New NIAID Director Scared of Masks

Comments from public health official confirm that scientific considerations played no role in decision to eschew mitigations at Long COVID meeting

This week, the head of the National Institute of Allergy and Infectious Diseases (NIAID), Jeanne Marrazzo, sat down with Stat News to discuss succeeding Anthony Fauci amid public concerns over ongoing H5N1 and mpox outbreaks.

The conversation yielded a staggering admission from Dr. Marrazzo as she downplayed risks of a bird flu pandemic:

Can I make a quick digression? We recently had a long Covid [research] meeting where we had about 200 people, in person. And we can’t mandate mask-wearing, because it’s federal property. But there was a fair amount of disturbance that we couldn’t, and people weren’t wearing masks, and one person accused us of committing a microaggression by not wearing masks.

And I take that very seriously. But I thought to myself, it’s more that people just want to live a normal life. We really don’t want to go back. It was so painful. We’re still all traumatized. Let’s be honest about that. None of us are over it.

This jaw-dropping justification is perhaps more jaw-dropping given that Dr. Marrazzo was not asked to comment on the meeting but broached the topic herself. Her statement clarifies that she and other public health officials don’t wear masks because they find basic disease control to be psychologically triggering. Let’s unpack the layers of anti-science, anti-patient, anti-public health and anti-reality rhetoric - not to mention rancid ableism- in this statement.

First let’s consider the context. Dr. Marrazzo is not referring to masking generally, although any public health official who is informed about the cumulative risks of COVID infections like long-term disability and brain damage should be. She is specifically justifying a refusal to mask at a Long COVID research meeting.

The RECOVER-TLC meeting in Bethesda at the end of September gathered hundreds of scientists, medical professionals and patients to discuss Long COVID. What is Long COVID? Let’s use the definition offered in a recent review article published in Nature Medicine:

Long COVID represents the constellation of post-acute and long-term health effects caused by SARS-CoV-2 infection; it is a complex, multisystem disorder that can affect nearly every organ system and can be severely disabling.

The cumulative global incidence of long COVID is around 400 million individuals, which is estimated to have an annual economic impact of approximately $1 trillion—equivalent to about 1% of the global economy. Several mechanistic pathways are implicated in long COVID, including viral persistence, immune dysregulation, mitochondrial dysfunction, complement dysregulation, endothelial inflammation and microbiome dysbiosis.

In other words, a quite serious, quite common outcome of SARS-COV-2 infection with a multitude of physical markers, poised to drastically disrupt world economies. Even after vaccination, Long COVID risk remained around 3-4% in a recent study. Long COVID can follow any COVID infection and affect anyone, and risks are known to be cumulative. That means reinfections continue to raise your risk of developing Long COVID. COVID is an airborne virus, transmitted by sharing air with infected individuals.

To debunk several misapprehensions, there is no special kind of person who gets Long COVID. There is, conversely, no special, “healthy” kind of person who cannot develop Long COVID. A person who has had COVID three times and feels okay is not now “immune” to Long COVID. No one has long-term immunity to COVID, and vaccinations can reduce the risk of, but not entirely prevent, COVID infections. COVID spreads in our communities at high rates year-round, with late-September wastewater data showing about half a million cases per day, or one in 57 Americans infected.

But experts gathering at a meeting about Long COVID should be well aware of all of the above.

In year five of the ongoing COVID pandemic, we have plenty of tools to ensure that a meeting- even an indoor, in-person meeting- remains safe for all attendees. Mitigation measures that would have reduced the risk of COVID transmission include adequate ventilation, CO2 monitoring, HEPA filtration, on site testing, Far UVC technology, and- of course- the use of high-quality, respirator style masks. While patients were easy to identify in respirators, many of the government officials and scientists who spoke plainly chose to make the space more dangerous for people with Long COVID.

The Sick Times noted that the lack of accessibility, the risk of reinfection for patient attendees paired with a poor-quality livestream, undercut the meeting’s message of urgency and care around the treatment of Long COVID.

Meetings among experts could easily serve as a gold standard for airborne disease mitigation, modeling how to prevent infections and therefore, inevitably, more Long COVID cases. Airborne disease mitigation could and should be the first line of defense against Long COVID; it is the one and only tool we have that is proven to be effective vs the little-understood disease. This is especially important at this early stage, when treatments are so limited, with no proven path to recovery and certainly no “cure”.

But Dr. Marrazzo and her colleagues, instead of focusing on how to halt the spread of COVID at their Long COVID research meeting, are focused on how to preserve their psychological denial that they, personally, are special people who are not at risk of developing Long COVID.

There is no scientific basis for this idea; it is the fantasy of the crowd, the collective delusion of people much less informed than they are, who are desperate to resume pre-pandemic life and have been fed years of propaganda about COVID’s supposed harmlessness. To participate in this public delusion rather than attempt to pop it is a social decision, not a scientific one. Marrazzo’s statement admits as much.

Marrazzo notes that there was a “fair amount of disturbance” that researchers continue to refuse to mitigate COVID while claiming to want to address the Long COVID crisis. She goes on to state that “one person” accused the group of “committing a microaggression” by not wearing masks, obliquely referring to longtime HIV/AIDS and COVID activist JD Davids. But Davids was far from the only activist angry with the lack of mitigations.

Long COVID patients have been exceedingly clear, for months and years, about their ongoing anger that even doctors explicitly engaged in COVID work refuse to practice mitigations. This failure to mitigate is violence that very literally harms, disables and kills people.

Long COVID patients participating in medical studies like this one at Stanford have been forced to drop out of critical research projects due to staff’s refusal to mask, take airborne precautions, and provide protection from reinfection in dangerous healthcare facilities.

Twitter user Michael Coyle stated in February 2023 that, “my partner and I have both dropped out of a multi-decade (longitudinal) health study, and I dropped out of a COVID transplant study because they weren't taking airborne precautions.”

In July of this year, Jordan Crane wrote, “I have had to withdraw from the Stronger study run by @georgeinstitute in collaboration with @MonashUni, 11 months in. LC patients should not be exposed to reinfection during trials aimed at helping those with LC, but that's exactly what @MonashUni are doing.”

This is not only immoral, it is bad science; if research teams reinfect Long COVID patients, as well as potentially infecting control subjects, any purported results of said studies would be corrupted and invalid.

If the public at large can claim ignorance- they have, after all, been repeatedly told that risks of COVID infection are minimal and comparable to other common viruses- public health officials have no such excuse.

And why is it, by the way, that the public is so certain that repeated, continual infection with COVID-19 will not harm them? Could it have something to do with the fact that researchers, doctors and public health officials continue to appear in public unmasked, clearly communicating that continual reinfections are safe and nothing to fear?

NIAID officials and other health professionals masking at a large, indoor meeting serves multiple critical public health purposes: one, it avoids spreading the virus, which would create new Long COVID cases. Two, it conveys to the public that SARS-COV-2 infections are not harmless, that Long COVID is serious and can develop from any case of COVID. And three, it expresses that prevention is the most vital- and really, the only- tool we currently have to effectively fight Long COVID.

Marrazzo states that she took public criticism of the lack of masks “seriously”. She then goes on to provide an entirely unserious response, dismissing said criticism by whining, “people just want to live a normal life.”

What, exactly, is meant by this? What population is seen as “people”, who is excluded, and what is “normal” in the construction of this odd sentence?

Quite clearly, Marrazzo and her colleagues do not want to live the life Long COVID patients and other disabled people are now forced to live- a life of continual infection avoidance. They do not want to wear masks, be associated with those who wear masks, be seen as “disabled,” as “other,” as “sick,” “vulnerable” or “abnormal”. They want to be normal- in other words, abled and ableist.

They do not want to be stigmatized, like the abnormal patients they claim to serve.

They do not want to stand out from the crowd of abled people who are healthy enough to tolerate another COVID infection- the “normal” people who aren’t annoying or weird or old or sick or dying.

Like normal (abled) people, they want to spread COVID in peace, while pretending they do not know the damage it inflicts. Like normal people, they want to use conferences as an opportunity to have their photos taken and network over cocktails. Like all the normal people who continue to exclude Long COVID patients from public spaces, these officials, too, will not be making it any easier for sick people to be safe outside their homes. Like normal people, they are going to operate under the assumption that Long COVID and disability cannot happen to them.

Because no study, no statistic, no patient, and no research can educate a medical professional out of ableism, the unmasked people who attended this meeting have all the information in front of them, and yet cannot understand that they, too, are at risk of disability.

Marrazzo goes on to say that she and her colleagues “don’t want to go back” because “it was so painful.” What was? Disease control? The thing public health literally exists to do? Because COVID is still very much with us - 1 in 57 Americans currently positive, you recall? Long COVID patients, disabled people, and people who are avoiding infection do not have any choice but to practice mitigations, and to do so with extreme strictness, given the lack of any coordinated disease control coming from the top. Every day, this task is made harder by the abdication of public health leaders who prioritize the comfort of the most privileged over the safety of the most vulnerable.

Patients are not merely harmed by the superspreader events Marrazzo and her colleagues continue to hold- although they and surrounding communities certainly are harmed by the spread of the virus itself- they are also harmed by the blasé attitude of officials which leads the families and friends of Long COVID patients to doubt the seriousness of their condition, or the need for precautions. Long COVID patients are unsafe in their own homes because masking has been so stigmatized that their own spouses, parents, and children will not stop reinfecting them.

If the head of the NIAID declares that she cannot wear a mask because she wants to be “normal,” what hope does an ill patient have to convince her husband to buck the social, political and professional pressure he faces in public life to consistently mask? When the very public health leaders who should be stressing the importance of tools that prevent reinfections are stigmatizing them, framing them as weird, abnormal and scary?

Lastly Marrazzo insists that researchers cannot wear masks because “we’re still all traumatized,” and “none of us are over it.”

A moment for the absurdity of the statement that you cannot use a safety tool that very literally saved lives during a traumatic event because you’re psychologically triggered by it. It is akin to saying you can’t wear a seatbelt because you were in a bad car accident and people died. Go to therapy. Wear the seatbelt. Definitely do not project your personal psychological problem with seatbelts onto the people fighting for auto safety.

Watching people get infected and die during a pandemic is certainly traumatizing. But…masks didn’t do that. SARS-COV-2 did. The same virus you’re spreading when you refuse to acknowledge and mitigate it, despite being well-aware of the long-term and cumulative harms of continual reinfections. By claiming the mask is triggering your trauma by reminding you of COVID, you are essentially saying that you exist in a state of utter denial that COVID currently surrounds you.

It’s doubly astounding to dare use the word “trauma” to describe the relationship of health officials toward masks while dismissing the trauma of patients being gaslit, ignored, further disabled, and forcibly reinfected by society at large- all while those who claim to want to heal them participate in stigmatizing the best prevention tool available.

Long COVID patients are traumatized by their illness, their abandonment, their social stigmatization, the relationships they continue to lose, in many cases the loss of careers and homes, and their utter exclusion from public life. Public health officials are not “traumatized” by having to mitigate the disease that inflicted and continues to inflict all of those actual traumas.

There is a social and cultural problem within public health institutions regarding airborne disease control. Broader social norms of ignorance and denial of the virus’s harms- which were themselves seeded by mainstream politicians and media, whose rhetoric was in turn cribbed from far-right libertarian thinktanks- have been absorbed into medical and public health settings.

The stigmatization of masking certainly began on the far right, but as Biden’s administration sought to normalize recurrent COVID reinfections and push people “back to normal,” Democrats joined in on the political project to socially destroy the tool humans would have killed for in centuries past. To be able to make use of respirators is not a burden or traumatic- it is a gift, not to mention a privilege that many around the world cannot access. People gathering for a Long COVID meeting should be all the more grateful, knowing full well the outsize outcomes such a small device can prevent.

It is a shame, a failure, and a shock to hear a public health official with so much power contribute to anti-mask sentiment amidst spreading mask bans which will kill disabled people. At a time when public health should be educating the public about the importance of mitigation, stressing the value of these tools, people in power are declaring masks weird and abnormal, contributing to further stigmatization of those who need these devices to even enter public spaces.

It is shockingly anti-science to hear a public health official disparage disease control technology at the altar of fascist social norms that seek to disappear disabled people from public entirely.

Dr. Marrazzo’s words reveal that she does not identify with Long COVID patients, nor does she see them as “people” who deserve to be a part of “normal” life. Only the able-bodied- those who have not yet been disabled by COVID- have a right to “normal,” which is defined by the disappearance of accessibility, disease mitigation, and medical devices. Trauma is not what has been and continues to be inflicted on those most harmed by COVID, it is what is experienced when a doctor sees a mask and, for just a second, remembers what it felt like to be scared, to feel vulnerable, to feel like maybe illness and death weren’t things that come only for the weak, the lesser, and the old.

But those days are over.