By Robert Moffit via The Daily Signal | March 06, 2025
This is the sixth in an eight-article series on “Restoring Trust in Public Health: Lessons from COVID-19.” Four years of the Biden-Harris administration has left Americans rightly skeptical of public health institutions. This series highlights key findings from several congressional oversight reports, including the final report of the U.S. House Select Committee on the Coronavirus Pandemic, and offers lessons for Congress and the new administration on ways to restore trust in public health.
Federal public health responses to COVID-19 revealed a myriad of big shortcomings. This was especially the case with regard to face mask protocols and mandates. In a comprehensive review of federal officials’ responses to COVID-19, the House Select Subcommittee on the Coronavirus Pandemic found that federal masking policies were often arbitrary and without sufficient scientific justification.
In early 2020, when COVID-19 swept the globe, federal officials such as Surgeon General Jerome Adams initially discouraged mask use among the general public to prevent infection. The Centers for Disease Control and Prevention and the World Health Organization initially recommended masks only for the sick or caregivers. Yet despite no new evidence at the time in favor of masking, officials soon reversed course, and ultimately, President Joe Biden issued an executive order mandating the use of masks in federal buildings and on federal lands.
The shifting guidance—ranging from discouraging mask usage to optional “recommendations” to strict mask mandates—was unaccompanied by clear science-based explanations for the radical shifts. The result was widespread confusion and erosion of public trust.
The Mandate
Following Biden’s February 2021 executive order, the CDC imposed a mandate to require masks on public transportation. This mandate was to be enforced under Section 264(a) of the Public Health Service Act of 1944. The CDC argued that the mask mandate was a “reasonable and necessary measure to prevent the introduction, transmission, and spread of COVID-19.”
Responding to the federal mandate, the attorneys general in 21 states filed a suit to block it. On April 18, 2022, in the case of the Health Freedom Defense Fund Inc. v. Biden, Judge Kathryn Kimball Mizelle of the U.S. District Court in Florida ruled that the CDC had exceeded its statutory authority as well as violated the Administrative Procedures Act, which required public notice and comment before issuing such a regulation.
Mizelle emphasized that CDC’s actions went far beyond the terms of the Public Health Service Act, which grants authority to prevent the spread of communicable diseases through such actions as “inspection, fumigation, disinfection, sanitation, pest extermination.” The law did not authorize blanket masking mandates.
In rendering her decision, Mizelle wrote: “If Congress intended this definition, the power bestowed on the CDC would be breathtaking. … And it certainly would not be limited to modest measures of ‘sanitation’ like masks.”
Weak Evidence and Public Confusion
Face masks provide “source control,” meaning that an infected masked person is less likely to infect others. Face masks in closed spaces might also offer some protection. However, the efficacy of masking as a measure to stop widespread viral contagion is an altogether different matter.
In a profoundly revealing February 2020 email to Sylvia Burwell, former HHS secretary under Barack Obama, Dr. Anthony Fauci, then-director of the National Institute of Allergy and Infectious Disease, advised:
Masks are really for infected people to prevent them from spreading infection to people who are not infected, rather than protecting uninfected people from acquiring infection. The typical mask you buy in the drugstore is not really effective in keeping out [the] virus, which is small enough to pass through material. It might, however, provide some slight benefit in keep[ing] out gross droplets if someone coughs or sneezes on you. I do not recommend that you wear a mask, particularly since you are going to a low-risk location.
On March 8, 2020, Fauci in a “60 Minutes” interview, declared, “Wearing a mask might make people feel a little bit better … but it’s not providing the perfect protection that people think that it is.”
In 2024, when the select subcommittee interrogated Fauci about any “new” studies between February and April 2020 allegedly supporting mask mandates, he said again that he couldn’t recall any randomized controlled trials backing the policy. Rather, he broadly reiterated his earlier position: “From a broad public health standpoint, at the population level, masks work at the margins—maybe 10%.”
Yet federal officials, however, relied on comparatively weak studies to justify the mandate. The CDC relied on observational studies—not the rigorous randomized controlled trials—to justify mask mandates. For example, CDC relied upon a Missouri hairstylists study that focused on two COVID-19-positive hairstylists wearing masks and serving 139 customers with no control group and an Arizona school study that concluded schools with mask mandates had fewer outbreaks but failed, among other things, to account for the vaccination status of students and teachers.
Federal officials apparently ignored scientific evidence undercutting the government’s position.
For example, in May 2020 the journal Emerging Infectious Diseases published an early review of the professional literature on viral transmission and concluded, “In a pooled analysis, we found no significant reduction in influenza transmission with the use of face masks.”
Likewise, in March 2022, the British Medical Journal published a Spanish study on the masking of schoolchildren, reporting that cloth face masks “were not associated with lower SARS-CoV-2 incidence or transmission, suggesting that this intervention was not effective.”
As noted by the House Subcommittee on Oversight and Investigations, in December 2022, Dr. Ashish Jha, a former top adviser to Biden, conceded, “There is no study in the world that shows that masks work that well.”
The January 2023 Cochrane Review, a prominent scientific journal, also concluded that wearing masks did not appear to have a significant effect in reducing the spread of respiratory illness. Noting that its major literature review focused on randomized controlled trials, the gold standard in health research, the Cochrane study found that masking “didnot show a clear reduction in respiratory viral infection with the use of medical/surgical masks.”
Moreover, the review also found no significant difference between surgical masks and N95 respirators in preventing viral infections among health care workers.
Child Masking
Children were infinitely less vulnerable to COVID-19 than older adults, and yet government officials insisted on child masking policies while ignoring developmental risks. Scientific evidence indicates that extended childhood masking may have caused speech, language, and social developmental delays. Moreover, such policies also deviated sharply from international public health guidelines warning against the masking of young children during the pandemic.
The CDC’s guidance, however, required children ages 2 and older to wear masks in schools from April 2020 to February 2022. Officials proposing this policy ignored emerging evidence.
A May 2022 study in the Journal of the American Medical Association reported that “children are at far greater risk of critical illness from influenza than from COVID-19.” Moreover, masking children may have led to significant developmental issues that will be felt for years to come.
The World Health Organization also recommended against masking children under 5 and cautioned that children aged 6-11 should not routinely wear masks due to potential harms like psychosocial and learning development issues. Likewise, an American Speech-Language Hearing Association survey found that two-thirds of speech-language pathologists reported an increase in referrals since 2020, suggesting the long-term language and speech delays were likely caused by mask mandates.
Ground Policy in Sound, Evidence-Based Data
Yet again, the Biden administration disregarded real-time research and evidence to advance its mandate agenda on the lives of Americans.
In its final 2024 report, the select subcommittee thus concluded: “These actions undermined the American people’s belief in the CDC, public health leadership, and science as a whole.”
As The New York Times reported, by March 2022, the number of Americans who trusted the CDC fell to just 44%, compared to 69% registering trust at the onset of the pandemic.
Going forward, Robert F. Kennedy Jr., the new HHS secretary, and his colleagues at the CDC must communicate clearly and consistently and make sure that any change in public health guidance is publicly acknowledged and firmly rooted in strong scientific evidence. Restoring faith in public health is crucial to ensuring a more effective response to the next national medical emergency.
Ana Sofia Santiago-Russe, a member of the Young Leaders Program at The Heritage Foundation, contributed research for this article.
Robert Moffit, Ph.D., is a senior research fellow in the Center for Health and Welfare Policy at The Heritage Foundation.
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