Public health experts concerned about Nassau mask ban, application of exemption

Public health experts said Thursday that Nassau County’s newly enacted ban on wearing masks in public could pose problems for people with a vast range of medical conditions as COVID-19 cases are rising.

They also worried that the ban’s exemption for those wearing masks for health reasons could be misunderstood or misinterpreted by the public and law enforcement.

"The message is, ‘COVID is over and you don't have to worry,’ said Perry Halkitis, dean of the Rutgers School of Public Health in New Jersey. "And the fact is that we know that throughout the world, there is a surge in COVID the last couple of months."

Nassau County Executive Bruce Blakeman signed the bill on Wednesday that makes it a misdemeanor to wear a mask "for the purposes of concealing an individual’s identity in public places." People who break the new law could face up to a year in jail and a $1,000 fine.

Proponents said the bill was in response to protesters over the Israel-Hamas war who wore face coverings on college campuses, making it difficult to identify them, as well as people using them to commit crimes. It also is illegal to wear a mask on private property without the consent of the owner or tenant.

There is an exemption for facial coverings worn for medical or religious reasons.

Halkitis, a public health psychologist, said the law is "equating mask wearing with crime and not equating mask wearing with public health." That is "empowering people who are anti-vaxxers, anti-maskers, to act out against those people who are trying to make decisions about mask-wearing to protect their health. You're making it unsafe for the people who want to wear a mask."

The law could be "misinterpreted or misapplied, both by members of the public who would be become [wary] of wearing masks for fear of running afoul of the law ... and also by law authorities," said Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine in Nashville. He worried law enforcement "might overapply the law, thinking they were doing the right thing but actually intruding on public health and personal medical reasons."

Schaffner said the law could most potentially endanger those who, because of their age or medical condition, are at higher risk of serious illness from COVID-19, flu and other respiratory viruses.

"Every Saturday morning, I do a run through the supermarket. I’m one of the very few people wearing a mask, and if I were in Nassau County I would hope the long arm of the law would not reach out to me," he said.

Dr. Irina Gelman, the Nassau County health commissioner, in a statement emphasized the exemption, stating that the law "contains an exception for health in that ‘this law shall not apply to facial coverings worn to protect the health or safety of the wearer.’"

Christopher Boyle, a spokesman for Blakeman, declined to comment.

Nassau County Police Commissioner Patrick Ryder told legislators at a hearing the law would be a helpful tool for officers and that they would be able to enforce it without infringing on someone's rights. 

"We will talk about what is a medical exemption and what is a religious exemption," Ryder said.

Several Long Island health systems, including Northwell Health, told Newsday the ban didn’t impact them because of the medical exemption.

"We encourage patients who have medical conditions (ex: cancer, immunosuppression) that place them at increased risk for acquiring an infection to wear masks when they are in environments considered to be high risk (especially, but not limited to, interior settings of mass assembly, such as shopping malls, movie theaters, etc)," Barbara Osborn, vice president for public relations at Northwell Health, wrote in a statement.

Dr. Stuart Ray, an infectious disease expert and professor of medicine at Johns Hopkins University School of Medicine, pointed out that people with severe allergies, chronic lung disease and weakened immune systems need masks around dusty areas.

"I recommend wearing masks when they are near a construction site or places where the ground is being disturbed," he said. "All those people need to be protected from a health and safety point of view."

Dr. Stanley H. Weiss, professor of medicine at Rutgers New Jersey Medical School, said he understands concerns that led to the ban, but said he worries how it will impact people who are at risk.

"Police are well trained to deal with urgent situations, urgent matters," said Weiss, who is also a professor of biostatistics and epidemiology at the Rutgers School of Public Health. "But here we are talking about something more nuanced — whether the person feels they have a legitimate medical concern. The view of that person should tend to be deferred to."

Weiss said he always carries a mask in case he is sitting near someone who is coughing and sneezing and he is not able to move away. On a recent trip to Manhattan, he and several friends carried masks in case a situation arose where they might need them.

"I don’t know how a police officer judges what are complex health and health-risk issues," Weiss said. "We could have people carry notes from their physicians, but I bet that wouldn’t work."