Today, Explained - A rough week for mask mandates

Episode Date: April 22, 2022

A Florida judge ended the federal government’s mass transit mask mandate this week. Vox’s Dylan Scott explains if mask mandates are over forever and Dr. Kavita Patel explores how much of a difference that would make. This episode was produced by Victoria Chamberlin, edited by Matt Collette, engineered by Paul Mounsey, fact-checked by Laura Bullard, and hosted by Sean Rameswaram. Transcript at vox.com/todayexplained   Support Today, Explained by making a financial contribution to Vox! bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Good afternoon passengers, welcome to Today Explained. This is the pre-show announcement for episode 1046, a rough week for mask mandates. We are now inviting those passengers who are sick and tired of wearing masks to remove them. Passengers who have been wearing them on their chins for the past two years may now continue to do so freely and finally without recourse. Those passengers who remain concerned about COVID-19 and COVID-22 may feel free to stay masked. After all, cases are rising in most states. We ask that you fasten your seatbelts because the Department of Justice is appealing that Florida judge's ruling. Secure all baggage because, who are we kidding, when it comes to this pandemic we've all over packed thanks again for riding today explained enjoy your flight

get groceries delivered across the gta from Canadian Superstore with PC Express. Shop online for super prices and super savings. Try it today and get up to $75 in PC Optimum Points. Visit superstore.ca to get started. Today Explained, I'm Sean Ramos-Verm, and I'm joined by Dylan Scott, senior correspondent covering health at Vox.com, to talk about the terrible, horrible, no good, very bad week mask mandates had in the United States. The week started with a bang. Nationwide mask mandates for planes and public transit struck down by a federal judge

just days after the CDC extended it. Now the Biden administration says masks are no longer required. The CDC is still recommending you wear a mask to keep yourself safe, but it is not required. Airlines pretty much are leaving it up to their passengers whether they want to mask up. Immediately, people started

taking off masks when there were some people who were mid-flight. Pilots came over the radio and said that the mandate had been reversed. And so people started celebrating. The Transportation Security Administration will no longer enforce the federal mandate requiring masks in all U.S. airports and on board aircraft. Effective immediately. Employees and customers may choose whether they would like to wear masks. We encourage you.

My company announces at this moment, if you choose to, you may remove your mask. Woo! Yeah! But then we got the news on Wednesday that the Biden administration was going to appeal the judge's ruling that rescinded the mask mandate. So now we're waiting to see what happens next in the higher court. Let's sort of wind back, Dylan, and talk about where this mask mandate on planes and on trains

in this country stood before this week? Was it already sort of on its last legs or was it still alive and thriving well? The CDC said recently that they recommended extending the mask mandate through early May, which, you know, I think reflected the fact that we have this BA.2 sub-variant of Omicron that'sicron that's starting to drive a new increase in cases nationwide. And so, you know, it seemed like an appropriate recognition of the public health situation as it stands right now. But the mask mandates days were probably numbered to some degree. But this judge's ruling has really moved up the timeline and introduced a lot of confusion at a pivotal moment in the pandemic. Was this mask mandate always vulnerable to the whims of like one random judge?

The Biden administration has been running into this problem throughout the pandemic when they've tried to institute a vaccine requirement for large employers or federal contractors. You know, those ended up getting tied up in the courts because somebody would appeal the federal guidance to a conservative judge in some part of the country. And in short order, you know, that judge would issue a ruling blocking or putting on hold or otherwise obstructing what the Biden administration wanted to do. So that's just kind of the nature of the system is that, you know, people can take these kinds of federal guidance to court, and often they can find a friendly judge. Let's talk about this Florida judge who threw this whole thing into a state of upheaval. Yeah, you know, I've heard that my colleague Ian Millhiser has some pretty strong feelings about this. Woof. Okay, where do I start?

Catherine Mizzell was 33 years old when she was appointed to the bench. And there's nothing wrong with being 33, except for the fact that she had eight years of experience as a lawyer. She wasn't even old enough to be a partner in her law firm yet. She was still an associate. She was still a junior lawyer when she got a lifetime appointment to the federal bench. But what she lacked in experience, she made up in having just about every conservative credential that a young lawyer can have. She clerked for Clarence Thomas. She worked in the Trump Justice Department. She gave a speech where she said that paper money is unconstitutional.

She thinks the dollar is unconstitutional. She thinks the dollar is unconstitutional. And so this opinion that she handed out on the mask mandate is exactly what you would expect from someone with this resume. The law says that the CDC is allowed to make sanitation regulations. Her primary argument is that sanitation only refers to cleaning something up and not preventing it from getting dirty in the first place. Suppose that there was a problem with airline toilets. There was some malfunction. They started spewing sewage all over the place. Under her opinion, the government's not allowed to order the airlines to fix their toilets so they stop spewing everywhere. They have to

wait until passengers are wading through s*** in the airline cabin before the government can order them to clean it up. Thanks, Ian. Dylan, back to you. This judge's decision immediately trickles down from the skies to just about all other forms of transportation? Right, yes. And, you know, you started to see at the state and local level, you know, other transit agencies changing their policies in response. MARTA has changed its COVID-19 restrictions. This morning, you don't need to take your mask along. Masks are no longer mandatory on any public transportation in Illinois.

Besides a travel update in the skies, mask changes are taking place at Uber. Starting today, rideshare drivers and passengers no longer have to wear a face covering. Maryland's Department of Transportation is the latest agency to update its mask policy. So effective immediately, masks are now optional at BWI Airport and on all Maryland transit and administration buses, trains and mobility vehicles. So this is just this amazing waterfall. The judge on Monday says the mask mandate's done. Planes immediately, mid-flight, are lifting the mandates. Then it's Amtrak.

Then it's local public transit. It's Uber. It's Lyft. What does the Biden administration say on Tuesday? How do they respond? It took the Biden administration a couple of days to figure out what they wanted to do. You know, at first the TSA just said like, well, because of this judge's ruling, we're going to stop enforcing the mask mandate. You know, President Biden, he was asked whether people should continue to mask on airplanes. And he said, that's up to them. That certainly seemed to suggest that

this wasn't like a matter of great urgency from the Biden administration's perspective. Now, what they were waiting for was for the CDC to kind of say like, well, do we still think that the public health situation necessitates having a mask mandate in place? And on Wednesday, they did make that determination. And so the Justice Department has appealed this judge's ruling to a higher court. But I think the way that it played out certainly gave an indication that ultimately, the Biden administration may be okay with the mask mandate going away. Like I said, its days were probably numbered to some degree anyway. But there is a sort of secondary fight here, which is just about

how much authority the federal government has to set rules about public health. And so part of the reason in all likelihood that the Biden administration is pursuing this in the courts is they want to make sure that a precedent isn't set that would make it harder in the future for the CDC and federal agencies to put things like mask mandates into place if they thought it was necessary. Justice says it may appeal if the CDC insists that the mask mandate is needed, but the Justice Department would not go for a stay. It really is concerned that this judge may have set precedent prohibiting the CDC from taking action like this in the future with another health emergency. Meanwhile, how do the American people feel about

this? The polling would suggest that people are actually generally fine with wearing masks. Like, I saw something just in the last couple days as all this was going on that more than half of Americans said, like, they thought people should continue to wear masks on airplanes and trains and public transportation. So, you know, I think there's probably a difference between people saying, like, in a poll whether or not they think people should wear masks versus like, do they feel that strongly about it? You know, that we know there's kind of a phenomenon with those surveys where people like say what they think they're supposed to say. So I never know like how, how literally to take that kind of thing. So I think, you know, we'll, we will see

going forward, like what the prevailing attitudes are. Like I said, you know, we'll, we will see going forward, like what the prevailing attitudes are. Like I said, we're entering a new phase of the pandemic where, you know, the burden is on the individual. Of course, if you live in a state like Florida, it's been choose your own adventure for a long time. That's the other thing is like, you know, this does kind of symbolize, you know, our moving on and entering some kind of post pandemic new normal. But yeah, like for a lot of people, that's the way they've been acting the whole time, you know? And I think that's why we've seen over time

some of this pushback against masks on airplanes and other places. We really are kind of moving on. And rather than there being this universal rule in place that everybody is supposed to follow, it's going to be up to you, whether you think wearing a mask or keeping your distance from people or avoiding large indoor events

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Member FDIC. Terms and conditions apply. Enough is enough! I have had it with these motherfuckers on this motherfucking plane! Everybody strap in! I'm about to open some motherfucking windows. Not sure how Sam Jackson feels about the news this week, but I definitely saw a lot of people on social media

who were incensed by this Florida judge. And then I saw lots of people who were like, bruh, people on planes are already masked off for most of the flight while they drink and eat. What is this even changing? We wanted to answer that question, so we reached out to Dr. Kavita Patel. Yeah, so it's a great question because I'm sure you have been on the exact same flights, transit, subways that I have where you're standing right next to somebody who's got a really nice mask, but it's on their chin.

Dr. Patel was a health policy director in the Obama administration. Let's just kind of dive into the science of it just to put this to rest. So masks do matter. And unfortunately, we don't have these like perfect, you know, randomized trials, kind of old standard trials, because that's a little bit unfeasible. So what we have done is looked at the impact of masks on planes. When we've gone back and looked in studies to look at people who have been on planes and have actually been found to be positive, testing or sick or both, and then look to see who they spread it masks, the infection probability or the secondary cases rose by 60%. And this is on a flight which we know has better than average, certainly, ventilation, yeah? We hear a lot of people say, including myself at times, I've said to patients, risk of transmission on planes are low because the circulation of air is very good.

What does that mean? It means that airplanes have, when their engines are running, that's key, engines are running, they exchange air 10 to 20 times per hour. So it's incredibly powerful at exchanging air. So that might give you like, you might be thinking, well, why did I ever have to wear a mask, right? Truly the person that is the most vulnerable on an airplane, it's really that row and probably the row in front of it. When you look at actual studies of air circulation in planes, because of that rapid air exchange, people who are 10 rows behind you really don't affect you and vice versa. So that's why we're talking about kind of how, quote, healthy, you know, it is to be on a plane compared to other things. But as you and I both know, getting onto that airplane, sitting on that airplane when the engines are not running, and then when you land and the engines stop and you're waiting for that, you know, for the gangway to come to the plane, all of those are incredibly vulnerable moments of exposure. Right. So if your plane gets like delayed on the runway and they just keep you in

there for three hours, then you should really be sweating. If the engines are off, and you know when they're off because you kind of hear the engines stop, that is definitely your most vulnerable period of time. If I am wearing a pretty well-fitted KN95 or N95 mask with like a flexible nose that has a little bit of cushion so I can kind of nicely fit it around my nose, that's pretty darn good protection. It's not perfect, but it probably gives you about 90 to 92% protection

from any of those viral particles getting to your nose and mouth. I'm glad you brought that up because that's the other thing I was seeing online a lot, which is just that, hey, listen, if you're freaking out about this news, just wear your N95 mask. One-way masking will work.

Is that true? One-way masking works under incredibly perfect conditions. And what do I mean by that? It's just very natural. If there's somebody next to you, mask off, and they're coughing, there is still a very significant, how significant? Anywhere from 6% to about 15% that you could have exposure. Will you get sick from it? No. It doesn't mean that 15% of people sitting next to someone sick gets sick. It just

means that you could have exposure to those viral particles. And then hopefully if you're vaccinated and boosted and you have a good immune system, you don't get infected. How does what we've discussed so far translate as you go down the line in terms of transportation from the flight to the airport, to the train station, to the train, to the subway, to the bus, to the rideshare? Because a lot of people threw out the regulations this week. Planes get a lot of attention because of the viral videos and everybody cheering, but the majority of the country isn't traveling on planes. In fact, the majority of country, particularly brown and black communities, are traveling in a disproportionate ratio on

exactly what you said, transit, buses, trains, and then Uber, Lyft, ride shares of any kind. But we do know that when buses have windows open, that that can almost make kind of that same dynamic of the plane where it's exchanging air rapidly. So that's good if you're on a bus and sometimes you have the freedom to open it, do it. So planes, trains, subways, buses can have decent circulation if it's not packed. When it's packed, again, that one-way masking or having to make a tough decision if you're immunocompromised about not taking that particular route, which is really unfortunate.

So again, remember, mask or air circulation. Ideally both, but controlling one or the other can really help to decrease chances. Let's talk more about the immunocompromised. We've been talking about them for two years. We were reminded of them many times this week. A lot of people were freaking out about how this would affect the immunocompromised. How much of America is immunocompromised? When we look at populations that I think get kind of, quote, typically thought of as severely immunocompromised,

let's talk organ transplant patients, patients that are undergoing active cancer therapies, and also people on certain chronic medications, for example, like for lupus and diseases that are actually not so, you know, that are common, not so rare. Those numbers, Sean, get into the 10 to 12 million Americans range, and this is adults. When we add in children, we add in anywhere from one to five million children. So we're not talking about a small number. I think there's been this notion that the quote immunocompromised are far and few between. When you really look at what I just mentioned, certain medications, chronic conditions such as cancer treatment, and then also organ transplant in your past, that's actually a lot of patients. And so this is not a small number of Americans. But I will add to that people like my parents, anybody over the age of 80, that you really do have a higher risk. Are they technically

immunocompromised? No. But are they at a much higher risk of getting severe COVID even with vaccinations and everything on board? Yes. So what about all the immunocompromised and elderly people out there? I mean, should they be reconsidering flights or trains or how they get around and commute every day? They might. If you have the options and freedom to make choices and decisions because your individual risk is you do not want to take a chance of getting sick, then yes, you do need to reconsider. But for a lot of people, they have none of it. So that's where the high quality mask, if you can't do an N95, it's hard to get one.

It's expensive. CVS has free ones provided by the government, by the way, or two surgical masks, which most people can seem to get access to. Okay, so go a little harder on your PPE. What about the kids? What about the kids under five who still don't have vaccines? If you've ever tried to get a two-year-old to wear a mask or a 17-month-old to wear a mask, you know it's impossible. So I'm not going to tell you to get your children under the age of five to wear a high-quality fitting mask. That's great. But you are going to probably need to make decisions about children if you're traveling.

And there is really no protection that they can take on a plane, on a subway, on a train. And so what I would recommend, honestly, as a parent, I would make sure that you're boosted if you're eligible, because your protection will be the best thing to protect them. You getting infected is the highest probability of them getting infected, obviously. So do what you can to protect yourself. Put yourself in a good PPE, high quality mask. And then with your child,

I've seen some toddlers that do have one of those face shields like I have at work. I think that's a false sense of security, so I don't love that, but sometimes it helps parents feel like they're doing something. And then again, try to have your child kind of by the window.

Sometimes we put kids in the middle to make it easier to handle them, but on a plane, put them near the window. On a train or bus or subway, I'm actually carrying spare masks, and I have no problem these days. I think becoming a parent makes you just do things to protect your child. I think everybody should say, look, I've got a kid. They can't get vaccinated. I beg of you to just wear this. You can take it off the minute you walk away from here. And I have done

that and it's worked sometimes. Wow. You do that? Yeah. I mean, I, maybe it's because I'm in- It probably helps that you're a doctor. You have like an extra air of authority. Oh, I don't tell them I'm a doctor. I think that, I do want to say that like, I'd like to think there's some like decent human kindness in the world. And when they see that it's like a mom with a kid, I think there is like a, look, I don't care what you do when you leave. I just need this one thing to be protected. My most precious asset is right in front of me, and I need this person to be protected. They tend to do it. I appreciate that.

But I feel like if this week has taught us anything is that like a lot of people were ready to be done with this. I mean, flight attendants who have been the enforcers of the rules were out there celebrating and crying and ripping off their masks. I mean, are we reaching the point in this pandemic where no matter what appeal you make to the person next to you, you might get the response that like, listen, for me, COVID is over. Yeah, you might. And here's where I will totally personally even take a part of the responsibility and why this has gone so south and just so awry of like what we needed in society. We have never also given people a sense of when can these masks come off? You know, because if you recall, like in March of 2021, we're like, everything's better, masks off if you're vaccinated. And then we were like, oh, no, wait, everybody needs to wear masks when Delta happened. And I think what we've done is people have felt like we've constantly moved

the finish line and people need a finish line. And I do think that that's been a problem. It's hard to do, but I think it would have been much better to say, look, when the country is in this level of cases, we will take this away. And for the transit, same thing. People wanted to know that if the rest of the country is not wearing masks, why are we wearing them on planes? And so we need those answers. After all this time, it still comes down to we could do a better job of communicating. This is something we're all learning. I had thought 10 years ago, hey, we'll be talking about air circulation and carbon dioxide levels on planes. I wouldn't have believed it. So yeah, it's definitely a skill set that we need, but have to be a pandemic advisor in the Obama administration.

Before her, you heard from Dylan Scott and Ian Millhiser there with Vox. As is Victoria Chamberlain. She produced the show today. We were edited by Matthew Collette, fact-checked by Laura Bullard, and mixed and mastered by Paul Mounsey. The rest of our team here includes Halima Shah, Will Reed, Hadi Mawagdi, and Miles Bryan. Our director of sound is Afim, the Dream Shapiro.

Our supervising producer is Amina Alsadi. Noelle King hosts the show with me, and Vox's VP of audio is Liz Kelly Nelson. We use music by Breakmaster Cylinder and Noam Hassenfeld, and we are distributed on public radio stations across the country in partnership with WNYC. I'm Sean Ramos-Furham. I have COVID-19, unfortunately. I'll be in my closet for the foreseeable future. If anyone needs me, get in touch with Today Explained anytime via email. TodayExplained at Vox.com is our address. We are on Twitter for the time being at Today underscore Explained.

Today Explained is part of the Vox Media Podcast Network. © transcript Emily Beynon you