Since Gov. Kate Brown ordered Oregonians statewide to wear masks inside grocery stores and other businesses last week, some residents who are philosophically opposed to covering their mouths and noses have come up with an easy out: Declaring a medical exemption.
Brown’s July 1 order exempts anyone with a medical condition “that makes it hard to breathe” or with “a disability that prevents the individual from wearing a mask” during the novel coronavirus pandemic.
So far the governors of 22 states have instituted statewide mask orders, and all 22 have allowed exemptions for medical conditions. Disability groups and doctors agree that there is a very small but real group of people who shouldn’t wear masks for health reasons.
But in Oregon and across the nation, the veracity of health claims made by a much larger group of maskless people has been viewed with suspicion.
One Portland woman proudly tweeted: “I went to the mall the other day, (T)arget, Peet’s... got asked to wear a mask and said I have a health condition so I didn’t have to wear one ...it works... (M)asks are not effective anyways.”
An Oregon judge, too, seemed dubious when a maskless defendant showed up to Sweet Home Municipal Court, explaining he has a sensitive respiratory system and couldn’t follow court rules to wear one. After the defendant walked out on the hearing, the judge ordered him arrested on accusations of failure to appear and contempt of court, then told him he’d better show up to his next appearance with a doctor’s note, a mask or head back to jail.
In one of the most viral mask videos to hit social media so far, a southern California woman raised eyebrows for her loud reaction when she was told to put on a mask. Cellphone videos by other customers show her yelling expletives at Trader Joe’s employees, throwing her shopping basket on the floor and then wagging her finger as she said: “I have a breathing problem. My doctor would not let me wear a mask.”
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Some medical professionals say it’s the rare medical condition that might make it dangerous to cover up. Those conditions include people with extreme respiratory ailments or muscular or motor-control disorders that prevent them from removing a mask in an emergency.
An Oregon Health & Science University review of various clinical studies, published last month in the Annals of Internal Medicine, found no evidence of serious harm from masks. Rather, the review concluded that masks are effective at slowing the spread of the novel coronavirus.
OHSU pulmonologist Gopal Allada, M.D., who didn’t take part in the review, said he hadn’t seen an assortment of videos online showing irate shoppers arguing that their breathing problems preclude them from wearing masks. But he said these shoppers don’t sound like the type of people whose respiratory systems would prevent them from covering up.
“If somebody is screaming and protesting up and down, that tells me they probably have a certain amount of respiratory reserve to scream and make a ruckus,” Allada said. “If they can do that, they can probably put on a mask and walk very slowly and grocery shop.”
Allada said it’d be far more dangerous for his patients -- most who have heart and lung disease that affect their respiratory systems -- to forgo masks. They’re the very people who are likely to suffer the most severe complications if they catch COVID-19, he said. Allada said if a patient’s health condition is so dire, he’d advise that they stay home.
“If they’re that sick where they can’t wear a mask while grocery shopping, then I have to be pretty frank with them -- that if they get COVID they could end up in the hospital in the intensive care unit and potentially pass away,” Allada said.
Advocates for people with disabilities point out there are some people with conditions that aren’t visible who might encounter extreme distress from covering their faces. That includes some people with autism, claustrophobia or post traumatic stress disorder.
As long as businesses and government agencies make reasonable accommodations for people with disabilities, the advocacy group Disability Rights Oregon welcomes Brown’s mask order. Those accommodations might include having employees grocery shop for people with disabilities who can’t wear masks or informing people with disabilities about pickup or delivery options. An employee might wear a transparent mask to make lip reading possible or communicate through writing with a deaf or hard-of-hearing person. Doctors’ offices might offer accommodations through telemedicine.
By far, people with disabilities benefit from universal mask orders because they’re at greatest risk of complications from COVID-19 if they come down with it, said Jake Cornett, executive director of Disability Rights Oregon.
“When others really refuse to wear a mask, it’s dangerous and it says that the lives of people with disabilities don’t matter,” Cornett said. “And I can’t really imagine a more shameful thing than that.”
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So can a business deny service to maskless customers, whether they have medical conditions or not?
Many legal experts say yes: The Americans with Disabilities Act doesn’t empower people with disabilities to enter businesses without masks because businesses or governments can legitimately argue that maskless customers pose a “direct threat” to public health.
Some customers have fired back by flashing “face mask exempt” cards that are issued by the “Freedom To Breathe Agency.” The cards state that their holders have conditions that prevent them from donning masks -- and threaten stiff penalties for “denying access to your business/organization.” The cards are emblazoned with the seal of the U.S. Department of Justice.
The department has debunked the cards, saying it hasn’t issued them to anyone and the “Freedom to Breathe Agency” isn’t a governmental agency.
On top of that, the American Civil Liberties Union -- which is one of the nation’s most zealous defenders of individuals’ constitutional rights -- doesn’t oppose mask mandates. Sarah Armstrong, a spokeswoman for ACLU Oregon, said the organization acknowledges the “overwhelming support” mask mandates have gained from public health experts.
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Although legal experts say businesses are justified in barring maskless customers, many businesses are reluctant to take any action at all -- whether customers have genuine medical conditions or not. Some are even reluctant to talk about it.
Fred Meyer spokesman Jeffery Temple didn’t answer a question posed by The Oregonian/OregonLive about whether store employees would require a maskless customer to leave.
Representatives at Trader Joe’s didn’t respond to a similar question posed by the news organization.
But a TriMet representative acknowledged the difficulties of confronting the public. Spokesperson Tyler Graf said inquiring why a passenger isn’t covering up could leave them feeling “uncomfortable or embarrassed” and escalate tensions.
“While it is unfortunate that some people have turned mask-wearing into a personal issue and may be untruthful about having a medical condition, operators are not in a position to investigate people’s claims,” Graf said.
Graf said the agency wants to avoid confrontations that can turn heated and has told bus and train operators not to demand compliance. Instead, the agency is focused on educating the public about the mask requirement and hoping for some goodwill, too.
“We can’t state it enough,” Graf said. “We are asking that people do the right thing for the health and safety of those around them.”
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-- Aimee Green; agreen@oregonian.com; @o_aimee
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