Perspective: A Cancer Doctor's View of the Great Mask War


The Great Mask War is still causing casualties. - DR. JAMES BEATTIE
  • The Great Mask War is still causing casualties.

This winter was supposed to be better.

As a cancer doctor trying to navigate immunocompromised patients through a respiratory pandemic, I have seen the devastating impact of COVID-19 from the outset. And as a lifelong resident of a blood-red county, I have also witnessed the battles of The Great Mask War in grocery stores, businesses and schools in this divided community.

The introduction of mRNA vaccines last December offered hope for a truce in The Great Mask War. The rapid development and production of effective vaccines was a medical marvel. But baked into the misplaced optimism regarding this scientific achievement was the idea that people would actually get them. With Missouri vaccination rates hovering at barely over 50 percent, there will be no vaccine armistice.

Recently, the head of the St. Louis Pandemic Taskforce warned of region-wide hospital staffing concerns due to “a pretty clear escalation” in the winter COVID-19 surge. Meanwhile, in what at times seems like an alternative universe, the Missouri Attorney General threatened “enforcement action” against any school district in the state using mask mandates, quarantines or other COVID-19 mitigation measures. The AG even implemented a state-sponsored “hotline” for parents to tattle on school districts who continue to pursue mask policies.

The Empire Strikes Back

The scientific debate over the benefit of masks is largely settled. While there are a few remaining holdouts in the tinfoil hat crowd screaming “C02 kills brain cells” (usually at a school board meeting or on TikTok), various studies, including a global analysis recently published in the British Medical Journal and a state analysis of data from Missouri’s own Department of Health and Senior Services (DHSS) have consistently proven the public health benefit with surgical masks.

Nobody seems to really be arguing that point anymore.

The debate now has focused on if any public health policy can proceed in Missouri at all, regardless of its impact.

The purported basis for the AG’s edict stems from a recent court ruling — Robinson v. MO DHSS. The actual Robinson decision, however, reveals a specific prohibition on unelected DHSS and local health departments from directly imposing quarantine and isolation guidelines without expressly prohibiting city councils, county commissioners, school boards or other elected officials from imposing public health policies. The AG’s own office was, in fact, responsible for defending the DHSS position. However, after a hollow defense (and refusal to file the appeal DHSS requested), the AG instead proclaimed this Cole County decision makes any school district policy aimed at COVID-19 mitigation in the entire state — including mask mandates — unconstitutional and sent “cease and desist” orders to school districts throughout the state.

This brazen misinterpretation of the ruling is consistent with an increasingly frequent display of partisan political hackery. St. Louis County Executive Sam Page deemed the AG’s threat as “carnival quackery,” but perhaps a new term is needed for this new age:

Noun - a public official who puts personal self-interest or brand above facts, logic and reasoning
Example - a state attorney general suing China

Ironically, the AG’s own lawsuit against China last year stated, “Missouri faces an urgent public health crisis due to COVID-19” while China “sought to minimize the consequences, engaging in a coverup and misleading public relations campaign by censoring scientists, ordering the destruction and suppression of valuable research, and refusing cooperation with the global community, all in violation of international health standards.” A year later, when the same AG authored a lawsuit against the Columbia Public School’s mask mandate, the danger of COVID-19 in Missouri now apparently paled in comparison to the risk of a student wearing a surgical mask during class — “The cure can not be worse than the disease.” (Also, masking students led to “less happiness,” according to the suit.)

So COVID-19 is both devastating enough for the Missouri AG to sue a sovereign nation for damages but also so trivial that there is no reason to quarantine COVID-19 exposed students from schools or even have them wear a mask. That’s because the current political climate calls only for grievance, not consistency or logic.

A chaotic response from school districts and health departments around the state predictably followed.

Some, like the Lee’s Summit School District, released a formal (and scalding) response to the AG, citing reasons both within the Robinson ruling and existing Missouri statute as to why the school “will not abandon the statutory duty to govern the operations of the school district.”

Others, like the Wentzville School District, quickly and quietly abandoned any effort at masking, contact tracing or quarantine for those with COVID-19 exposures faster than the NRA sends out “thoughts and prayers” messaging after a school shooting.

In Wentzville, the pandemic is officially over as of December 22.

As in all conflicts, the battles in The Great Mask War ebb and flow. Ground gained. Ground lost. While the AG and the pro-virus side press ahead in this latest sortie, the next fight cues up. There are other hills to fight on. And other hills to die on.

Because casualties remain the one connective tissue that links all wars.

Missouri deaths:

Civil War - 13,000
WWII - 8,003
Vietnam - 945
Korea - 737
COVID-19 - 15,600 (and counting)

In September 1864, General William Tecumseh Sherman remarked that the Civil War “began in error and is perpetuated in pride.” Shortly thereafter, Sherman launched the infamous “March to the Sea” campaign that destructively ransacked the entire state of Georgia and left Atlanta in flames. The Civil War ended barely a month later.

How will The Great Mask War end? Will Missouri be left in tatters like Georgia when the truce flag flies?

It’s too soon to tell.

Until then, The Great Mask War wages on.

I suppose dealing with COVID-19 is different in the trenches than on the campaign trail. But up close, it's a hard slog. And with no end in sight, it's clear something else that General Sherman said was also true.

War is hell.

Dr. James Beattie is a practicing Medical Oncologist in St. Charles County.

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