One month after Raul Labrador led the Central District Health board in voting to remove all recommendations regarding masks from district communications and the district’s website, three of the four counties in the district moved into the “high” community spread category for COVID-19, in which the U.S. Centers for Disease Control and Prevention recommends wearing masks in indoor public spaces.

CDH said nothing. And it’ll continue to take that tack.

“If people want to follow the CDC, I can’t do anything about that,” Labrador told his fellow board members at the board’s May 20 meeting. “But I don’t think this board should be setting forth that policy.”

Dr. Ryan Cole, another CDH board member from Ada County, told the board, “We know that the CDC has been publishing false data and withholding data.” Speaking remotely from London, Cole said, “I’m at a meeting here with world experts discussing how corrupted the federal literature is.”

Cole claimed masking “has never worked and never will work for any community respiratory virus in any community setting.”

Top Idaho health experts strongly disagreed, and said the CDC is not in any way corrupt. “I think they take great pride in trying to be honest, transparent and direct, so I would disagree with that assessment,” said Dr. Christine Hahn, Idaho state epidemiologist.

“I have worked with the CDC for over 20 years, and for me, they’re a trusted partner,” she said. “The CDC is not one person who is to be trusted or not trusted. The CDC is a group of dedicated people, some of whom I trained with early on, many of whom I’ve met through the years. They are the most hard-working, honest, down-to-earth people I have worked with in my career.”

After more than a month during which COVID cases were down in Idaho and only one Idaho county, Payette County, strayed into the “high” community transmission level for a single week, four Idaho counties hit that mark on June 16, including Ada, Valley and Elmore counties. This past Thursday, all three dropped back into the “medium” range.

Hahn said the swings are a sign that residents should take care. “What Ada County is experiencing, we’re flirting on the edge between high and medium,” she said. “Does it really make sense for us to wear masks indoors one week, and then, whoops, we don’t need to any more the next day? … I think for most people, it’s going to be helpful to decide, OK, we’re in this period of time while COVID is circulating, wearing a mask while in indoor settings, which is a fairly easy thing to do, might be appropriate through summer and into fall.”

“I wear a mask when I go into the grocery store,” she said. “It’s not that hard to do, I’ve kind of gotten used to that. I probably will do that through the summer and fall until I see what’s happening with COVID.”

Valley County Commissioner Elt Hasbrouck, a CDH board member who opposed Labrador’s push to remove all mention of masking from CDH communications, said, “They wanted to basically, in my feeling, kind of gut the whole purpose of public health.” He said he and Dr. Jane Young, another Ada County board member who’s a nurse practitioner, “felt like we still need to inform the public and let the public know that there’s a risk out there.”

Young didn’t respond to a request for comment. Hasbrouck said, “I think everybody understands the coronavirus situation, that it kind of comes and goes. But the rest of the board felt like, ‘No, we need to get clear out of that and just kind of let the chips fall where they may.’ Which I think is not our role as a public health agency.”

The CDH board first took up the issue at its March meeting, when Labrador said he thought the CDC’s guidance hadn’t always been correct, and called for any recommendations regarding children and COVID-19 to come before the board for approval before going out to the public. The board at that time asked its director, Russ Duke, to develop a policy for the board to vote on.

At the board’s April meeting, Duke presented the policy to require board approval, which Labrador praised, saying the district needed this additional level of board oversight. It was approved on a 4-2 vote, with Hasbrouck and Young dissenting.

In May, Labrador made a motion to remove all recommendations to wear masks from the CDH website and documents, providing only a link to the CDC website for more information. After much discussion, in which board members said that likely was appropriate at that point but would need to be reconsidered if conditions changed, the motion carried unanimously.

“If it blows up again, which it is in other parts of the world right now, and comes back, then we’ll have to come back and revisit it,” Hasbrouck said before the vote. “I don’t want to burn any bridges. I think we still need to keep this in our back pocket, if the virus does come back and hits us again. Which, who knows? We may never have to talk about this again,” he said to laughter, adding, “We hope, we hope.”

A month later, conditions changed. But the board doesn’t meet again until August.

Betty Ann Nettleton, the board’s chair and a retired nurse from Elmore County, said, “If we see the necessity to call an emergency meeting, we will definitely do that. … We’re looking at the community numbers and hospitalizations, management of the situation overall. That’s been our goal from the start. So with all of the numbers that are coming out, various conflicting studies on masking, at the time of the meeting the numbers were somewhat different than they are now, so that’s why we did what we did.”

CDH spokesperson Rachel Garceau said, “There’s no plan to change anything, as we have not been directed by the board to do so.”

“We did exactly what they directed us to do,” Garceau said. “We removed all CDH guidance and recommendations for masking,” including from overall COVID pages on the website and from guidance for schools and child care operators.

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When the board took its vote May 20, it had just been presented a white paper from its staff summarizing current scientific data on mask use among children and the effectiveness of masking in reducing disease transmission. The white paper cited 17 U.S. guidance documents and peer-reviewed studies documenting the effectiveness of masks in slowing the transmission of COVID-19 in school settings and the impact of mask-wearing on children, which concluded there were no adverse health impacts and children still were able to perceive emotions when interacting with people wearing masks.

Cole and Labrador both disagreed with all the studies. “I think the data is negligible at best on the effects,” Labrador said. “But I think the moment that we recommend it, I have heard from many schools that that recommendation is seen as ‘we have to do it or we’re going to get in trouble.’ And I think we just remain silent on it, and let people decide.”

“I know people disagree with me, but I think we need to be more responsible and we need to stop pushing masks on children,” Labrador said.

“Silence is a statement,” Young commented.

“It’s a statement that you believe in freedom, that you believe in making a decision for yourself based on whatever you’re comfortable with,” Labrador responded.

Though much of the discussion focused on children, Labrador’s motion removed all recommendations for anyone, of any age, to wear masks. He declined to answer a question from the Idaho Press about why his proposal was so broad.

“Some scientific studies confirm what most people intuitively know, that masks interfere with basic human interaction and can have a negative impact on our children,” Labrador said in a statement to the Idaho Press.

A former four-term congressman who last month won the GOP primary for Idaho attorney general, Labrador declined an interview, and agreed only to answer written questions; however, his statement didn’t answer most of the questions and he declined to address follow-up questions.

“He does not have anything else to add,” said Labrador’s campaign spokesman, Brent Littlefield. “He feels his statement speaks for itself.”

“In supporting a motion to remove masking recommendations from the Central District Health website, I specifically noted a concern for our children,” Labrador said in his written statement, which Littlefield provided to the Press via email. “Parents and citizens should be allowed to make their own decisions on these issues without coercion or pressure.”

Dr. David Pate, former CEO of the St. Luke’s Health System and a member of Idaho’s coronavirus task force, said, “That board is a hot mess.”

He said the CDC aroused some mistrust by not communicating effectively early in the pandemic, particularly when it at first didn’t recommend masking, and then did. “But no, the CDC is not corrupt,” Pate said. He said Cole shouldn’t be making “wild aspersions, especially in the view that he’s not speaking as a private citizen who can say whatever nonsense he wants, he’s speaking as a board member of a public health agency. And therefore I think his comments that have mostly been directed at undermining public health are particularly reprehensible.”

Removing all recommendations for masking from all CDH communications, Pate said, “I think reflects a political influence on the CDH board, rather than a public health or scientific or epidemiologic approach.”

“The science is clear now,” he said. “At this point in the pandemic, we have very high-quality scientific evidence to show that in fact masks will reduce your chance of being infected.”

He noted that people who disagree don’t have to visit the CDH website or follow recommendations they find there. “For those people going to the website, let’s be transparent, let’s be honest. Let’s give the facts,” Pate said. “Let people have the information, so that they can make the right decision for themselves.”

The city of Boise convened its emergency operations team after the county moved up into the “high” range for community spread, to consider additional measures like requiring masks in city buildings, but decided to stick with just recommendations for now, according to city spokesperson Maria Weeg, for people to “take care of themselves and their families the best they can, by taking actions like wearing masks, getting tests if they’re showing symptoms, taking all of those precautions that we know are working, staying up to date on vaccinations.”

“We’re certainly keeping all of that on our website,” she said.

CDH board vice chair Megan Blanksma declined to comment, referring questions to Garceau, who referred them back to the board.

Hasbrouck said, “We lost the vote. And so as a board you have to reach accord. That’s kind of what we’re doing.”

“My thought is after the first of the year, when Raul would probably go off the board and Ada County would appoint a new person, that hopefully we can come back and look at that policy change and maybe undo it. We’re just going to have to live with that decision until we get new board members that feel differently.”

Hasbrouck said temporary mask requirements in several of the district’s counties helped slow the spread of the virus when Idaho’s hospitals were overwhelmed at the height of the pandemic. “We got to critical care in the hospitals twice,” he said. “We were able to get through it, thanks to the hospitals and the great job they did. That was the main reason for the mask mandate, was just to slow the spread down so that the hospitals could handle the load. We got pretty close, but it worked.”

“Nobody knew how bad this was going to be at the beginning, so we may have overreacted a little bit,” he said, “but it’s probably better to overreact than not do anything, which is kind of where we’re at now.”

“You can find a study that’ll tell you anything you want,” Hasbrouck said. “I think we need to stick with the national organization, the CDC. That’s what those people do. We need to use those for our information.”

Labrador declined to respond to the Idaho Press on whether the move of three of the district’s counties into the “high” category for community spread changed his thoughts on the matter; or to describe his views on government’s responsibility for sharing public information either at the health district level or at the attorney general’s office level.

Hahn said, “We hope the public is looking at multiple sources for information, not just the district health department, which has great local public health information, but also our state health site, which continues to have that type of information available, and of course the CDC’s site and their recommendations.” The state of Idaho continues to update its COVID-19 website at coronavirus.idaho.gov, she said.

“I do like having all information available to the public on as many different sites as possible,” Hahn said. “I think that’s best.”

She echoed Pate that the CDC misstepped in its communications about masks early in the pandemic, but said, “I think they’re right on about masks right now. I think they’ve made it more clear that if you wear what they’re calling a ‘high quality mask,’ this would either be the medical-surgical mask or even better a KN-95 or N-95 mask, you have very good protection.”

“In the grocery store, I now wear a KN-95 mask,” she said. “Even if other people are not masked, I feel protected. I think that’s a reasonable approach.”

Idaho has seven public health districts; no other boards have reported passing similar motions regarding removing references to masking.

“I understand the health districts are run by the boards, and that the boards ultimately decide what the health district’s communications and focus … should be and are,” Hahn said. “Personally, I prefer an approach where the health district staff and the director are encouraged to put out as much information as possible. But I understand that the board had that authority to make those decisions.”

Nettleton said, “I just hope people will try to use common sense and stay safe as they proceed with having a fun summer.”