We've all seen the viral videos of people being denied service in cafes and restaurants, and even removed from flights, on account of their refusal to wear a face mask in accordance with current public safety guidelines during the pandemic. Often, these individuals will cite underlying health reasons as justification, claiming they are unable to breathe while wearing one, and even supplying a "face mask exempt" card as evidence, referring to the Americans with Disabilities Act.
According to pulmonary medicine specialist and YouTube myth-buster Dr. Mike Hansen, these exemption cards, along with all the other excuses these people might try, are fake. "This really irks me for two reasons," says Hansen. "One, because they should be wearing a mask. And two, because this is the equivalent of someone parking in a handicapped spot who isn't disabled."
According to the CDC, "cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance." But are there any other, genuine medical reasons which might mean someone can't or shouldn't wear a face mask? For instance, does a mask actually affect our ability to breathe in and out the same amount of air?
"This is like asking if, when you go to the beach and you leave with sand in between your toes, 'is there less sand on the beach?'" Hansen says. "Technically yeah, but it's negligible... Air passes freely in the areas around the mask, so as long as the mask is not too thick, or too tight on your face, it's not going to obstruct air flow in and out of your lungs." There's a very easy way to tell that the air is escaping the mouth and nostrils without any difficulty, in fact it's already a common complaint among those who do wear them: breathing out causes your glasses or sunglasses to fog up.
As long as the mask has been fitted properly, difficulty breathing should not be a problem. Of course, this hasn't prevented people from asserting that they really do experience trouble breathing when wearing a mask. "First of all, define 'trouble breathing,'" he says. "Anyone could say 'I feel short of breath' without actually having trouble breathing. I have patients who always have trouble breathing, and require supplemental oxygen around the clock, and they can still wear a mask."
In addition to the CDC's fairly clear guidelines, however, each state currently has its own rules about face masks. For example, California exempts people from wearing a mask if they have a medical condition, mental health condition or disability that prevents wearing a face covering.
"Here's the issue with these policies: they don't list any specific health conditions that would preclude somebody from wearing a mask," says Hansen. "Probably because there really aren't any... There are no medical exemptions from wearing a face mask, unless someone has a severe skin condition of their face, like a second or third-degree burn."
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