Las Vegas Sun

March 28, 2024

Nevada doctor’s advice: Can’t wear a face mask due to illness? Stay home

Mask requirement leaves little room for exceptions among general public

Chavez

John Locher / AP

Ariana Chavez holds a mask up to her face after taking pictures at a closed and boarded up business due to coronavirus Wednesday, March 25, 2020, in Las Vegas. Local artists have been painting the raw plywood boards on shuttered businesses in the area know as the Arts District.

The directive that all Nevadans wear a face covering to limit the COVID-19 spread came with a few exceptions: Those with medical conditions making it difficult to breathe, those with a disability that prevents them from wearing a face covering, and young children ages 2-9 are exempt.

Businesses are required to make reasonable accommodations for customers who are inhibited by a mask due to a medical condition, said Dr. David Orentlicher, a UNLV law professor and director of the health law program.

The Americans with Disabilities Act dictates that businesses and government agencies should make “reasonable modifications” to face-mask policies. These accommodations could include allowing a person to wear a scarf or loose face covering, or full face shield instead of mask. It could also include providing curb-side pickup or no-contact delivery.

“If you are able to make an accommodation where they can shop at your store while still protecting other customers and employees, then yes, you should make that accommodation,” Orentlicher said.

If you have a severe illness that causes shortness of breath, such as pulmonary disease or severe asthma, it is possible wearing a face-covering could make you worse, said Dr. Traci Biondi, medical director at Prominence Health Plan in Reno.

But, she stresses, it’s a small minority of people. And those people should be at home during the pandemic because of being at a higher risk to exposure.

“If you are too ill to wear a mask in public then you should probably stay home to try to further reduce your exposure,” she said. “Ultimately, wearing a mask is an easy way you can help protect others in your family and community.”

The ADA requirement to provide “reasonable accommodations” does not apply to those who aren’t protected under the disabilities act. In some cases, businesses and agencies may be exempt from providing “reasonable modifications” if doing so would inflict an “undue burden,” fundamental alteration” or “direct threat,” according to the ADA.

An example of this would be a hair salon, Orentlicher said.

“You can’t really do curbside pickup for your haircut,” he said. “So where it gets tricky is when there’s a service where you have to be face-to-face with somebody.”

While most medical providers will typically wear PPE or an N95 when interacting closely with patients to protect themselves, it’s not reasonable to ask a hair stylist to do the same thing, he added.

For patients who can’t tolerate face masks due to a pulmonary condition, UNLV’s Dr. Evelyn Montalvo Stanton, who specializes in pulmonology, said it’s recommended they get an evaluation.

“If they need to come in, we try to use a face mask and then immediately when they get to the office, we check their oxygen level and see where we can go from there,” she said.

Masks can also hinder those who have severe anxiety, post-traumatic stress disorder or folks who are extremely sensitive to touch or texture, Montalvo Stanton said. “Sometimes you just need to train for children and adults slowly,” she said.

Wearing certain masks like the N95 for a prolonged period of time can cause breathing problems, but most masks and face coverings worn properly shouldn’t harm healthy people, Biondi said.

“An N95 looks like a mask but is actually considered to be a respirator,” she said. “A respirator will protect the wearer from exposure to small airborne particles including aerosolized viruses and bacteria. A cloth or surgical mask is a barrier to protect and prevent the spread of large droplets and respiratory particles.”

But not everyone can wear an N95 due to potential medical conditions related to breathing, Biondi said. She cautions those with severe respiratory diseases from wearing the N95 for long.

“Even health care professionals recognize that they must keep their N95 respirator on for only as long as necessary and they will take breaks when safe to do so,” she said.