Fact Check

Did Fauci Blame Mask Use for 1918 'Spanish Flu' Deaths?

Masks definitely aren't responsible for mass deaths today.

Published Oct. 26, 2020

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Dr. Anthony Fauci blamed mask use for the majority of deaths during the 1918 flu pandemic.

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In October 2020, after more than 225,000 people had died in the United States and after the repeated insistence from public health officials that mask use helped slow the spread of COVID-19, rumors continued to circulate on social media that attempted to negate the use of this simple protective device. One such rumor claimed that Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID), had written in a 2008 study that mask use was responsible for many of the deaths during the 1918 flu pandemic.

Another Facebook user wrote: "Dr. Fauci saying masks should be mandated. Even though in 2008 he wrote a paper saying the MAJORITY OF THE PEOPLE THAY DIED IN THE 1918 SPANISH FLU DIED FROM SECONDARY BACTERIAL PNEUMONIA AS A DIRECT RESULT OF THE USE OF FACE MASKS."

Fauci did not blame mask use for any deaths that occurred during the 1918 Spanish flu. In fact, the paper mentioned in the above-displayed Facebook posts doesn't even mention masks.

In October 2008, Fauci co-authored a paper published in The Journal of Infectious Diseases about the role that bacterial pneumonia played during the 1918 flu pandemic (commonly referred to by the misnomer "Spanish flu"). An estimated 50 million people died during the 1918 flu pandemic, with approximately 675,000 of those deaths taking place in the United States. The paper co-authored by Fauci in 2008 found that these deaths weren't caused by the flu alone, but that the majority "likely resulted directly from secondary bacterial pneumonia."

Fauci said in a contemporary news release:

"The weight of evidence we examined from both historical and modern analyses of the 1918 influenza pandemic favors a scenario in which viral damage followed by bacterial pneumonia led to the vast majority of deaths ... In essence, the virus landed the first blow while bacteria delivered the knockout punch."

While some social media users presented this study as a cautionary tale against mask use — incorrectly claiming that it was the masks that were responsible for the development of bacteria — Fauci's paper actually highlighted the need to stockpile antibiotics and bacterial vaccines as well as antiviral drugs and influenza vaccines in order to properly combat a pandemic.

Another excerpt from this news release explained:

The majority of deaths during the influenza pandemic of 1918-1919 were not caused by the influenza virus acting alone, report researchers from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Instead, most victims succumbed to bacterial pneumonia following influenza virus infection. The pneumonia was caused when bacteria that normally inhabit the nose and throat invaded the lungs along a pathway created when the virus destroyed the cells that line the bronchial tubes and lungs.

A future influenza pandemic may unfold in a similar manner, say the NIAID authors, whose paper in the Oct. 1 issue of The Journal of Infectious Diseases is now available online. Therefore, the authors conclude, comprehensive pandemic preparations should include not only efforts to produce new or improved influenza vaccines and antiviral drugs but also provisions to stockpile antibiotics and bacterial vaccines as well.

In other words, this paper did not blame mask use for causing these bacterial infections. That connection — that mask use is actually dangerous because it causes bacterial infections — was made by social media users and is one that has been repeatedly shot down by experts.

In June 2020, The Associated Press investigated the false claim that mask use leads to bacterial pneumonia. Davidson Hamer, infectious disease specialist and professor of global health and medicine at Boston University, said at the time:

“There’s no evidence of masks leading to fungal or bacterial infections of the upper airway or the lower airway as in pneumonia."
There’s no evidence that wearing face masks cause any harm besides some discomfort, Hamer said. However, he added paper masks that become visibly wet should be discarded.
"It’s so highly unlikely with normal mask use. There’s a real danger at spreading incorrect information like this, especially at a time when we really need to be encouraging more people to wear masks."

Reuters spoke with the global team of health experts at LeanAboutCovid19.com, and were told that there was "no evidence" that regular mask use increased the risk of developing any “bacterial, fungal or viral infection in the lung."

A statement from LeanAboutCovid19.com reads:

"In fact, according to a study published in the Preventive Medicine journal, wearing face masks is shown to protect people against bacterial infections in hospital settings, where health care workers are most prone to antibiotic-resistant  bacteria.”

Doctors at Lawrence Memorial Hospital in Lawrence, Kansas, also addressed this claim in an article debunking common mask myths. While one doctor noted that it was important to clean masks to prevent bacterial build-up, both noted that regular mask use does not lead to bacterial, fungal, or viral infections.

Am I breathing in more bacteria or virus if I wear a mask?
Dr. Brychel: If utilized and cared for properly, no. However, it is important that you either clean or exchange your mask at least once a day because masks can accumulate environmental particles, including virus, bacteria and fungi.

Dr. Penn: No. There is no evidence that masks lead to bacterial, fungal or viral infections of the upper or lower airway. However, masks that become soiled should be replaced and masks should not be worn for more than one day before laundering (if cloth) or replacing.

In short:  In 2008, Fauci co-authored a report stating that the majority of deaths during the 1918 flu pandemic "likely resulted directly from secondary bacterial pneumonia." This paper did not state that this secondary bacterial pneumonia had been caused by mask use. In addition to the fact that this study doesn't mention or deal with masks, a multitude of experts have since dismissed the notion that masks increase the risk of bacterial infections.


Lajka, Arijeta.   "Normal Use of Face Masks Do Not Cause Pneumonia."     Associated Press.   24 June 2020.

Reuters.   "Fact Check: People Have Not Been Developing Antibiotic-Resistant Pneumonia From Wearing Face Masks."     23 September 2020.

Reuters.   "Fact Check: Fauci Study Did Not Attribute 1918 Spanish Flu Deaths to Bacterial Pneumonia Caused by Masks."     22 October 2020.

National Institute of Health.   "Bacterial Pneumonia Caused Most Deaths in 1918 Influenza Pandemic."     19 August 2008.

Morens, David, Taubenberger, Jeffrey, and Fauci, Anthony.   "Predominant Role of Bacterial Pneumonia as a Cause of Death in Pandemic Influenza: Implications for Pandemic Influenza Preparedness."     Journal of Infectious Diseases..   1 October 2008.

Dan Evon is a former writer for Snopes.

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