At some point in the pandemic, you probably found yourself waiting in line at a convenience store, inching uneasily away from a man in front of you who was ranting at the clerk after being asked to put on a mask.

Or, maybe you were at a red light, and your eyes happened to wander over to the car idling next to you. The driver sat all alone — no passengers — but was wearing a mask anyway.

Then there was your college buddy’s wedding where the masks came off long before the booze ran out, and everyone toasted, hugged and danced ’til dawn without a care in the world.

Then again, how about the adorable millennial couple you noticed riding their bikes along a path in the wide-open outdoors, looking so young, fit and invincible — and yet, inexplicably, masked?

Like people across the country and probably around the world during COVID, Coloradans have spanned the spectrum in their response to the almighty mask. It has evoked rage and reverence, scorn and pride. It has adorned the Twitter avatars of its devotees — but only the chins, if that, of doubters who wore theirs grudgingly.

Of course, that was before the governor and local authorities lifted their mask orders last spring as COVID cases ebbed. Sure, there remained plenty of settings in which masks still were required — like air travel, mass transit, most public schools and health care facilities. But Coloradans got to show their faces in a lot more places through the summer and into the fall.

Until last week. Fueled by the “delta” variant, COVID came back strong. Now, the masks are back, too.

After weeks of fuming by public health officials and the press over Gov. Jared Polis’ reluctance to implement a new statewide mask mandate amid spiking COVID hospitalizations, metro Denver’s largest counties imposed mask orders last week for public indoor spaces. Boulder and Larimer counties had done so earlier. Meanwhile, places such as El Paso County in the Colorado Springs area and Douglas County in metro Denver, have yet to follow suit — and likely won’t.

The newly imposed rules go beyond masks alone in those counties that are masking up. There are escape clauses, such as Denver’s allowance for going mask free in businesses that can prove 95% of their walk-ins and employees are vaccinated. That opens the door to more testing, vaccine passports and so forth. But the stick behind such carrots remains the mask.

The upshot of it is a county-by-county patchwork of policies, which public health officials say they’ve feared — but Polis and, perhaps, a lot of Coloradans seem to prefer. It allows leeway for variations from county to county, not only in COVID’S basic indicators — caseload, hospitalizations and deaths — but also in public sensibilities. Including politics.

It’s no secret by now that liberal and Democratic-leaning counties are more mask-compliant while conservative and Republican-inclined counties would rather take it on the chin.

It’s worth noting as well that Polis is an elected official — answerable, at least in theory, to the voters. His critics in the public health world are appointed — answerable, as they might say, to science. Yet, the science might not be as clear cut on the subject as they would have you believe.

A mixed bag of masking data

Colorado’s most outspoken public health leaders — some of the larger county health boards and their chief execs — maintain that masking is essential in this latest COVID surge. That’s so, they say, even as a majority of Coloradans are now vaccinated and, if not always immune to the virus, by most indicators far less endangered by it. The public health authorities say until the holdout minority of residents gets vaccinated, the potential for overwhelming hospitals and their ICUS remains. Indeed, most COVID hospitalizations these days are among the unvaccinated. And to slow transmission among them, masks are basically the backup plan.

Toward that end, the officials contend science upholds masking. And they are likely to roll their eyes when lay people second-guess that science. The physicians, epidemiologists and other experts insist the research is on their side. But is it?

There is an array of data reaffirming the formidable filtration capabilities of some kinds of masks as well as their real world applications on a wider scale. A lot of that data, derived from by-now-familiar research studies, has made the rounds in the U.S. public health establishment and can be found on local public health department websites.

For example, there’s a study of 124 Beijing households in which at least one member was infected with COVID, and mask use reduced secondary transmission within the households by 79%. An oft-cited study of a COVID outbreak aboard a Navy aircraft carrier, with its sizable crew, found the use of face coverings onboard yielded a 70% reduction in risk.

Intuitively, it makes sense that a face covering would reduce the flow of aerosolized droplets and particles, or what our moms simply called germs. The question that raises doubts is whether that close-quarters efficacy is mooted by myriad, workaday factors when masks are mandated throughout a community or an entire state.

Mask advocates in the public health community cite a range of research substantiating the mask’s value in broader settings. Analyses in various European and U.S. cities and states are cited as confirming the benefit of universal masking, with transmission rates falling significantly.

Closer to home, as reported last week by The Gazette, Front Range health officials say hospitalizations fell in Boulder and Larimer counties after mask mandates were reimposed in October. The numbers might be too small to mean much, however, especially in such a short

time frame. In Larimer County, for example, Covid-related hospitalizations as of last Wednesday stood at 103 according to the county’s website — out of a county population of 360,000.

All that said, there is credible data indicating mask mandates don’t necessarily make much of a difference after all. Noteworthy is an eye-opening study this year by molecular biologists Daniel Guerra and Damian Guerra, the latter of the University of Louisville. Guerra and Guerra calculated COVID-19 case growth and mask use for the continental United States with data from the Centers for Disease Control and Prevention and Institute for Health Metrics and Evaluation. They compared states with mask mandates and those without.

Their conclusion: “We did not observe association between mask mandates or use and reduced COVID-19 spread in US states. COVID-19 mitigation requires further research and use of existing efficacious strategies, most notably vaccination.”

They elaborate: “…we found limited association between COVID-19 case growth and mask mandates or mask use before 1 October 2020, and no association during the subsequent and largest third wave. These findings do not support the hypothesis that statewide mandates and enhanced mask use slow COVID-19 spread. “

For the record, the study wasn’t funded by outside special interests; it was published by medrxiv.org, a co-venture of Yale University, the British Medical Journal and Cold Spring Harbor Laboratory. Though still awaiting formal peer review, their work faces the usual rigors of academic research.

So, what’s going on here? Guerra and Guerra make a pretty bold and sweeping statement about state-bystate mask mandates, explicitly referencing a lot of the earlier, familiar studies and implying those efforts got it wrong. Who’s right?

One size fits few

A researcher writing in the online journal Health Services Research and Managerial Epidemiology inspires this question: What if the research that supports mask mandates correctly attributes declining COVID transmission to masks — but gives the mandates too much credit?

Alberto Boretti of Prince Mohammad

Bin Fahd University in Saudi Arabia reviewed research worldwide and looked at COVID-19 cases and fatalities of different countries and concluded in a paper published this month, “…generalized mask mandates are excessive and inefficient, and targeted uses of masks could deliver much better results.”

“Face masks certainly help against COVID-19 infection. However, their benefits are presently overestimated, while their risks are unnoticed,” he wrote. “Generalized mask-wearing policies for COVID-19 applying to anyone in public spaces no matter the specific circumstances ignore the scientific evidence gathered before the COVID-19 emergence and during the pandemic.”

Boretti details wide-ranging scenarios in which face masks might well be making a big difference as well as settings where they are pointless. It suggests that the widely accepted data pointing to the successes of mask mandates might be missing out on a nuance: that masks’ value lies in their use in only some kinds of circumstances. In other words, the data reflect only the gains from mandated mask use where masks mattered. Yet, the same mandates also covered, and smothered, a whole lot more of our daily lives, yielding little or no benefit.

Just think of all the settings during Colorado’s previous mandate in which we wondered how masks possibly could help. Parents whose kids played sports in clubs or schools as recently as last spring are still befuddled by rules that, for example, made their young soccer players don masks for practice and even games — while outdoors, on wide-open playing fields.

Data driven — or dogma driven?

Yet, it’s the blanket mandate the public health establishment seem to embrace. It’s only natural to wonder if they are knowingly engaging in overkill just to play it safe. Is it easier to require masking up as an all-purpose, one-size-fits-all mantra than to advocate more effectively “targeted” uses, as Boretti proposes? Is there a fear of disrupting the drumbeat for unified action — that maybe too many people would break ranks and fall out of lockstep?

James Rohrer, PH.D., a managerial epidemiologist and editor in chief of the aforementioned journal Health Services Research and Managerial Epidemiology, describes compellingly in an article in his journal last August how prevailing dogmas can eclipse, even cancel important alternative data and analysis in science, just as in politics or any other endeavor.

“Political correctness is a powerful force, even in science,” Rohrer writes. “Articles assuming that the benefits of masks and mandates exceeded the harms were easily published and those testing the evidence girding up the Group-think had few outlets. This happened despite conflicting guidance from public health authorities …”

How could that happen? Rohrer asserts that during COVID, “… a mantra came into popular use that asserted only one set of conclusions was scientific and other perspectives were not ‘based on science.’ This is not how science works. Scientists always disagree about the interpretation of scientific data. Objective analysis, replication by independent investigators, the passage of time can eventually lead to the emergence of a consensus about the interpretation of scientific data. Decrying those who disagreed as ignorant and unscientific during the epidemic was in itself not scientific, but instead an exercise in political correctness. Conclusions charged ahead of the data and policies were based on those conclusions.”

Is the governor getting it right?

It’s a pretty safe bet Jared Polis knows all this and then some. His latest pronouncements on the subject, and his resistance to a statewide mask order, make that clear.

He understands the political polarization surrounding mask mandates. He grasps the public’s fatigue with them. He probably even gets their targeted value vs. their diminishing returns as they are applied ever more broadly. And he appreciates how most Coloradans have availed themselves of a much more effective defense against COVID-19, one he has championed ceaselessly — vaccinations — and they are ready to reap their reward. Which is all the more why he’s willing to let the counties go their own way on masking — even if it means denizens of metro Denver’s inner-urban core still will be muzzled through the holidays.

The governor might even have tired of the public health establishment’s backseat driving. He indulged it for much of last year with only a growing COVID caseload to show for it by year’s end.

And it’s a safe assumption Polis doesn’t want to place himself or the rest of the state in the double jeopardy that faces our southern neighbor New Mexico. There, citizens are suffocating under a statewide mask mandate — while also enduring a soaring caseload. (A spokesman for the New Mexico governor could offer only the feeblest of political sops when contacted by The Gazette: “Without a mask mandate, New Mexico would have more cases.”)

The mask might remain a security blanket for Colorado’s public health hierarchy, but the governor and, arguably, plenty of the public are ready to move on to more effective means of curbing COVID. That includes pushing vaccination and expanding the supply side of the health care equation — hospital capacity — for the unvaccinated. Polis seems to realize it beats curtailing the demand side through mass coercion.

All of which is to say it could be time for a little more moderation and a little less masking up. Colorado really could use a break.

James Rohrer, managerial epidemiologist and editor in chief of the journal Health Services Research and Managerial Epidemiology “Articles assuming that the benefits of masks and mandates exceeded the harms were easily published and those testing the evidence girding up the Group-think had few outlets. This happened despite conflicting guidance from public health authorities …”