Shelly Lewis approached the California supermarket with a script in mind.
“Hi, I have a medical condition that I’m not allowed to wear a mask and I’m not required by HIPAA rules and regulations to disclose that,” Lewis told a supermarket manager, who nonetheless explained that she would not be allowed inside without a protective face mask. “You’re discriminating against me now, do you know that? You’re discriminating against me.”
Lewis, a prominent member of the Flat Earth movement, recently uploaded footage of the encounter online, where it went viral even after she deleted it. A re-upload on Twitter currently has 5.4 million views.
But across the internet, in circles decidedly less fringe than Flat Earth, Americans are spreading disinformation about medical laws that allegedly exempt them from wearing face masks amid a pandemic that has killed over 90,000 people in the United States. Earlier this month, a set of memes began instructing COVID-19 skeptics (many of them conspiracy theorists or conservatives) to lie about having a medical condition in order to avoid masking up. One meme, which was amplified by an erstwhile Republican congressional candidate, tells readers to cite laws like the Americans with Disabilities Act (ADA) and the Health Insurance Portability and Accountability Act (HIPAA) to essentially trick people who ask them to wear protective gear.
The memes aren’t just annoying for frontline grocery-store workers who have to enforce masking rules. They undermine regulations written for people with legitimate disabilities, experts said.
Lawrence Gostin, a Georgetown University professor specializing in public health law, said some people do have real health concerns that could give them ADA protection to avoid a mask—even amid the COVID-19 pandemic.
“If they have severe breathing difficulties—asthma, or other significant respiratory problems—if a mask makes their breathing more labored, they’d be protected under the ADA,” Gostin told The Daily Beast. “But you need to be able to demonstrate that you’re disabled. It can’t be an idle claim.”
The anti-masking backlash seeks to exploit that very grey area.
An early iteration of the meme, flagged by fact-checking site Snopes this month, called it a “mask loophole.” The original post, in a conspiratorial Facebook group, offered a script to follow. It told readers to falsely claim they had a medical condition that prohibited wearing a mask. If questioned, the person was told to answer that “according to HIPAA regulations, you’re not allowed to ask me that. Please don’t discriminate against those who can not wear masks.”
That is not how HIPAA, an act that prevents health-care workers from sharing your medical details, works. People like Lewis tried using the script anyway.
The earlier Facebook post has since been refashioned with a more formal-looking image, adding photoshopping on an ADA logo, as well as legal gobbledegook threatening a $75,000 violation for businesses that ask a person why they aren’t wearing a mask. Shortly after the images emerged, believers began spamming them into the comments sections for local businesses.
Two of the most popular memes in this genre look like hall passes that can be printed out and stuffed in the hands of Walgreens workers. “ATTN government agents,” reads one. “Please provide lawful and necessary consideration to aid the bearer in the unimpeded exercise of constitutionally protected rights.” The other includes the mailing address of the Justice Department’s Civil Rights Division, vaguely implying the flyer might be federally sanctioned.
Both misspell HIPAA as “HIPPA.”
As with many successful disinformation ploys, the claims have a kernel of truth. If a person has a legitimate disability that prevents them from wearing a mask, the ADA might require businesses to let them in. But even in the case of a legitimate disability, Gostin noted, a business would be legally allowed to bar a person who was “endangering the public.”
And if a person were to prove medically unable to wear a mask, it would only be doubly important for those around them to wear protective equipment.
“A person with asthma or other respiratory problems is a highly vulnerable individual,” Gostin said. “If they were to get COVID-19, it’d be a stronger likelihood that they might get a very serious illness, resulting in hospitalization or death. They’re more likely to contract the illness if exposed, so we need widespread masking to protect persons with disabilities.”
Nevertheless, the supposed anti-mask pass seemed to be creeping toward the mainstream. One popular version, with hundreds of shares, was uploaded by a Flat Earther on Facebook. (For all anti-maskers’ gripes that masks are tyrannical, the uploader had liked the Facebook page for an openly pro-Nazi Flat Earth YouTuber, who recently released a rap with the lyric “you are blind so fuck what you say, I’ll expose the flat Earth and Heil Hitler all day.”) Longshot ex-congressional candidate James Marter shared one version earlier this month.
Mistrust in institutions, like public health organizations, can help make people more susceptible to health hoaxes, like the HIPAA meme. Such appears to have been the case for Lewis, the California woman whose showdown at the grocery store went viral.
Lewis often speaks about being diagnosed with lupus and losing faith in the medical field, though she has said she overcame the illness by eating healthy food and natural supplements. (Lupus may be covered by the ADA, but advocacy groups have encouraged people with the disease to wear a facemask during the pandemic.) Prior to her diagnosis and her conversion to Flat Earth belief, she wanted to be an astronaut—a profession ridiculed by Flat Earthers who believe space is fake.
“I jumped from job to job and doctor to doctor,” Lewis said in an interview at a Flat Earth conference in November 2019. “No doctor could really help me. ‘This is lupus, sorry, just take medication the rest of your life.’ Long story short, I got the medical discharge, and kept getting sicker and sicker. I basically just said there’s gotta be a better way. I started looking into alternative medicine.”
In 2014, when she started watching Flat Earth videos on YouTube, her prior medical skepticism helped shape her new worldview.
“Most people don’t test [space travel] because we’ve been taught that rocket science is hard. We need to leave it to the professionals,” she said. “We don’t question our doctors.”
Lewis deleted her Facebook account this month after her mask video went viral.