It is, admittedly, difficult to keep up with all of the #COVID-19 news but the lunacy occurring in Orange County has the makings of a public health nightmare of their own creating.

On June 8th, Orange County’s Health Officer Dr. Nichole Quick quit her position after receiving death threats over her order for people to wear masks in public. Irate residents blasted the requirement, and the county sheriff said he wouldn’t enforce it (sound familiar Riverside County?). Dr. Clayton Chau who has now assumed Dr. Quick’s position then lifted this requirement “after taking a closer look at the state’s virus monitoring criteria.”

Here’s the scientific problem with this misguided approach, a study published this week by Renyl Zhang and colleagures from Texas A&M and Cal Tech has shown that the primary determinant in shaping the spread of COVID-19 is mandated face coverings. What a time to be on the wrong side of science and history, especially when the answer is a mouse click away.

But lets break the paper down a little bit further to understand its conclusions. First off, Dr. Zhang is in the Department of Atmospheric Sciences which is a fascinating perspective by which to study an airborne pathogen. The authors evaluated three epicenters of the disease: Wuhan, Italy and New York City. They then compared the outbreak trends in each region in the context of various mitigation measures – including mandated face coverings, social distancing, quarantine, hand sanitizing and minimizing social contacts. Their atmospheric analysis was so detailed that they concluded that winter haze conditions in Wuhan likely exacerbated viral spread because of low UV radiation and air stagnation.

Their analysis of these three massive outbreaks of COVID-19 showed that the primary determinant in shaping the trend of the pandemic was mandated face coverings. This protective measure “significantly reduces the number of infections” by blocking atomization and inhalation of virus-bearing aerosols AND contact transmission by blocking viral shedding of droplets. The unique function of face coverings accounted for significant reduction in infections in China, Italy and NYC.

Now Orange County isn’t solely to blame. One month ago Riverside County similarly decided to roll back mandated face coverings – and this has not worked out well for them. The WHO and CDC have thus far emphasized the prevention of contact transmission and largely ignored the importance of face coverings. As the authors note “clearly, integration between science and policy is crucial to formulation of effective emergency responses by policy makers and preparedness by the public for the current and future public health pandemics.”

So Orange County, somehow surgeons can manage wearing a facemask through procedures lasting 8, 12 or even 14 hours without passing out from “toxic levels of CO2.” I think mandating you wear one for a 20 minute trip to the grocery store is not a major imposition when it is the most effective means to prevent person-to-person spread of COVID-19.

Plus, it is more than a bit disingenuous to threaten a Public Health Officer’s life when she is trying to save yours.