For Your Health
For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

From the Dean: Masks work, mask mandates don’t

This past Tuesday I had the pleasure of welcoming over 50 undergraduates to the SMHS for a summer research experience at UND. The goal of the program is to attract talented undergraduate students studying science, technology, engineering, and/or mathematics (STEM) at a North Dakota college/university to a career in the biomedical sciences. The program provides a 10-week summer research experience under the direction of selected faculty members at the University of North Dakota. The research projects the students undertake span the spectrum of biomedical science. The program is organized under the direction of Dr. Don Sens and his colleagues and through the auspices of the North Dakota IDeA Network for Biomedical Research Excellence (INBRE).

In my opening remarks, I reflected back on my own early research experience and recalled how excited I felt when I was fortunate enough to be part of a research team that figured out why the heart muscle hypertrophies (thickens) in one way when it is presented with a pressure load (often due to a narrowed valve) and another way when presented with a volume load (such as due to a leaky valve). This interest in studying and further understanding the function of heart muscle has been a recurring theme in my research interests over the subsequent decades.

An important question, however, is whether these research pursuits make students better healthcare providers. I think the answer is a definite “yes,” because to be a good doctor, for example, you need to be able to incorporate new knowledge into clinical practice. New knowledge comes from research, and if one doesn’t understand the principles of research, one can’t optimally integrate that information into your clinical care. The Liaison Committee on Medical Education (LCME), the medical program accreditation organization that I’ve mentioned recently, certainly agrees – Element 7.3 of its accreditation requirements states that “the faculty of a medical school ensure that the medical curriculum includes instruction in the scientific method and in the basic scientific and ethical principles of clinical and translational research, including the ways in which such research is conducted, evaluated, explained to patients, and applied to patient care.”

Unfortunately, there has been an increasing trend of late for disbelief or denial of scientific evidence, especially those in the general public. Vaccine hesitancy is one example. Another is the masking controversy. However, a better understanding of the flap over masks may provide an opportunity to get beyond the rhetoric and get to the science. As pointed out by David Leonhardt in a recent column in the New York Times, there is an apparent paradox regarding the evidence about masks reducing infection rates (they do) and the efficacy of mask mandates in doing the same thing (they don’t appear to work). So how can that be, that masks work but mask mandates don’t?

It appears that the answer is that many people don’t use well-fitting, high-quality masks and keep them on consistently when around others even though there may be a mask mandate. On a recent Uber ride, for example, Susan and I were in the car (both of us using well-fitting KN95 masks) when the masked driver removed his mask to drink from his coffee mug! With the highly contagious variants that have appeared more recently in the pandemic, that’s enough of a potential exposure to spread the virus. I’m glad we had our masks on all the time we were in the car!

The issue thus isn’t that mandates don’t necessarily work – in this case, they probably would if people followed all the rules. Thus, the (recently lifted) mask requirement at the SMHS likely was effective, at least to some degree, because our faculty, students, and staff likely were highly motivated to follow the mask rules. But because the general public often doesn’t follow the policy effectively or wear well-fitting masks, I don’t think we’re likely to see a return of government-mandated mask mandates (unless things really go downhill related to the pandemic).

That doesn’t mean that at-risk individuals shouldn’t continue to mask as need be. They should. And even if that practice doesn’t protect the population at large, at least it helps to protect masking individuals themselves and their families. Susan and I plan to continue to mask when we are indoors (such as today when I’m seeing patients in clinic).

In the final analysis, it does come down to personal responsibility and accountability. So please, even if you choose not to mask, don’t disparage those who do.

Finally, I hope that you paused this past Memorial Day, as I did, to remember and thank those countless women and men who have so generously sacrificed to keep America free, strong, and vibrant, especially those who made the ultimate sacrifice. Thank you all for your service!

Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences