In my trip to Boston recently, I distinctly got the impression that many people have decided that the pandemic is effectively, if not officially, over. While there was sporadic wearing of masks, most people were not doing so, nor did they seem to be making any effort to sit away from others on the airplanes, in the airport waiting areas, or the museums and other indoor venues I attended. While I usually wore my mask and tried to stay away from people, even I occasionally forgot. A friend of mine who just returned from a trip to Hungary and Poland said that masks were nowhere to be seen and people acted as if they were living in pre-pandemic times.
So is it over? Should we continue to wear masks? David Leonhardt discusses the issue.
From the beginning of the pandemic, there has been a paradox involving masks. As Dr. Shira Doron, an epidemiologist at Tufts Medical Center, puts it, “It is simultaneously true that masks work and mask mandates do not work.”
To start with the first half of the paradox: Masks reduce the spread of the Covid virus by preventing virus particles from traveling from one person’s nose or mouth into the air and infecting another person. Laboratory studies have repeatedly demonstrated the effect.
Given this, you would think that communities where mask-wearing has been more common would have had many fewer Covid infections. But that hasn’t been the case.
The idea that masks work better than mask mandates seems to defy logic. It inverts a notion connected to Aristotle’s writings: that the whole should be greater than the sum of the parts, not less.
The main explanation seems to be that the exceptions often end up mattering more than the rule. The Covid virus is so contagious that it can spread during brief times when people take off their masks, even when a mandate is in place.
Airplane passengers remove their masks to have a drink. Restaurant patrons go maskless as soon as they walk in the door. Schoolchildren let their masks slide down their faces. So do adults: Research by the University of Minnesota suggests that between 25 percent and 30 percent of Americans consistently wear their masks below their nose.
“Even though masks work, getting millions of people to wear them, and wear them consistently and properly, is a far greater challenge,” Steven Salzberg, a biostatistician at Johns Hopkins University, has written. Part of the problem, Salzberg explains, is that the most effective masks also tend to be less comfortable. They cover a larger part of a person’s face, fit more snugly and restrict the flow of more air particles.
During an acute crisis — such as the early months of Covid, when masks were one of the few available forms of protection — strict guidelines can nonetheless make sense. Public health officials can urge people to wear tightfitting, high-quality masks and almost never take them off in public. If the mandate has even a modest benefit, it can be worth it.
But this approach is not sustainable for years on end. Masks hinder communication, fog glasses and can be uncomfortable.
The country is probably never going to come to a consensus on masks. They have become yet another source of political polarization. Democrats are more likely to wear masks than Republicans, and Democrats who identify as “very liberal” are more likely to support mandates.
Fortunately, the scientific evidence points to a reasonable compromise. Because masks work and mandates often don’t, people can make their own decisions. Anybody who wants to wear a snug, high-quality mask can do so and will be less likely to contract Covid.
If anything, that approach — one-way masking — is consistent with what hospitals have long done, as Doron, the Tufts epidemiologist, points out. Patients, including those sick with infectious diseases, typically have not worn masks, but doctors and nurses have. “One-way masking is how we have always used them,” she wrote.
The same system can work for Covid outside of hospitals. Wachter, for example, believes that the time for mandates has passed but still wears one at the supermarket, in classrooms, on airplanes and elsewhere. Different people can reasonably make different choices.
I have decided to continue my practice of wearing the high quality N95 masks in all indoor setting. It is not onerous.