The N95 Mask: A Tool to Fight Fascism

It's time to bring them back.

Unsplash/CDC

As you’ve probably heard, the Trump administration has frozen communications for every public health agency as another pandemic looms over us. The news even reached the desk of Rachel Maddow, who bashed the administration hard. Publications everywhere say that key agencies have “ground to a halt,” and that many labs aren’t even able to run their studies now.

There’s more going on here.

Much more.

Yes, bird flu has entered the chat. Robert Reich illustrates the standard response to everything going on lately. He recently called the current administration “a threat to our health.” In fact, he recently published a list of 10 things we should all be doing to resist fascism and protect the vulnerable. That list leaves out something very, very important. It’s something many of us have been urging for the last four years, something we’ve increasingly been punished for.

So I’m going to talk about it:

You should be stocking up on quality masks. You should be wearing them. And you should be offering them to others.

Here’s the why and how.

First, it’s not just bird flu. A 2024 study in BMJ found that we’re at the beginning of a “large post-covid global surge in common communicable diseases including influenza, measles, tuberculosis, and whooping cough.” These experts “can’t fully explain the resurgence of infectious diseases.” As a piece in Bloomberg put it, “It’s not just your imagination.” Dozens of countries have reported infectious diseases as striking back ten times worse than before. As we speak, an ongoing outbreak of tuberculosis in Kansas has become “the largest in recorded history in the United States.” Yes, the largest recorded outbreak of tuberculosis, an airborne disease, didn’t happen a hundred years ago.

It’s happening now.

We know it’s not immunity debt, an especially insidious piece of misinformation that circulated widely in corporate media back in 2023.

We already know why it’s happening.

The truth is we need masks, and we’re going to need them for years to come. They work. A major investigation on masks in Clinical Microbiology Reviews examined 100 published articles on masks and found that when they’re “correctly and consistently worn,” masks and especially N95 respirators are “effective in reducing transmission of respiratory diseases.” The authors explain why N95 masks work. As they point out, “respirators are not simple sieves,” meaning they can easily trap viral particles 65-125 nanometers in diameter. Here’s how they do it:

• “Viruses travel through the air as passengers in or on respiratory aerosols [much larger], rather than alone.

• Filters work via “inertial impaction” and “interception” of larger particles that get stuck in the filter fibers.

• The electrostatic charge of an N95 mask creates a field that attracts and captures smaller particles (.1-.5 microns).

• Filters also work via “diffusion, in which smaller lighter particles (.01-.4 microns) impact fibers with Brownian (zigzag) motion.

The authors go on to describe their work in The Conversation and why it corrects a popular misconception after a widely misinterpreted Cochrane Review went viral on social media in 2023. As they state:

Like the Cochrane team, we pooled data from randomised controlled trials (RCTs) and analysed the combined data – a so-called meta-analysis. Unlike them, we also examined non-RCT evidence, including dozens of laboratory studies which showed that respiratory infections, including the common cold, COVID, flu, measles and TB, spread mainly through the air… When we looked at RCTs, we found that masks do protect in the community, and N95 respirators (masks made using higher-grade filtration material and designed to fit closely around the face to protect against airborne contaminants) are superior to masks in healthcare workers, especially when respirators were worn continuously at work. Non-RCT evidence also shows that masks work and respirators work better.

If you want more evidence:

A major 2023 study by the Royal Society examined the available research on masks and found that “wearing masks, wearing higher quality masks (respirators) and mask mandates generally reduced… transmission.”

The case for N95 masks also includes an official statement by OSHA that “surgical masks are not designed or certified to prevent the inhalation of small airborne contaminants” and “are not designed to seal tightly against the user’s face.” They just don’t work as well. As they further state:

During inhalation, much of the potentially contaminated air can pass through gaps between the face and the surgical mask and not be pulled through the filter material of the mask… so they cannot be relied upon to protect workers against airborne infectious agents.

More evidence:

Another major study in eBioMedicine (a Lancet Journal) reached similar conclusions, stating that “an N95 is significantly better than the other options.” The authors of the study have stated very clearly that “N95 masks should be the standard of care in high-risk situations, such as nursing homes and healthcare settings.” They work even without training or fit-testing. How do surgical masks stack up? Not well. In this study, even cloth masks with a good fit outperformed them.

A review of studies by Michael Klompas and Chanu Rhee in the Journal of Infectious Diseases also shows that “surgical masks provide substantially less protection against viral inoculation of the respiratory tract compared to fitted N95 respirators” and refers to “a wealth of real-world studies that document failures of surgical masks worn by healthcare workers… to prevent transmission, as well as case-control studies that found respirators to be more protective than surgical masks.” In fact, the authors end by declaring it’s time for the CDC to update its infection control guidelines in the face of such overwhelming evidence. Frankly, they should’ve been recommending N95 masks to the public this entire time.

Over the last few years, corporate media have fed the public a steady diet of misinformation that every mitigation behavior, like wearing a mask in public, constituted a form of “lockdown” that destroyed our mental health and put kids behind in school, leading to “learning loss.” On the contrary, studies have found these protection measures saved hundreds of thousands of lives. A 2024 study in JAMA found that stronger mask-wearing could’ve saved hundreds of thousands of additional lives, lowering deaths by as much as 21 percent.

We had a growing body of evidence in favor of N95 masks before the current pandemic began. One 2017 study in Influenza and Other Respiratory Viruses found that N95 masks “provide superior protection” for droplets.

Nonetheless, a handful of poorly designed studies and reviews reinforced the myth that surgical masks work just as well as respirators. In reality, these studies simply reveal that many healthcare workers aren’t trained or educated on how diseases spread. They don’t wear protection as often as they should, and they don’t understand asymptomatic transmission.

Neither does the general public.

Many people stopped wearing a mask simply because they never found a comfortable one with a good fit they could trust. For the last several years, Aaron Collins (the mask nerd) has been reviewing masks for effectiveness, comfort, and fit—even for different face sizes. Here are his top picks:

Go to his channel, and you’ll find videos on everything from elastomeric masks to identifying counterfeit masks.

He keeps a list of them here.

He also talks about masks for kids:

Aaron Collins also provides a great spreadsheet for ordering these kinds of masks. My family has been using Well Before.

Now, for a little venting:

It’s 2025, and it’s still hard to find good masks in the U.S., especially for children. As Aaron Collins points out in the last video I posted, other countries like South Korea are light years ahead of us on this front:

You just go to a Korean grocery store, or you could go to your pharmacy, and they would have a row of all these KF94s. You know they’re safe. You just try them on and figure out which one fits you best and which one you like the best, and then you just buy them for 80 cents.

We had four years to make this happen in the U.S.

We didn’t.

The public didn’t put pressure on their politicians to develop the infrastructure we would need to make masks available for the general population. Our institutions didn’t take up the charge. If anything, they suppressed information and minimized the threat of airborne diseases. The media helped, so it’s a little irritating that they’re now sounding the alarm about bird flu when that and several other diseases have presented an imminent threat for years now.

In fact, most people don’t even know that, last December, a crucial CDC committee voted against recommending N95 respirators over surgical masks in healthcare settings. In their own words, “N95 respirators should not be recommended for all pathogens that spread by air.” Dubbed the Healthcare Infection Control Practices Advisory Committee (HICPAC), its members have spent the last two years working largely without participation from experts on aerosols, ignoring evidence and outcry at every turn. Honestly, you can’t get more anti-science. They even declined to strengthen guidance protecting voluntary use of N95 respirators, saying their existing language was sufficient. During the meeting, only one HICPAC member, Lisa Baum of the New York State Nurses Association, consistently spoke out in favor of N95 masks. (She was also the only person wearing one.)

More than 900 experts and healthcare workers sent a letter to the CDC in 2023, urging them to reconsider their stance in light of current research on masks, which we just talked about. During their meeting to finalize the guidance, public commenters declared, “CDC guidance must recognize the science.”

They were overruled.

Even before Trump shut things down completely, the CDC hasn’t been so great at communication with the public. Last summer, they tweeted this. Yes, that’s a doctor declining to wear a mask for a vulnerable patient, who wears a photoshopped earloop mask, upside down, incorrectly labeled as an N95:

Dozens of activists pointed out the mistakes. Instead of correcting this misinformation, the CDC decided to hide replies to their embarrassing failure, and it’s currently still up on their feed.

As for removing N95 masks from healthcare:

Hospital-acquired infections already happen on a regular basis. One study estimates these hospital-acquired infections run as high as 19 percent in the ICU, with a rate of 4 percent for general patients. If you get sick while recovering from a severe illness, your mortality rate shoots up to 50 percent. If you're in the ICU, it runs above 70 percent. Infection during surgery isn't even the most common risk. You can catch an airborne disease like tuberculosis, measles, or Covid in your room during recovery. In fact, based on the evidence reviewed here, it’s more likely than ever because diseases are striking back hard, and our public health agencies were doing a poor job, even before they were silenced by Trump.

The point here isn’t to shift blame. It’s to acknowledge something simple and universal, something true for us all. Many of us already recognize this, but we need more people to get on board:

Here it is:

Nobody in a position of authority will tell you to put on a mask to protect yourself and the ones you care about, not once they’re in office. Nobody is going to spell it out as a vital means of fighting fascism and eugenics, the bad science behind it. After reading this, you have a wealth of truth and evidence.

Also:

If there’s one thing that should separate us from Donald Trump and the MAGA movement, it’s the ability to admit when we’re wrong and to change our behavior based on evidence. More than ever, nobody should be using the worst of humanity as a standard to evaluate their own behavior.

You have to make the decision to do the right thing.

It’s up to you.