Benicia physician cites data on mask mandates

Solano Public Health Director opposes mask mandates

By Richard Fleming, MD, September 2, 2021

[BenIndy Editor:  Dr. Fleming slightly modified his analysis here from the piece that appeared in today’s Vallejo Times-Herald.  This updated version is published here with permission.  – R.S.]

Richard Fleming, M.D., Benicia CA

The Vallejo Times-Herald carried an interview with County Public Health Director Bela Matyas on August 29. In it, he explained why he opposes a county mask mandate for indoor public settings and why he feels the recent decision by the Benicia City Council to establish a mask mandate was “unnecessary.”

Dr. Matyas indicated he was looking at three factors – politics, community consensus, and science. He stated there is no consensus on masking in the county so, “My decision is purely based on science.” Yet in that interview, Dr. Matyas offered no scientific data.

These comments echo comments he made before the Benicia City Council on August 24. At that meeting, Matyas said there is no evidence mask mandates work. According to him, if they did, then the disease curve in Solano County would look different than in the eight other Bay Area counties, all of which have recently re-established mask mandates. He  said the curves are the same in all the Bay Area counties.

However, the curves are not the same. On every measure of the covid-19 pandemic, case rates, hospitalization rates, and mortality rates, Solano County is far higher than our peer Bay Area counties. Not only that, the rate of increase for Solano is significantly higher than for the rest of the Bay Area.

When Mayor Steve Young pointed these facts out to Matyas, the health director pivoted and said that  Solano County is not like the rest of the Bay Area, that we are in between the Bay Area and the Central Valley. Yet if one looks at the pandemic numbers in the Central Valley counties, there are quite a few doing better than we are.

There are also studies from various parts of the country showing the effectiveness of masks. A very informative one from Kansas was published in June 2021 in JAMA Network Open. It compared 15 counties which imposed mask mandates to 68 counties that did not. After ten months, the counties with mandates were doing far better on every measure. There are also excellent studies looking at school districts where teachers were mandated to wear masks, and the spread of the virus in those districts was much less than in districts without such mandates.

At the Benicia City Council meeting, Matyas said that in Solano County, “Our data clearly shows that indoor public spaces are not where the disease spreads.” He said spread results from private gatherings, so a mask mandate would not help. When I heard him say this, what came to mind is, “Where’s the beef?” He did not present any evidence publicly to support his statement.

There is no doubt that private gatherings are a big problem. But the odds are high that the virus behaves similarly in our county as elsewhere. There is no infectious disease expert in the country who says that indoor public gatherings are insignificant and can be ignored as a source of viral spread.

Solano County is a great place to live, but that does not mean covid-19 spreads differently here than in the rest of the U.S. During my 30 years practicing internal medicine in Solano County, I was never advised to treat infectious diseases here differently than the way doctors treat them in Kansas, Florida, or New York.

Matyas said he is relying on science to decide against mask mandates. Yet science confirms that mask mandates work. Of course other factors help as well, especially vaccinations. Sadly, our county has the lowest vaccination rate in the Bay Area. And lower than some Central Valley counties.

Matyas says mask mandates can backfire, because people will wonder why they got vaccinated if masks are still needed. He suggests that people in the northern parts of our county are not disposed towards masking. These are valid concerns. And there are two ways our county’s top health officer can address them.

He can say, “I understand why you feel that way, so I won’t rock your boats.”

Or he can say, “I understand why you feel that way, but I want you to understand some things. Vaccinated people are very protected against serious illness, but can still spread the virus. That’s why you still need to wear a mask. And there is very good evidence that wearing masks in indoor public settings will protect our community’s health and help our economy.”

Bela Matyas has chosen the first option. He appears to feel we are somehow incapable of performing as well as our peers in the rest of the Bay Area.

In times of crisis, leaders need to step up and lead. Every other Bay Area county public health director has followed the second option, and the data shows clearly we are falling behind. Thankfully, the city leadership of both Benicia and Vallejo decided we should rise to this challenge, follow the science, and try to protect our communities. They are not willing to say we have to settle for less than our neighbors in Contra Costa, or Napa, or Marin.

But we still have a lot to do to improve our vaccination rate.

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