Back on March 27, Gov. Cooper turned the idea of quarantine upside down — ordering healthy people to “STAY AT HOME.” Quarantine had always been for the sick, not the healthy.

Then on June 26 he turned another longtime health practice upside down. He forced mask-wearing on healthy people, and he did so citing reliance on “the data and the science.”

Earlier that month, however, the World Health Organization (WHO) had released guidance on the use of face masks. The guidance was not concerned about protection from people who felt healthy, but instead from people who (a) have the virus, (b) are symptomatic of having the virus, and (c) are in close contact with others.

What about forcing masks on healthy people? According to WHO:

At the present time, the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence, and there are potential benefits and harms to consider (see below).

In other words, the “science and data” don’t support forcing face masks on everyone. Cooper and DHHS Sec. Mandy Cohen knew that before Cooper issued the mask order.

Masks on healthy people: What are the benefits? What are the harms?

Here are what WHO sees as the benefits, the “likely advantages of the use of masks by healthy people in the general public,” rewritten in plain English (see below for WHO’s text):

  • You could have a lower risk of catching the virus from an infected person
  • You could make sick people or their caretakers who have to wear masks not feel so weird about it
  • You could give people the impression they’re actually doing something meaningful to stop the virus
  • You could help remind people to wash their hands and not touch their faces, sort of
  • You could create avenues for people to make money crafting and selling their own masks, and maybe you could even work in some cultural expression or something that would get others to go along with it

Those are heady benefits, to be sure. Did you notice that only one was actually related to health?

Here are the harms, the “likely disadvantages of the use of masks by healthy people in the general public” in plain English:

  • You could self-contaminate — touching and moving the mask and then touching your eyes and face
  • No, really, you could self-contaminate — putting the mask down, getting it dirty, letting it get wet with your exhalation and sweat while all kinds of bacterial cultures and microorganisms fester and grow as you exclusively breathe them into your body
  • You could start getting headaches and suffer breathing problems
  • You could start getting skin lesions on your face, irritating dermatitis, or maybe just acne
  • You could have a hard time speaking clearly, which could make you start touching and moving your mask (see above regarding “You could self-contaminate”)
  • You could experience discomfort, which could make you start touching and moving your mask (see above regarding “You could self-contaminate”)
  • You could think you’re safe now that you’re wearing a mask and then not be as diligent in washing your hands and keeping your distance
  • Kids especially, but also some adults, don’t wear their masks properly (see above regarding “You could self-contaminate” and “No, really, you could self-contaminate”)
  • People just throw their masks anywhere, creating potentially infectious litter (see above regarding “No, really, you could self-contaminate”)
  • You couldn’t communicate with deaf friends or family who lip-read, which could make you start touching and moving your mask (see above regarding “You could self-contaminate”)
  • Lots of people have significant, serious reasons not to wear them: small children, developmentally challenged people, people with mental illness, elderly patients with dementia, people with asthma or chronic breathing problems, and people who have had facial trauma or recent surgery
  • People living in hot, humid environments are also particularly disadvantaged by wearing them (see above regarding “No, really, you could self-contaminate”)

That last one is something else to consider. Not only does WHO try to guide policymakers to understand that the science doesn’t support forcing face masks on healthy people, but also it warns that it’s potentially harmful for healthy people to use masks, even voluntarily, if they live in a hot, humid environment such as North Carolina in the summer.

Here is the text of WHO’s potential benefits and harms of “the use of masks by healthy people”:

Potential benefits/advantages

The likely advantages of the use of masks by healthy people in the general public include:

  • reduced potential exposure risk from infected persons before they develop symptoms;
  • reduced potential stigmatization of individuals wearing masks to prevent infecting others (source control) or of people caring for COVID-19 patients in non-clinical settings;
  • making people feel they can play a role in contributing to stopping spread of the virus;
  • reminding people to be compliant with other measures (e.g., hand hygiene, not touching nose and mouth). However, this can also have the reverse effect (see below);
  • potential social and economic benefits. Amidst the global shortage of surgical masks and PPE, encouraging the public to create their own fabric masks may promote individual enterprise and community integration. Moreover, the production of non-medical masks may offer a source of income for those able to manufacture masks within their communities. Fabric masks can also be a form of cultural expression, encouraging public acceptance of protection measures in general. The safe re-use of fabric masks will also reduce costs and waste and contribute to sustainability.

Potential harms/disadvantages
The likely disadvantages of the use of mask by healthy people in the general public include:

  • potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands;
  • potential self-contamination that can occur if non- medical masks are not changed when wet or soiled. This can create favourable conditions for microorganism to amplify;
  • potential headache and/or breathing difficulties, depending on type of mask used;
  • potential development of facial skin lesions, irritant dermatitis or worsening acne, when used frequently for long hours;
  • difficulty with communicating clearly;
  • potential discomfort;
  • a false sense of security, leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene;
  • poor compliance with mask wearing, in particular by young children;
  • waste management issues; improper mask disposal leading to increased litter in public places, risk of contamination to street cleaners and environment hazard;
  • difficulty communicating for deaf persons who rely on lip reading;
  • disadvantages for or difficulty wearing them, especially for children, developmentally challenged persons, those with mental illness, elderly persons with cognitive impairment, those with asthma or chronic respiratory or breathing problems, those who have had facial trauma or recent oral maxillofacial surgery, and those living in hot and humid environments.