Despite considerable opposition, Nassau County passed a mask ban, with all the Republican members voting for it, and Democrats abstaining. Per Howard Kopel, who chaired the hearing, the bill was introduced in response to “antisemitic incidents, often perpetrated by those in masks.”
On August 14, World Health Organization’s Director General-Tedros Adhanom Ghebreyesus declared mpox a public health emergency of international concern. This PHEIC followed the Africa CDC’s similar declaration because infections have been surging and are 160% higher than last year, with more than 15,000 cases and 400 deaths in 2024. Further, the virus has spread from Congo to six new countries in only ten days. On August 15, Sweden confirmed the first case of clade 1 mpox outside of Africa.
What Are Clades And Why Does It Matter?
Mpox (formerly monkeypox) has two clades—or “groups of organisms composed of an ancestor and its descendants.” A strain is a variant with unique observable characteristics.
Clade 2 mpox has been circulating globally for several years, spread primarily by sexual or close skin contact. It has a low death rate. This new clade, type 1, spreads more readily and can kill up to 10% of people. Children younger than 15 years-old, now make up more than 70% of cases and 85% of deaths. In contrast, the Omicron variant of SARS-CoV-2 had a 0.7% fatality rate, less than earlier strains.
Is mpox Transmission Airborne?
A key question is how is mpox spread. We know that clade II mpox is primarily spread sexually, and through very close contact. However, the outbreak in children suggests that clade1 is transmitted through air, respiratory droplets, or very close contact.
There are differing views on whether mpox has “airborne” transmission. We are echoing the Covid-19 debates. If small droplets are inhaled by people who are close, is that “airborne” or “droplet?” It’s a game of semantics as the implications overlap.
Experts are divided. Linsey Marr, a Virginia Tech expert on airborne transmission of viruses, was quoted in the New York Times as saying, “Airborne transmission may not be the dominant route of transmission nor very efficient, but it could still occur.”
The WHO said transmission of mpox could occur via “respiratory droplets (and possibly short-range aerosols).” The UK has a list of “high-consequence infectious diseases.” They say, “Airborne HCIDs are spread by respiratory droplets or aerosol transmission, in addition to contact routes of transmission.” Clade 1 mpox is on this list.
While the CDC is not supporting airborne transmission now, in 2022 they recommended wearing a mask to help protect you from transmission. The page, which stated that people could become infected through contact with “the skin lesions or bodily fluids of infected animals or humans (alive or dead), including respiratory droplets, was deleted.
Another thing to note supporting possible airborne transmission is that the mpox virus is closely related to smallpox. We have strong evidence that smallpox has airborne transmission. CDC says transmission of smallpox is through “inhalation of large, virus-containing airborne droplets.”
Nassau Mask Ban
Consider the information about the new global public health emergency announcement and how mpox is spread in the context of the Nassau County mask ban decision and hearing. The mask ban, signed this week by County Executive Bruce Blakeman, calls for penalties of up to a year in jail, a $1000 fine or both. It allows police very broad discretion. There is a medical exemption (in theory) for those trying to protect themselves, but not for those trying to protect others (e.g., an immunocompromised family member). Nor does it allow those who are already ill to wear a mask to prevent transmission and protect others. Do you really want a police officer to stop you and decide if your wearing a mask is legitimate?
The proponents of the mask ban, such as Congressman Anthony D’Esposito (R-NY) (1:03:02 on Vimeo) spoke about masked protestors brandishing Hamas and Hezbollah flags, with anti-Israel and anti-American hate speech, and threatening Jews. Others similarly spoke about the bill being needed to fight antisemitism. Previously, Mayor Eric Adams spoke strongly of criminals hiding behind masks and the need to go back to the way it was pre-COVID. There is strong data showing that masks don’t preclude the identification of criminals.
There were also Jewish people who strongly opposed the mask ban. Jews for Mask Rights now has more than 1300 signatures on their letter. A disabled speaker from that organization was loudly heckled and booed during the hearing. She then said, “Banning masks will not make us safer. It won’t solve antisemitism, it won’t stop crime, it will only violate our rights and place us in more danger.”
According to a several reports, the hearing itself was conducted in a biased manner, . Although anti-mask speakers had signed up to speak earlier, supporters of the ban were allowed to speak first. Opponents, many of whom were disabled, had to wait more than five hours in an “overheated, overcrowded, poorly ventilated room.” They couldn’t eat or drink safely because of their masks. Supporters of the ban were allowed to go over the 3 minute limit. Opponents, including William Tronsor, a disability rights lawyer, were threatened with being removed by the police by Howard Kopel (R), who chaired the meeting. (Video is available here.) It appears Kopel did nothing about the abusive heckling that pro-mask speakers endured. (Neither Blakeman nor Kopel has responded to requests for comment). At one point, things got so heated that a pro-mask attendee was injured as they were arrested. In a press release, Jews for Mask Rights noted the irony of “how these bans empower hate towards disabled people who rely on masks,” with vitriol directed towards the pro-maskers.
Mpox vs Mask Bans
Dr. Angelique Corthals is a Covid-19 expert, scientific advisor for MaskTogetherAmerica and associate professor at CUNY. She said the mask bans are “robbing us of the main tool to prevent not just this pathogen, but also novel pathogens that are coming our way thanks to climate change.” Speaking of anti-mask advocates, she added, “These people are not into nuances.”
Corthals continued, “The mask bans come at the worst time. Not only are we facing a new pandemic of actually airborne virus (H5N1), but mpox was another storm waiting to happen.” Because clade 1 mpox is more infectious and more virulent than the earlier clade, we need to take non-pharmacologic interventions (NPIs) to reduce the spread. Corthals stressed “that no mode of transmission be dismissed (‘oh, it’s only through sexual contacts’ or ‘it’s only skin to skin’).” And she concluded, “Public settings, such as schools, universities, and hospitals should have precautions in place, so we don’t see outbreaks spilling from kids to adults.”
What NPIs do we have that would address each of these infections—Covid-19, avian flu, and mpox? Masking and improved ventilation. “It seems few lessons have been learned,” Corthals concluded.
Read the full article here
