I have multiple files with links to actual medical data from all around the world. All of it indicates that the pandemic was not what it was, and there are so many questions that the medical community cannot or will not answer. I am more than happy to meet and show the amount of data indicating that not only are these measures not the end all cure all thing, but the vaccines obviously have side effects, that there are questions on the efficacy of the vaccine and usefulness in certain demographics. 

We don't need control oriented useless helps. Basic infection suggestions work. 

It is an important rule in healthcare to do no harm. Universal masking, following health guidelines, and being able to have a complete medical history before treatment are critical to doing no harm. Forcing vulnerable individuals and their families to receive medical care in facilities with unmasked individuals or go without medical care does harm. Many health care providers have died due to workplace exposure to infectious diseases. Forbidding them from protecting themselves is wrong and would contribute to existing shortages of providers. I strongly oppose any regulation which would forbid health care providers from doing their utmost to prevent the spread of infectious disease.

The request is asking the Board/State to implement a rule that would take away a doctors right to impose its requirements on its patients. Further, it would require the doctor to put themselves at risk. The state cannot possibly know every circumstance where wearing a mask may come up and to put this rule into place would be detrimental because it is over broad and not specific. 

I also believe that this rules petition would be contrary to Virginia law. Under  18VAC85-20-29. Practitioner responsibility, it states:

A practitioner shall not:

1. Knowingly allow subordinates to jeopardize patient safety or provide patient care outside of the subordinate's scope of practice or area of responsibility. Practitioners shall delegate patient care only to subordinates who are properly trained and supervised

But by forcing doctors to allow people refusing to wear a mask in to their practice, the would be knowingly requiring their subordinates to allow this practice. That would not only endanger the doctor, the other employees, but also the other patients. 

I do believe doctors should have the freedom to treat patients who engage in the willing treatment of their provider. I do believe there are exceptions to this rule. For example, under the Americans with Disabilities Act, accommodations must be made for a person who can't wear a mask due to health disabilities such as needing oxygen, having asthma, COPD, or other respiratory problems.

There should be a complaint process for doctors who are not compliant with the ADA but outside of that, doctors should have the freedom to decide what is best for their patients so long as they do not discriminate based on anything protected under the Civil Rights Act.

I do agree with the petitioner that a patient should have the right to refuse any vaccine. I also agree that a doctor should not be able to refuse care based on this practice. If this were the case, every time a new vaccine came out a doctor could terminate the doctor-patient relationship and that would cause havoc. 

Prof. Michael Moates, MA, QBA, LBA, LMHP

While a mask is an inconvenience, it's an important and simple way to limit transmission of air borne pathogens, especially to protect vulnerable patients.   I oppose regulations which would undermine access to health care for immune-compromised patients or those with co-morbidities.

I’m really glad that requests like this are finally being made to regulate demands that healthcare practitioners can make of their patients. In regards to vaccination requirements— I believe it is unconstitutional to require patients to receive vaccinations and it violates bodily autonomy. Vaccinations should be a personal choice not a requirement. 
I believe asking patients to disclose their vaccination status is wrong as well. 
In regards to masking, I don’t believe there is any harm in asking patients (without medical conditions that would impair their breathing) to wear a mask but I think that should be at the discretion of the medical health provider and not a generic blanket requirement. 

I have recently been informed of a petition to the Virginia Board of Medicine, Petition #362 "Prohibition of requirements for mask wearing, receipt of vaccines, and disclosure of vaccine status to receive medical care". 

I object to passing this petition in that: 

I oppose any regulation which would forbid health care providers from following health department and CDC guidance.

I oppose regulations which would make it impossible for health care providers to do everything they can to prevent the transmission of infectious diseases.

I oppose regulations which would undermine access to health care for immune-compromised patients or those with comorbidities.

I oppose regulations which would make it impossible for health care providers to choose not to treat patients who will not share their full health histories.

I oppose any regulation which would forbid health care providers from following health department and CDC guidance.

I oppose regulations which would make it impossible for health care providers to do everything they can to prevent the transmission of infectious diseases.

I oppose regulations which would undermine access to health care for immune-compromised patients or those with co-morbidities.

I oppose regulations which would make it impossible for health care providers to choose not to treat patients who will not share their full health histories.

I oppose any regulation which would forbid health care providers from following health department and CDC guidance.

I oppose regulations which would make it impossible for health care providers to do everything they can to prevent the transmission of infectious diseases.

Completely on board with this legislation. Long overdue. The covid vaccines do not work, masks do not filter virus-sized particles anyways, and no one should be required to disclose vaccine status.

If adopted, this rule would prevent providers from gathering all of the information necessary to best service their clients. And it would prevent them from employing protocols widely known to prevent the spread of infectious disease. 

It is the duty of practitioner's to uphold the safety of both themselves and their patients.

Agree. 

I oppose any legislation that prohibits a licensed health care provider from following guidelines issued by the Virginia Dept of Health or the Centers for Disease Control.  As a health care provider, I base decisions about my clinic, my own health, the health of my patients and my staff on these guidelines.  To prohibit me from doing so interferes with my ability to provide safe care to may patients and a safe environment for myself and my staff to work.  Should this pass, and it becomes illegal for me to follow guidelines issued by these organizations, it may well be time for me to change to a career that does not put my own health at risk.  Our health care providers have been through enough the past two years.  Let's not risk losing anymore of that vital work force because of ongoing threats and hostile work environments, for which I believe this regulation will contribute.

I strongly oppose the adoption of petition 362. The suggested changes within this petition would undermine access to health care for immune-compromised patients or those with co-morbidities and would place more people at unnecessary risk including us healthcare practitioners. If our goal is to bring the pandemic to a close, we must be attentive to the health of everyone in the state of Virginia and work together. New variants will continue to rise and will continuously put more people at risk. By forcing us to change our policies that are in place for patient-practitioner protection, it should be common sense that adopting such measures would be a threat to public safety. If we are in fact a community of care providers that pledge to "do no harm", this would clearly be a move in the wrong direction.

Practitioners should have the choice to follow CDC guidelines and safe practice protocols. Patients are free to choose a provider who aligns with their thinking on mask requirements but it is not okay to take the right away from office practices. Masks are a health protective device — requiring them is not discriminatory but discerning. Safety and welfare are the right of every individual. Freedom to endanger others is not. 

Please refrain from your irresponsible use of misguided education of children 

I believe it should be up to the individual. 

As a Virginian, I believe it should be up to the business.  Freedom of choice has been destroyed by many of our leaders overreaching the last two years. 

I agree with the petition as masks and vaccinations should not be required to receive medical care. People should be given the freedom to decide if they want to wear a mask to get vaccinated after receiving information about these items. The government or medical facilities should not be able to force people to get vaccinated or wear a mask.

I oppose any regulation which would forbid health care providers from following health department and CDC guidance.

I oppose regulations which would make it impossible for health care providers to do everything they can to prevent the transmission of infectious diseases.

I oppose regulations which would undermine access to health care for immune-compromised patients or those with co-morbidities.

I oppose regulations which would make it impossible for health care providers to choose not to treat patients who will not share their full health histories.

I am an immuno-compromised health care provider serving a vulnerable patient population.  Compliance with CDC recommendations regarding disclosure of vaccination status, masking to permit transmission of pathogens, and other infectious disease protocols is vital for my own safety and that of my patients.  Health care workers are already at risk every single day.  There is no reason to increase that risk by allowing this petition to move forward. 

In my previous comment I meant to say "..masking to PREVENT transmission of pathogens..,,"

As the petitioner who has submitted the proposed regulation, I feel the need for clarification and context on my initial proposal, and some much-needed responses to comments published in opposition.  There is quite a bit of unsupported statements out there made by parties in opposition to the petition claiming this petition will somehow “endanger patients,” by allowing individuals, not practitioners, to make the medical choice as to whether they must wear a mask or not.  I will attempt to call these comments out to point out the illogic or fallacy of their arguments.  There also is the issue of the Board of Medicine’s receipt of my petition and the actual language posted by the Board.  The Virginia Board of Medicine didn’t post exactly word for word what my petition originally proposed.  The Board paraphrased a good portion of my proposal, and changed my language in certain phrases, which I feel was dishonest. It did not reflect the actual proposed language, which I will repeat below.  In addition, the Transmittal Sheet as published also didn’t include the rationale behind why I feel this regulation is necessary, which provides much needed context and supporting background.  I do appreciate the comments on both sides, but as the petitioner, I feel that by not posting the rationale behind my proposal, the Virginia Board is deliberately withholding necessary supporting information critical to supporting my position. 

First, my original proposed language and the rationale.  This is word for word, Proposed Clause 5:

Original version: A practitioner shall not: “5. Prohibit, or refuse to provide medical care to, or consult with, a patient (or prospective patient) based upon the patient’s, prospective patient’s, family member’s, or authorized patient representative’s (including Parental Guardian’s) choice to not wear a mask.  A mask shall be considered any covering across the face that is intended solely as a means of potential infection control.”

The Board’s paraphrased version, made to appear that a patient is refusing to wear a mask: “(1) prohibit physicians, podiatrists, and chiropractors from refusing to provide medical care to patients or prospective patients if those individuals or their accompanying representatives refuse to wear masks.”

The distinction here is critical.  Under current Virginia state public health regulation and Executive Orders, there is no longer any public health crisis requiring an employer to mandate its employees, nor ordinary citizens, to wear masks as a condition of citizenship, let alone the ability to receive necessary medical care, worship at a religious institution, attend school, or to participate in commerce, for that matter.  The decision to wear a mask is that of the patient’s, prospective patient’s, or the family member’s alone.  A practitioner has no legal or ethical right to force or make decisions for the patient, especially if the patient does not have informed consent on the efficacy of masks. The decision is the individual’s right. My proposed regulation does not state that a patient is prohibited from wearing a mask if they choose; on the contrary, if they want to wear a mask, they are free to do so. But a practitioner has no legal authority under existing Virginia state law or Board of Medicine regulation to demand that a patient, prospective patient, or family member accompanying them do so, especially since this type of tyrannical behavior never was practiced or allowed prior to 2020, and definitely since all Executive Orders mandating mandatory masking in Virginia have now been lifted. 

One commenter claims that if a patient does not wear a mask, this somehow puts a practitioner somehow in a position under 18VAC85-20-29, Practitioner responsibility, that they are knowingly jeopardizing patient safety:  The commenter claims “A practitioner shall not knowingly allow subordinates to jeopardize patient safety or provide patient care outside of the subordinate's scope of practice or area of responsibility. Practitioners shall delegate patient care only to subordinates who are properly trained and supervised.” The commenter claims that “. . .  by forcing doctors to allow people refusing to wear a mask in to their practice, the would be knowingly requiring their subordinates to allow this practice. That would not only endanger the doctor, the other employees, but also the other patients.”  Given the fact that there is documented evidence that mask wearing actually can make a patient sick (https://www.sciencedaily.com/releases/2015/04/150422121724.htm; https://www.aier.org/article/the-dangers-of-masks/; https://www.aier.org/article/masking-a-careful-review-of-the-evidence/; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490318/), then how would a practitioner explain that forcing one to wear a mask is actually a net positive for the patient’s health, or is not putting the doctor at risk? If you demand that a patient wears a mask upon entry to your practice and will not treat a patient if they do not wear a mask, but in the process of that patient being required to wear a mask, they actually do get sick from wearing a face mask, how does that protect anyone? 

This practice however (forced masking as a condition of participating in commerce or receipt of medical care) continues to this day because all patients in many practitioners' offices are considered “guilty until proven innocent,” or unethically assumed to have COVID-19 and require them to wear a mask, without even asking if a patient has symptoms, or has previously had COVID-19, recovered, and now possesses natural immunity (a documented medical fact the FDA and Pfizer, manufacturer of one of the COVID-19 “vaccines,” have been forced to admit: http://Youtube.com/watch?v=5eJ5TIT6zvk).  Do practitioners demand every patient prior to entry into an office take precautions against the flu before they enter their practice?  Norovirus? Rotavirus? What about tuberculosis?  HIV? Pertussis?  Meningitis? Pneumonia? Strep throat? Each of these infectious diseases are highly contagious, but infection control practices to stop the spread of these diseases are not mandated by a practitioner prior to one receiving care, especially for care unrelated to infectious disease.

As a resident of the Commonwealth for the past 14 years, I can tell you first hand I never had to wear a mask as a condition of receiving care prior to 2020, and prior to 2020 I have had multiple outpatient surgeries, emergency room visits, doctor’s appointments, had the flu, attended children well child visits, my children’s births, attended physical therapy appointments, and had literally hundreds of interactions with medical staff and other patients, all while either being injured, sick, contagious, or healthy.  Not once was I forced to wear a mask, even during the height of raging flu seasons.

Patient autonomy must be respected.  Up until 2020, all practitioners in the Commonwealth respected that decision.  No practitioner has the authority to act as a defacto member of a Board of Health, as they have no legal authority to enforce a mask requirement that only the Board of Health, Board of Labor and Industry or the State legislature have the authority to enforce.  But sadly, this situation still remains today with practitioners (especially in Fairfax County), acting as defacto agents of the State or County Board of Health, continuing to demand patients wear masks as a “public health protection measure,” or claiming “it’s company policy” when no such evidence exists as to the efficacy of masking preventing one from contracting the virus that causes COVID-19, nor stopping the spread of the COVID-19 virus.  Despite unsubstantiated claims to the contrary from opposers of my petition claiming masks have been effective in stopping the virus, the evidence does not exist.

Proposed Clause 6

Here is the original text as I proposed, stating a Practitioner shall not:

“6. Enact, implement, enforce, or execute any practitioner-authored, insurer-required, or organizational policy, instruction, or guidance (including, but not limited to, guidance issued by the Centers for Disease Control, local County or municipality Board of Health, or Virginia Department of Health) that prohibits patients, prospective patients, family members, or authorized patient representatives to receive medical care based solely upon an individual’s choice to not wear a mask, as outlined in 5., above.”

The Board’s paraphrased version: “(2) prohibit physicians, podiatrists, and chiropractors from enforcing any requirements for patients, prospective patients, or patient representatives to wear masks to receive medical care, including when following policies of insurers or organizations or when following guidance issued by the Centers for Disease Control, local health departments, or the Virginia Department of Health;”

One can obviously see the difference in my proposal.  My proposal simply limits a practitioner from enacting, implementing, enforcing, or executing any practitioner-authored, insurer-required, or organizational policy, instruction, or guidance prohibiting patients, prospective patients, family members, or authorized patient representatives to receive medical care based solely upon an individual’s choice to not wear a mask.  The proposal does not claim outright that a practitioner cannot place some necessary restrictions on the receipt of care, for example, providing necessary body temperature screening.  However, given the fact that the State of Virginia has now revoked (as of March 23, 2022) the Virginia Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus that Causes COVID-19, under Virginia Code 16VAC25-220, based on emerging scientific and medical evidence that the current widespread variants of the virus no longer constitute a grave danger to employees in the workplace, it logically follows that no practitioner can still retain or enact such outdated policies continuing masking from the previous finding of a grave danger, when the emerging scientific and medical evidence proves that a grave danger no longer exists.  If masks are now deemed not required for employees in the workplace by the State of Virginia, how can patients be subjected to a different standard by their practitioner, when they interact with those same employees on a daily basis? 

For background, commenters need to know that the Virginia Department of Labor and Industry on February 16, 2022, through the Virginia Safety and Health Codes Board, adopted a proposed finding that there is no longer a continued need for the Virginia Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus that Causes COVID-19, under Virginia Code 16VAC25-220, based on emerging scientific and medical evidence that the current widespread variants of the virus no longer constitute a grave danger to employees in the workplace under Va. Code §40.1-22(6a), and as discussed in the U. S. Supreme Court’s decision in National Federation of Independent Businesses, et al., Applicants v. Department of Labor, Occupational Safety and Health Administration, et al.  The supporting public comment period has passed and is posted at https://townhall.virginia.gov/L/ViewNotice.cfm?gnid=2373.

Under Governor Youngkin’s Executive Order, the Virginia Standard for Infectious Disease Prevention of the SARS-CoV-2 Virus That Causes COVID-19, 16VAC25-220, which previously established requirements for employers to control, prevent, and mitigate the spread of SARS-CoV-2, the virus that causes COVID-19, among employees and employers, including provisions for employer mandatory masking, has now been repealed.  On March 22, 2022, the proposed revocation of that Standard was finalized.  The link showing the revoked standard is located here: http://register.dls.virginia.gov/details.aspx?id=10202.

The rationale that I originally proposed behind my petition is of utmost relevance, and so I post it here:

“These regulations are necessary due to the thousands upon thousands of examples in Virginia where patients and prospective patients were denied their right to necessary medical care solely because of their individual choice to not take the COVID-19 vaccine, or their choice to not wear a mask during a visit to a licensed medical practitioner or medical facility.  Both mask wearing and the vaccine have now been shown (based on years of peer-reviewed scientific studies and empirical data) to be largely ineffective in preventing contracting of the virus that causes COVID-19 disease, or in preventing transmission to others. Numerous studies provide the factual basis behind these statements:

https://www.lifesitenews.com/news/47-studies-confirm-inefectiveness-of-masks-for-covid-and-32-more-confirm-their-negative-health-effects

https://aapsonline.org/mask-facts/

https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data

https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a-H.pdf
https://www.cdc.gov/mmwr/volumes/70/wr/mm7031e2.htm
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410
https://brownstone.org/articles/more-than-150-comparative-studies-and-articles-on-mask-ineffectiveness-and-harms/
https://lcaction.org/vaccine#cases

Prior to February 2020, no citizen in the Commonwealth of Virginia was required to wear a mask as a condition to receiving necessary medical care.  For example, no patients were denied treatment for the seasonal flu by a general practitioner or family doctor if they had not received a flu shot that year, or were not wearing a mask.  No pediatrician would deny treatment of a child for pertussis if they were not wearing a mask. Yet, unfortunately these instances surrounding COVID-19 occurred thousands of times across the Commonwealth within the past 2 years by practitioners, and still continue to happen to this day, even when all mask restrictions in the Commonwealth have been lifted by the Virginia Board of Health.  I myself am still required to wear a mask to see my surgeon for post-surgery follow up appointments after receiving ankle surgery in February 2022 here in Fairfax County, over 3 weeks ago, despite the Centers for Disease Control lifting most mask guidelines and states such as New York, Massachusetts, Florida, and Texas now having no mask mandates.  Why does Virginia still allow this?  I am a survivor of COVID-19 disease from August of 2021, and have recovered fully, with documented natural immunity through antibody testing.  My practitioner still will not accept any of that information as relevant, and assumes all patients as possibly infected (an unethical and unscientific practice, by the way), and therefore requires me to wear a mask in his office, even threatening patients (through administrative staff) with cancelling a necessary medical appointment if they do not comply, despite overwhelming evidence that masking does almost nothing to stop the spread of the COVID-19 virus or prevent transmission.  It is unconscionable that licensed practitioners, their subordinates, and administrative or office employees can still refuse to treat patients if the patient chooses to not wear a mask.  This discriminatory practice must end immediately.

One of the main principles of the Hippocratic oath is to First, Do No Harm.  Demanding that a patient wear a mask (when multiple, peer-reviewed studies documenting the adverse effects of mask wearing is well established), is harmful to a patient and violates patient autonomy.  It must be their choice to wear a mask, not mandated by an individual practitioner, when local and State Boards of Health have lifted masking restrictions for all business establishments. Patient autonomy and patient rights must be respected by that practitioner. 

It is also ridiculous and an outrage to patient rights that some licensed practitioners can still demand that patients, prospective patients, or family members accompanying them wear a mask as a precondition to receiving treatment, (and as a consequence, can refuse or deny treatment for a patient when they exercise their right to not wear one), when it is now state law in Virginia that no child who attends a school is required to wear a mask (Senate Bill 739).  If a child has the legal right to not have to wear a mask while in a school environment, of which that child is potentially indoors for periods of up to 6-8 hours a day, five days a week, in close proximity to potentially hundreds of other children each day, how can the Virginia Board of Medicine still allow medical practitioners to continue these blatantly discriminatory and coercive practices of mandatory mask wearing, or demand proof of a COVID-19 vaccination in order for a patient to obtain medical care? How do children now have this right, but somehow patients now do not? 

Requiring a patient to wear a mask indoors for a doctor’s appointment, medical procedure, or for any duration of time in a medical facility (for example, as a visitor), was rarely, if ever required on a widespread, Commonwealth basis prior to 2020.  At this point continuance of these policies is nonsensical. The facts are clear: masks and the COVID-19 vaccine do not stop transmission, nor prevent transmission of the virus that causes COVID-19 disease.  The Virginia Board of Medicine has an obligation to put an end to unethical, coercive, and discriminatory practices by practitioners requiring mask wearing and demanding proof of vaccination as a precondition to receiving necessary medical care.”

Response to Specific Commenters In Opposition to Prohibiting Masking

As the petitioner, I feel the need to respond to multiple commenters claiming, without evidence, that masking is effective in stopping transmission of the COVID-19 virus, and masking “protects vulnerable populations.”  Comments such as “Compliance with CDC recommendations regarding disclosure of vaccination status, masking to permit transmission of pathogens, and other infectious disease protocols is vital for my own safety and that of my patients,” or “I oppose regulations which would undermine access to health care for immune-compromised patients or those with co-morbidities,” completely ignore the vast body of scientific evidence clearly established by hundreds of peer-reviewed studies on the efficacy of masks and completely deny the concept of patient autonomy.  This proposed regulation does not undermine access to health care for immune-compromised patients or any patients in any way.  No one will be denied medical treatment if a practitioner is prohibited from forcing someone to wear a useless mask against their will – on the contrary, this regulation would actually ensure that practitioners cannot deny treatment to those who choose to not wear a mask and need such care, since denying individuals the right to receive compassionate medical care on that basis alone is unethical.  Multiple other proven, effective infection control protocols can be put in place to adequately protect immunocompromised patients, such as enhanced hand washing, and temperature screening. Nowhere in this petition does it state practitioners are forbidden from treating immune-compromised patients who choose to not wear a mask.  In fact, practitioners in the Commonwealth (and across the United States, for that matter) routinely treated tens of millions of immune-compromised patients, without wearing a mask prior to 2020, and no practitioners denied treatment of someone who chose to not wear a mask or refused to take an experimental “vaccine.”  Statements about undermining access to health care are pure hyperbole and unsupported by facts.

Nothing in the petition states practitioners can’t treat individuals who also refuse to disclose if they have not received the COVID-19 “vaccine” (practitioners currently by and large do not ask (as a precondition to receiving care) if you have been vaccinated for any infectious disease as a condition of treating you for any ailment, injury, or illness regardless), and no commenter has provided any evidence showing that those who don’t take the COVID-19 “vaccine” or refuse to disclose whether they have taken it are driving COVID-19 infection rates higher than “vaccinated” patients.  What this regulation does is return to the patient the autonomy and decision as to whether they will wear a mask, not the Practitioner.  This returns to the patient the decision whether they will be able to receive life-saving treatment, regardless of their vaccination status, not the Practitioner.  Unfortunately what the public has also seen over the past two years is egregious behavior by some practitioners refusing to treat patients or prospective patients because they have refused to receive the COVID-19 “vaccine,” which has been proven by recent FDA Freedom of Information Act disclosures over the past 2 months to have dangerous side effects in many immunocompromised and otherwise healthy patients (https://childrenshealthdefense.org/defender/1-million-covid-vaccine-injuries-27000-deaths-reported-vaers-cdc-data/ and here: https://childrenshealthdefense.org/defender/pfizer-vaccine-injuries-more-severe-people-under-55/.

There have been cases across the country, and even in the Commonwealth of Virginia, where individuals who needed life-saving organ transplants that were removed from an organ donor recipient list at the last minute because the individual chose not to receive the COVID-19 “vaccine.” This removal was due to a hospital or practitioner making the discriminatory (and highly unethical) decision to deny that person life-saving medical care because of the patient’s choice to not receive a COVID-19 “vaccine.” This proposed regulation would prohibit that discriminatory behavior by practitioners. Here is the evidence: https://theroanokestar.com/2022/02/04/unvaccinated-patients-denied-organ-transplants-everywhere/. Now where are the claims by opponents of this petition of "undermining access to health care for immune-compromised patients or those with co-morbidities?"

Hundreds of peer reviewed studies show little to no evidence of the efficacy of mask wearing on stopping transmission or receipt of the virus that causes COVID-19, and of many other respiratory diseases. These links below are just a sampling of the overwhelming body of literature demonstrating the futility of enforcing masking as an infection control technique against the virus that causes COVID-19, both in medical facilities and in the general population.

1. “CDC data shows 85% of those who contracted COVID-19 during July 2020 were mask wearers.”
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6936a5-H.pdf

2. “The COVID-19 pandemic has led to critical shortages of medical-grade PPE. Alternative forms of facial protection offer inferior protection”: https://pubmed.ncbi.nlm.nih.gov/32371574/

3. “There is moderate certainty evidence that wearing a mask probably makes little or no difference to the outcome of laboratory-confirmed influenza compared to not wearing a mask.” https://pubmed.ncbi.nlm.nih.gov/33215698/

4.  Disposable surgical face masks for preventing surgical wound infection in clean surgery

“We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials.” https://pubmed.ncbi.nlm.nih.gov/27115326/

5.  Disposable surgical face masks: a systematic review

“Two randomized controlled trials were included involving a total of 1453 patients. In a small trial there was a trend towards masks being associated with fewer infections, whereas in a large trial there was no difference in infection rates between the masked and unmasked group.” https://pubmed.ncbi.nlm.nih.gov/16295987/

6. Evaluating the efficacy of cloth facemasks in reducing particulate matter exposure

“Our results suggest that cloth masks are only marginally beneficial in protecting individuals from particles<2.5 μm.”  Scientific studies show the COVID-19 virus is approx. 0.125 μm in diameter.
https://pubmed.ncbi.nlm.nih.gov/27531371/

7.  Comparison of the Filter Efficiency of Medical Nonwoven Fabrics against Three Different Microbe Aerosols

“The filter efficiencies against influenza virus particles were the lowest”

“We conclude that the filter efficiency test using the phi-X174 phage aerosol may overestimate the protective performance of nonwoven fabrics with filter structure compared to that against real pathogens such as the influenza virus” https://pubmed.ncbi.nlm.nih.gov/29910210/

8. The efficacy of standard surgical face masks: an investigation using “tracer particles”

“Since the microspheres were not identified on the exterior of these face masks, they must have escaped around the mask edges and found their way into the wound”. Human albumin cells, aka aborted fetal tissue, is much larger than the virus and still escaped the mask. https://pubmed.ncbi.nlm.nih.gov/7379387/

9. Using half-facepiece respirators for H1N1

“Increasing the filtration level of a particle respirator does not increase the respirator’s ability to reduce a user’s exposure to contaminants” https://pubmed.ncbi.nlm.nih.gov/19927872/

10. Why Masks Don’t Work Against COVID-19

https://www.citizensforfreespeech.org/why_masks_don_t_work_against_covid_19?fbclid=IwAR0Qviyvt6BObOg aMij03Cj0fgTcm_gm5jhXcMkO8GcH3Kur-bwib0o8rf8

11. Masks Don’t Work: A Review of Science Relevant to COVID-19 Social Policy

https://www.rcreader.com/commentary/masks-dont-work-covid-a-review-of-science-relevant-to-covide-19-social-policy?fbclid=IwAR0Qviyvt6BObOgaMij03Cj0fgTcm_gm5jhXcMkO8GcH3Kur-bwib0o8rf8

12. Face masks to prevent transmission of influenza virus: a systematic review

There is less data to support the use of face masks or respirators to prevent becoming infected.
https://pubmed.ncbi.nlm.nih.gov/20092668/

13. Use of face masks by non-scrubbed operating room staff: a randomized controlled trial:
Surgical site infection rates did not increase when non-scrubbed personnel did not wear face masks.
2010 Study article: https://pubmed.ncbi.nlm.nih.gov/20575920/

14. Surgical face masks in modern operating rooms – a costly and unnecessary ritual?

When the wearing of face masks by non-scrubbed staff working in an operating room with forced ventilation seems to be unnecessary. https://pubmed.ncbi.nlm.nih.gov/1680906/

15. Masks: a ward investigation and review of the literature

Wearing multi-layer operating room masks for every visit had no effect on nose and throat carriage rates. https://pubmed.ncbi.nlm.nih.gov/2873176/

16. Masks for prevention of viral respiratory infections among health care workers and the public: PEER umbrella systematic review.  Meta analysis review that says there is limited evidence to suggest that the use of masks may reduce the risk of spreading viral respiratory infections. https://pubmed.ncbi.nlm.nih.gov/32675098/

17. Modeling of the Transmission of Coronaviruses, Measles Virus, Influenza Virus, Mycobacterium tuberculosis, and Legionella pneumophila in Dental Clinics

Evidence to suggest that transmission probability is strongly driven by indoor air quality, followed by patient effectiveness and the least by respiratory protection via mask use. https://pubmed.ncbi.nlm.nih.gov/32614681/

18. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Personal Protective and Environmental Measures

The use of face masks, either by infected or non-infected persons, does not have a significant effect on influenza transmission. https://pubmed.ncbi.nlm.nih.gov/32027586/

19. Effectiveness of personal protective measures in reducing pandemic influenza transmission: A systematic review and meta-analysis

Meta analyses suggest that regular hand hygiene provided a significant protective effect over face masks and their insignificant protection. https://pubmed.ncbi.nlm.nih.gov/28487207/

20. Effectiveness of N95 respirators versus surgical masks against influenza: A systematic review and meta- analysis

Use of n95 respirators compared to surgical masks is not associated with a lower risk of laboratory confirmed influenza.
https://pubmed.ncbi.nlm.nih.gov/32167245/

21. Adolescents’ face mask usage and contact transmission in novel Coronavirus

Face mask surfaces can become contamination sources. People are storing them in their pockets, bags, putting them on tables, people are reusing them etc. This is why this study is relevant: https://pubmed.ncbi.nlm.nih.gov/32582579/

22. Visualizing the effectiveness of face masks in obstructing respiratory jets

Loosely folded face masks and “bandana style” face coverings provide minimum stopping capability for the smallest aerosolized droplets.  This applies to anyone who folds or shoves a mask into their pockets or bag. It also applies to cloth and homemade cloth masks: https://pubmed.ncbi.nlm.nih.gov/32624649/

23. Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: a randomized controlled trial. Face mask use in healthcare workers has not been demonstrated to provide benefit in terms of colds symptoms or getting colds.
https://pubmed.ncbi.nlm.nih.gov/19216002/

24. A cluster randomized trial of cloth masks compared with medical masks in healthcare workers

Penetration of cloth masks by influenza particles was almost 97 percent and medical masks 44 percent. So cloth masks are essentially useless, and “medical grade” masks don’t provide adequate protection.
https://pubmed.ncbi.nlm.nih.gov/25903751/

25. Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial

“The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50 percent in a community with modest infection rates, some degree of social distancing, and uncommon general mask use”: https://pubmed.ncbi.nlm.nih.gov/33205991/

26. Mask mandates and use are not associated with slower state-level COVID-19 spread during COVID-19 growth surges.
https://www.medrxiv.org/content/10.1101/2021.05.18.21257385v1

In addition to the numerous internet citations provided above that document overwhelming evidence that masking does not prevent the contracting of the virus, nor stop transmission, of particular relevance is a comment submitted by Mr. Mark Fraser, PhD, Aerosol Scientist and OSHA Safety Officer in support of revoking the Virginia Standard for Infectious Disease Prevention of the SARSCoV-2 Virus That Causes COVID-19 (16VAC25-220).  Mr. Fraser’s comment shows that masking is completely ineffective as a means of infection control against the SARS-CoV-2 Virus, summarized below: (https://townhall.virginia.gov/L/viewcomments.cfm?commentid=120823)

“The Standard, subsection 40(G), specifies the mandated Personal Protective Equipment (PPE): “employees shall wear a face covering or surgical mask that covers the nose and mouth to contain the wearer's respiratory droplets and help protect others and potentially themselves.” This selection of PPE was unfortunate because these types of masks bear no certification of effectiveness against germs and viruses and, in fact, were known to be ineffective against these pathogens at the beginning of the COVID outbreak¹. . .  Sufficient data have been acquired to allow the performance of Mask Mandates to be assessed.  The unmistakable conclusion is that COVID infections were driven largely by seasonal and endemic factors, whereas Mask Mandates had no discernable impact on infections here in the U.S.⁴ . . .

The Standard also failed to address the possibility of short and long-term health issues raised by prolonged use of PPE.  These issues include: difficulty in breathing, skin rashes, and CO2 intoxication.4 

Conclusions: Considering the PPE specified under the Standard provided little or no protection against the SARS-CoV-2 virus and long-term use presents health risks to employees, the Standard should be revoked.”

So, since masking has been overwhelmingly shown through multiple peer reviewed studies to have not stopped or slowed the spread of the virus that causes COVID-19, why does the Board of Medicine still allow practitioners to force patients to wear one as a condition to receiving care?

Several commenters have stated that any patient or prospective patient doesn’t have to wear a mask, as they could seek a practitioner that aligns with their philosophy on mask wearing if they choose not to wear one.  While this sounds feasible in theory, unfortunately if there are only a minimal number of practitioners in one’s local area, patients would be unfairly discriminated against for their choice should all practitioners demand that a mask be worn, even just in order to be seen for an initial appointment! In reality in densely populated locations such as Fairfax County, there is no way for a patient or prospective patient to adequately research or filter practitioners for this option without an exhaustive time and resource-intensive search.  No practitioners in the Commonwealth advertise “mask free,” or “masks optional,” on their websites, or in their practice’s literature, or brochures. There is no county government, or Association of medical providers, or medical guild that advertises “mask free” practitioners.  So, while this initially sounds like a reasonable option for patients to have their autonomy respected, in reality this is an undue burden that patients or prospective patients must not be required to bear in order to simply receive compassionate, unrestricted medical care. The more reasonable option is to simply prohibit practitioners from acting as defacto agents of the Local or State Board of Health, where they have not been accorded any authority under Virginia State law or Board of Health regulation to continue to force masking on patients.

In addition, as explained in my rationale submitted to the Board, forced masking violates patient autonomy by requiring a patient to wear ineffective facial masks that actually can be shown to make individuals sick, as is clearly outlined in multiple studies cited in the above internet links (for example, University of New South Wales. (2015, April 22). Cloth masks: Dangerous to your health? ScienceDaily. Retrieved March 19, 2022 from https://www.sciencedaily.com/releases/2015/04/150422121724.htm

How is it ethical (or in the interest of patient safety) then, to force a patient to wear a mask as a condition to receiving care, when that mask can actually make them sicker than they are to begin with, or possibly negatively contribute to their health? No practitioner is checking a patient for proper fit and wear, quality of mask, or cleanliness of mask, to begin with. So, even on that basis alone, forced masking must be prohibited as a condition of receiving care. 

Yesterday, a judge ruled that it was illegal for the government to force a mask mandate on anyone. Would that not apply to private healthcare providers?

The government cannot force anyone to wear a mask nor can they force anyone to not wear a mask. This is up to the choice of the treating physician and what they are willing to do.

See: 8:21-cv-01693-KKM-AEP in the United States District Court Middle District of Florida - Tampa Division

https://s3.documentcloud.org/documents/21636220/047124235804.pdf

Government entities cannot force someone to give up their own rights to treat a patient. Similarly in, Masterpiece Cakeshop v. Colorado Civil Rights Commission, the Supreme Court rules that a government entity cannot violate the rights of the seller to protect the rights of the purchaser. 

Healthcare policy needs  to follow CDC and health dept guidelines to protect older, at risk and  the Immunocompromised population . We need to use that science to take care of one another. Virginians can always choose to get care at providers who choose not to follow the guidelines.

For protection of vulnerable health workers and other patients, another patient should not be able to make the decision to expose them to their potential or real communicable illness. I do think it could be up to the health practitioner or facility at this point, however, so that those who refuse to comply can try to find a like-minded caregiver and fellow patients.

This proposal is really hard to even believe.  It is a direct attack on selfless healthcare workers and systems whom, often at their own risk, have worked so hard to stay as "healthy as possible" during this time of COVID.  Who better to make decisions about health protocols than those who work in healthcare systems and see not only the data but also the human toll on caretakers and patients?  Why would we legislate against wisdom and the communal good?

Healthcare workers have been the backbone of our process of helping those who suffer from Covid get well, or have care as they are dying. They've witnessed much suffering and have made tremendous sacrifices to stay healthy so they can minister to those who have had Covid. We don't know what the next virus will be, and the current one is not yet quiet. Why put healthcare workers at risk like this? They are doing their best to be there for us and are interested in the good of all, and that is what should be supported.

I oppose this proposed rule.  I trust the CDC, and would hope any Virginia rule making would be consistent with current research and guidance of one of the pre-eminent disease control agencies in the world. 

Short answer: Forcing a doctor to allow anyone on their property regardless of reason is a violation of the Constitution.

I fully support this petition.  I've read many of the comments in opposition to this proposed regulation by commenters and they are not based on facts or common sense.  Many in opposition state this would harm healthcare workers if the regulation would be allowed to pass.  I have two questions to ask these commenters (and the Board of Medicine):

First, if you truly believe that your mask wearing as a practitioner or healthcare worker protects you from the Coronavirus, why does it matter if a patient wears a mask or not? Is it not the patient's decision?  The state of Virginia has already stated that the grave danger to employers does not exist anymore from this virus based on their repeal of the Safety and Health Codes Board Standard for Infectious Disease Prevention of the SARSCoV-2 Virus That Causes COVID-19 (16VAC25-220) on March 21, 2022 (http://register.dls.virginia.gov/details.aspx?id=10202). 

Second, where in the Virginia Board of Medicine regulations or Virginia constitution (or anywhere for that matter) does a practitioner get to dictate what a patient's acceptable risk tolerance level is? Does your neighbor get to dictate to you that you drive a Volvo as opposed to a Ford? No, they cannot, and neither can a practitioner demand that a patient wear a mask, or demand they receive a "vaccine" in order to receive life-saving treatment, such as a liver transplant.  Commenters in opposition to this petition are conveniently ignoring the fact that if a healthcare worker (or a patient for that matter) wants to wear a mask, this regulation DOES NOT STOP THEM IN ANY WAY. If you want to wear a mask and you feel it protects you, by all means, go ahead.  This petition just prohibits a practitioner from demanding that you as a patient must wear one in order for the patient to receive necessary compassionate medical care.

May 6, 2022

William L. Harp, M.D.

Executive Director

Board of Medicine

9960 Mayland Drive, Suite 300

Henrico Virginia 23233

Re:       Comment on Petition for Rulemaking: Prohibition of Requirements for Mask Wearing, Receipt of Vaccines, and Disclosure of Vaccine Status to Receive Medical Care

Dear Dr. Harp,

For reasons discussed in further detail below, the Virginia Hospital & Healthcare Association (VHHA) urges the Board of Medicine to reject the petitioner’s request to amend its regulations to prohibit requirements for mask wearing, receipt of vaccines, or disclosure of vaccine status. 

The ability to require patients or prospective patients or their accompanying representatives to wear masks when present in health care settings, including physician offices or clinics and hospital inpatient and outpatient departments, is essential to proper infection control practices necessary for the protection of patients, staff, and the public.  Interference with this ability could not only expose individuals to disease, disability, or death, but could also result in health care providers being liable for negligence and being out of compliance with applicable laws and regulations that require proper infection control practices. 

For example, the Medicare conditions of participation for hospitals at 42 CFR § 482.42 require hospitals to have active hospital-wide programs for the surveillance, prevention, and control of infectious diseases and such programs must demonstrate adherence to nationally recognized infection prevention and control guidelines, such as those established from time to time by the Centers for Disease Prevention and Control (CDC).  Depending upon the circumstances, proper infection control practices may require the wearing of masks in sterile and non-sterile environments and in patient care and non-patient care areas.  As we have seen with COVID-19, wearing of masks in health care settings has been and continues to be included in guidelines adopted by the CDC.   

Current CDC guidelines for COVID-19 have included masking as a recognized source control in healthcare settings and continue to prefer that it be applied universally.  It has recently, however, included some allowances for individuals who are up to date with all recommended COVID-19 vaccine doses in healthcare facilities located in counties with low to moderate community transmission. Similarly, health care providers who are up to date with all recommended COVID-19 vaccine doses can chose not to wear masks when they are in well-defined areas that are restricted from patient access (e.g., staff meeting rooms, kitchen), but are instructed to wear source control when they are in areas of the healthcare facility where they could encounter patients (e.g., hospital cafeteria, common halls/corridors).

CDC continues to instruct that the safest practice is for patients and visitors to wear masks, particularly if at risk for severe disease or are unvaccinated. 

Accordingly, it is the case now, and would likely be for any future pandemics or outbreaks of infectious disease, that health care settings, including hospitals, will be required to enforce masking requirements in order to maintain proper infection control practices and compliance with applicable regulations.  The requested regulations’ prohibition on mask wearing requirements would be in direct interference with such obligations.  The regulations would also appear to place health care providers in the untenable position of either complying with the regulations or violating other applicable requirements as the prohibitions are to apply even “when following policies of insurers or organizations or when following guidance issued by the Centers for Disease Control, local health departments, or the Virginia Department of Health.” 

Further, as demonstrated by the CDC guidance, it will be necessary to inquire about or request disclosure of vaccination status of patients or prospective patients or accompanying representatives to determine whether applicable requirements are being complied with.  If it is determined that an individual is not vaccinated, additional steps would be required to ensure compliance, including, but not limited to requests for the individual to wear a mask.  Consequently, the requested regulations’ prohibition on disclosure of whether they have received any vaccine would likewise be in direct interference with existing obligations.

As it relates to any prohibition against disclosure of vaccination status or provision of medical care to any patient or prospective patient based on the vaccination status of the patient, vaccination may be clinically indicated to produce the best possible outcome for a patient, could be a contraindication for treatment, or serve as an appropriate factor in scarce resource allocations.  As such, information about vaccination status cannot and should not be eliminated from clinical decision-making.  Ultimately, the patient controls consent to receiving any vaccination, but vaccination status is clinically relevant and there should not be interference in communication about vaccination status between patients or potential patients and their health care providers.

Virginia’s hospitals and health systems strive to provide the best possible care experience for patients and visitors in the least restrictive manner possible; however, it is essential that they retain the flexibility to implement proper infection control practices when necessary in response to threats to the health and safety of those patients and visitors and their dedicated staff.  The requested regulations would be in conflict with this mission and are therefore not supported by VHHA.  We again respectfully urge you to reject the petitioner’s request.

Sincerely,

R. Brent Rawlings

Senior Vice President and General Counsel

No medical procedure is one size fits all. Masks have proven to do more harm than good. Fauci is a psychopathic narcissist who should not be trusted. Medicine has become political and weaponized. Vaccines should never be mandatory as the vaccine manufacturers are not liable. No placebo studies were done on any. This is Experimental EUA is creating mass genocide. There has never been truly informed consent to any biologic. The inserts are not shown to the people. If bodily autonomy is attacked what freedom does anyone have? Can you comply your way to freedom? When doctors get paid to jab children that is a conflict of interest! We must end this violation of the Constitution. Thank you for making an amendment as good legislation have been blocked by politicians who get paid by big pharmaceutical lobbyists. 

William L. Harp, M.D.
Executive Director
Board of Medicine
9960 Mayland Drive, Suite 300
Henrico, VA 23233

Re: Comment on Petition for Rulemaking: Prohibition of Requirement for Mask Wearing, Receipt of Vaccines, and Disclosure of Vaccine Status to Receive Medical Care

Dear Dr. Harp,

On behalf of the Commonwealth’s physicians, PAs, residents, and medical students, the Medical Society of Virginia (MSV) respectfully opposes Petition 362. The petitioner’s request would prohibit requirements for mask wearing, receipt of vaccines, or disclosure of vaccine status—jeopardizing the health and wellness of Virginia’s providers and patients.

The decision to maintain masking in healthcare settings by the CDC is evidence-based and in the best interest of the patient and the healthcare team. Healthcare settings should continue to abide by CDC guidelines. Similarly, the healthcare community strongly encourages all individuals to get vaccinated against COVID-19.

Physician practices, like any other business in the Commonwealth, have the autonomy to do what is best for their business and staff. The petition's ask would limit that freedom. When the mask mandate is lifted for healthcare settings, physician offices will continue to have the right to require patients seeking care in their space to wear a mask or be vaccinated -- the choice is theirs to either implement or not.

As an organization of healthcare providers, the MSV is supportive of measures that aim to protect Virginians from serious illness, reduce the rate of hospitalizations, and ease the overall burden on our healthcare system. We, therefore, respectfully ask you reject the petitioner’s request.

Sincerely,

Clark Barrineau
Assistant Vice President of Government Affairs and Policy
The Medical Society of Virginia

As further evidence the CDC "guidelines" in terms of required masking and forced "vaccinations" referenced by multiple commenters that supposedly are so effective  and necessary in preventing COVID-19 infections are utterly worthless, Bill Gates, former CEO of Microsoft Corp, declared that he contracted COVID-19 today. He is fully "vaccinated"and boosted. Add this to the list of millions of others who are fully "vaccinated" and boosted who have contracted this virus. Here is a list of others:

1. Hillary Clinton
2. Current Secretary of Defense Lloyd Austin
3. Comedian Stephen Colbert
4. Current Commandant of the Marine Corps David Berger
5. Chairman of the Joint Chiefs of Staff Mark Milley
6. Senator Elizabeth Warren
7. White House Press Secretary Jenn Psaki

Need I go on? When does this nonsense with forced masking and forced "vaccinations" in order to receive necessary medical treatment end? THE STATE OF VIRGINIA HAS DECLARED THE GRAVE DANGER FROM THIS VIRUS HAS ENDED. IT IS TIME TO RETURN TO NORMAL. WILL THE BOARD OF MEDICINE RETURN TO NORMAL OR REMAIN STUCK IN THE PAST RELYING ON OUTDATED DATA?

Then I realized they would have instantly realized their mistake but for a fishlike memory.

Perhaps trusting experts and their self-refuting statements is the best of all possible worlds.