Fact check: Lt. Gov. Forest says masks don’t work with viruses. Experts disagree.
The issue: At a campaign event on July 4, Lt. Gov. Dan Forest claimed that multiple studies have shown masks are not effective at preventing the spread of viruses, and cast doubt on their usefulness when it comes to preventing the spread of COVID-19.
Why we’re checking this: Despite a recent poll showing widespread support for a statewide mask mandate, Gov. Roy Cooper’s executive order requiring that masks be worn has faced significant pushback from Republican lawmakers. With masks quickly becoming a political issue, it’s important that the facts are clear when it comes to their impact on public health.
What you need to know: Forest, the Republican running for governor against Democrat Cooper, held a Fourth of July campaign event with Republican U.S. House candidate Madison Cawthorn in Henderson County, where he criticized Cooper’s approach to handling the COVID-19 pandemic. In a conversation with the Hendersonville Times-News after his speech, Forest claimed past studies had shown masks are ineffective at containing the spread of viruses.
“There have been multiple comprehensive studies at the deepest level held to scientific standards in controlled environments that have all said for decades, masks do not work with viruses,” he said, according to the Times-News. “That’s why we’ve never used a mask for a coronavirus before, ever.”
But Gavin Yamey, a professor of global health and public policy at Duke University, said the lieutenant governor was “factually incorrect.”
“There is evidence that masks reduce viral transmission,” he said, pointing to an analysis of 10 studies published last month. The analysis found that “face mask use could result in a large reduction in risk of infection, a reduction of as much as 85%,” Yamey said.
In a statement via email, Andrew Dunn, a spokesperson for the Forest campaign, said Forest’s comments “deal with the conflicting advice on masks that our nation’s health leaders have given over the last four months.” He pointed to a comment made by Dr. Anthony Fauci, the nation’s leading health expert on COVID-19 and a White House adviser, about mask use in March. In an interview with “60 Minutes,” Fauci said at the time that the general public should not be wearing masks.
“Only in June did the World Health Organization change its long-standing guidance and recommend that the public wear masks,” Dunn added.
While the Forest campaign is correct that initially Fauci and other officials did not advise the general public to use masks, Fauci has since reversed that position and actively advocated for people to wear masks, and health experts say that over time the research has grown to show that wearing a mask can curb the spread of the virus.
“The evidence gets stronger by the day, as more and more studies show that masks are a critical tool in preventing transmission of the novel coronavirus,” Yamey said. “Research has shown that face masks block the spread of respiratory droplets that can carry the coronavirus. Countries where masks were widely used soon after their COVID-19 outbreak started were more likely to keep their death rates low and to have a shorter outbreak.”
The research on the topic continues to evolve, revealing new details on how to prevent the spread of the virus. A study from researchers at UNC-Chapel Hill found the virus could be transmitted more easily through nasal passages, and that masks which covered the nose were particularly effective at preventing the spread of the virus, the N&O reported last month.
In the emailed statement, Dunn pointed to two different studies in supporting Forest’s comments.
In the first, a May study from the New England Journal of Medicine, researchers stated, “We know that wearing a mask outside health care facilities offers little, if any, protection from infection.” But just two weeks later, the Journal issued a follow up statement acknowledging that some had cited its article to discredit the widespread use of masks, and clarifying that “the intent of our article was to push for more masking, not less.”
The researchers added they “strongly support the calls of public health agencies for all people to wear masks when circumstances compel them to be within 6 ft of others for sustained periods.”
In the second, a 2015 study from the National Institutes of Health which looked at influenza and other viral outbreaks, researchers concluded masks and other protective gear may not be effective or necessary outside of clinical areas.
Frank Scholle, a virologist at N.C. State University, said it’s important to distinguish between the kinds of protection a mask can offer.
“Yes, there are conflicting reports on whether masks are protective, but by and large they focus on healthy people trying to prevent getting infected,” he said. “With COVID-19 we are trying to get people to use masks so they don’t spread the virus to other folks if they are asymptomatic or presymptomatic.”
Still, he added that “there is a difference between an absence of evidence and an evidence of absence.”
In other words, a mask may also protect its wearer, but the research isn’t quite there yet to make a more definitive statement in either direction.
He added that this “is not influenza,” as is the focus of one of the cited studies, and that “different viruses need to be handled differently.”
Scholle said with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two previous coronaviruses, infected individuals were not contagious until they became sick. That reduced the need for masks as those with symptoms could stay home. But a person could have COVID-19 and not realize they are infected until after spreading it to others.
And while masks have not been widespread in the U.S., they have been used in other places like South Korea and Hong Kong in previous viral outbreaks, including for SARS, MERS and even some cases of influenza.
Regardless, health experts agree that with this virus, masks can dramatically reduce the odds that an asymptomatic person infected with the virus unknowingly transmits it to others.
Our sources. Here’s where we found information and research on this topic.
Hendersonville Times-News’ article about Lt. Gov. Dan Forest’s Fourth of July campaign event
“60 Minutes” interview with Dr. Anthony Fauci from March, 2020
ABC News article on Fauci urging people to wear masks to curb spread of virus
N&O article on University of North Carolina at Chapel Hill study on mask effectiveness and the nose
NPR article on South Koreans wearing masks amid 2015 MERS outbreak
New York Times article on a 2008 flu outbreak shutting down schools in Hong Kong
Nature study on respiratory viruses and the effectiveness of masks
This story was originally published July 9, 2020 at 8:45 AM.