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Are there medical causes to not put on a masks? Sure, however not many

When Amber Lynn Gilles was refused a job by a San Diego Starbucks barista in June, she brought her frustrations to Facebook: "Meet Starbucks leans who refused to serve me because I am not wearing a mask. Next time I'm waiting for police officers and bring a medical exception. "

After collecting a $ 100,000 GoFundMe ride for barista Lenin Gutierrez (whom Gilles claims she owns), she handed over her medical records – a 2015 pelvic exam and a handwritten note from a local chiropractor in the "underlying breathing conditions" were noted. ""

Probably the most well-known attempt to use a disease to bypass a mask request is hardly the only one. Similar scenes have dissolved in North Hollywood, Dana Point and San Luis Obispo – and only in grocery stores in California.

Some airlines have reached a break point. American, Southwest, JetBlue and Alaska Airlines and Spirit Airlines no longer allow medical exceptions.

Exceptions for medical masks vs. no mask, no service

Viral videos and the proliferation of meaningless exception cards available for sale online have led to widespread public skepticism about health-related mask exceptions.

The problem became even more complicated in the United States, where political partisanship and claims of excess government and personal rights confused mask habits during the pandemic.

Misinformation doesn't help either. Some believe that simply citing the presence of a "medical condition" provides automatic protection under the Disabled Americans Act (ADA), which is designed to prohibit discrimination against people with disabilities, thereby enabling them to circumvent mask requirements.

Disabilities in the context of the ADA are, however, case-specific and require an individual assessment.

"The person would have to demonstrate that they are a legal disabled person who has specific legal standards and is not always easy or straightforward to do," said Professor Jessica Roberts, director of the University's Health Law & Policy Institute of Houston Law Center said USA Today.

Few diseases are really not compatible with all forms of mask wearing.

Mical Raz and Doron Dorfman

JAMA health forum

In addition, the ADA allows restrictions if a person poses a "direct threat to the health or safety of others". In March, the Equal Employment Opportunity Commission noted that the Covid 19 pandemic reached this threshold.

The Northwest ADA Center, part of the ADA National Network, believes that businesses should have the right to rely on the guidelines of the Centers for Control and Prevention of Disease (CDC), as well as instructions from states and local governments Justifying policies that masquerade prevent customers from entering their stores.

"In certain circumstances, a customer may not be able to wear a face mask for health reasons," says an article on the center's website. "In that case … a company may not need to change the required face mask guidelines, but should definitely try to accommodate that customer in an alternative way … providing roadside pickup, no contact delivery or online store support -Services. "

So what are the medical reasons that prevent you from wearing a mask?

While the standards set by state and local governments as well as private companies vary, the CDC states that masks should not be worn by:

· Children under 2 years old

· Anyone who has difficulty breathing

· People who are passed out, unable to act or otherwise unable to remove the mask without help

The problem lies mainly in the nebulous middle category – a health problem with a number of possible underlying diseases.

Chronic lung disease in itself is likely to be a compelling reason for masking rather than a category of exceptions.

Mical Raz and Doron Dorfman

JAMA health forum

Asthma is a common condition that causes breathing problems. According to the CDC, more than 25 million Americans have asthma, or about 1 in 13 people. However, doctors advise that most asthmatics can safely wear masks.

"For people with very mild asthma or well-controlled asthma, this will likely not be a problem," said Dr. David Stukus, a member of the Medical Scientific Council of the Asthma and Allergy Foundation of America (AAFA), in an article on the organization's website. The UK charity Asthma UK agreed and said on its website: "Most people with asthma can wear a face mask or face mask for a short time, even if it's hard."

But what about chronic lung diseases like chronic bronchitis and emphysema?

In an article published on July 10, 2020 entitled "Mask Exceptions During the Covid-19 Pandemic – A New Frontier for Clinicians", the authors argue Dr. Mical Raz and attorney Doron Dorfman that people with these conditions may have more reasons to mask themselves.

"Chronic lung disease in itself is likely to be a compelling reason for masking rather than a category of exceptions," Raz and Dorfman write in the JAMA Health Forum.

The danger is twofold, it is said. People with chronic lung disease are at higher risk of serious illness if they become infected with Covid-19. You would also be at greater risk of spreading it to others due to chronic cough related to your medical conditions.

Without recommending blanket exceptions for these groups, the CDC recognizes that people with sensory sensitivity, intellectual and developmental disabilities, and mental illness may have difficulty wearing masks.

Mark Liddell | Moment | Getty Images

The article states that this applies to "lung disease without active exacerbation" and advocates the issuing of clear guidelines based on objective measures to help clinicians determine mask relief.

By stating that "only a few diseases are really incompatible with all forms of wearing a mask", the authors acknowledge the existence of conditions that go beyond the recommendations of the CDC and can make wearing masks more difficult.

"Some people, especially children with sensory processing disorders, may not be able to tolerate masks. Facial deformities that are incompatible with masking are an additional exception category."

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