain settings based on the local risk assessments”, for example if a person has “suspected or confirmed COVID-19”. The telling part of its announcement appears at the end of the press release when NNUH’s Chief Nurse and Director of IPC offers these soothing words to those who use its services:
We understand that after three years of mask wearing there will be some anxiety and we want to reassure staff, patients, carers and visitors that masks will still be available at our hospitals for those who wish to wear one.
And here we have it, an admission that the population’s mental health and acuity has been damaged by the ceaseless propaganda surrounding masks, in some cases beyond repair. Without a candid and truthful re-evaluation of the usefulness of masks, and absent clear and unambiguous instructions from the top of the NHS, there will always be a desire amongst mask obsessives to cling on to the false idea that masks work.
The Smile Free campaign does not accept we should be subject to interminable masking based on the arbitrary decisions of local healthcare managers, and we invite you to sign our Open Letter to NHS leaders, calling on them to issue new guidance that explicitly discourages this harmful practice.
Paul Stevens is a member of Smile Free which campaigns for the end of mask mandates and masking.