The masks conundrum: Masks yes, mask mandates no?

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.


  1. anat says

    For one-way masking to work one needs masks that are very effective for the infectious agent in question. Cloth masks are rather useless for COVID in this regard, but medical and above masks are pretty good. I have been wearing a fitted N-95 in all indoor public spaces for a long while now and intend on keeping wearing such masks for the long haul. (I also like not having colds!) I am fortunate that my work place has good quality air filtration systems in place (I know they work because open agar plates in incubators do not grow anything over the course of 72 hours) so I don’t worry about taking my mask off for lunch. I’m still concerned about how to time the long flights that would be required to visit family across the Atlantic.

  2. garnetstar says

    I’m also wearing my KF 94, very snug, mask in indoor public places, forever, if need be, and for the reason Mano states: it’s so un-onerous that I don’t care. So I just wear it, it’s nothing.

  3. billseymour says

    I doubt that we’ll see national mask mandates again, but it can happen locally in small ways where COVID cases are on the rise.  Here in St. Louis, Missouri, for example, the grocery store where I shop has resumed requiring masks for employees, but not for customers.  I never see more than a handful of people wearing masks when I go there.

    I always wear an N95 when I’m indoors (except home alone), and often outdoors as well if there are other people around.  As a 76-year-old with a bit of diabetes, I’m at high risk for the disease being severe, so I try to keep myself at as low a risk as possible for catching it to begin with.

    And since I tend to be fairly Utilitarian when it comes to small matters that are well understood, it seems to me that an even better reason for wearing the mask is to avoid becoming a vector for the disease myself.  (I could have an asymptomatic infection that I don’t know about.)  Unfortunately, concern for others is something that a great many Americans can’t even comprehend.

  4. seachange says

    Mano asked is it over. It was never going to be over? Viruses are viruses and behave like viruses. It’s what they do. The whole masky point across masky general society was the compassion either real or performative to; not overwhelm and cause massive failure the medical system. The plague rats won. Nevertheless, if you do actually value life, and we have plenty of reason to suppose you and many of your readers do, it -was worth doing-.

    It shouldn’t surprise anyone that the plague rats take many other anti-life positions.

    The general position to be taken now could be the general position usually taken about clothing (first ammendment) and protective clothing (if you are doing something that is dangerous it is okay or should be okay to wear it without social opprobium).

  5. invivoMark says

    It’s absurd to conclude that “mask mandates don’t work.” Masks should be part of a broader public health response, not the one and only thing we do.

    Overwhelmingly, the number one route of transmission is among members of the same household. People who live with each other don’t wear masks around each other, and if one member of a household gets infected, the whole household gets infected.

    Number two is among close friends and family who visit each other and spend time together indoors.

    Everyone but the most extreme antisocial hermit is part of a global overlapping social web of friends and families who all visit each other or cohabitate. So even if you could completely eliminate transmission in public settings — if masks were 100% effective all the time — transmission of SARS-CoV-2 would still be very high, and you’d still have navel-gazers pondering whether masks worked.

    Furthermore, even if masks don’t prevent transmission of the virus, they could decrease the severity of disease by reducing the total viral load that is transmitted.

    Mask effectiveness is very difficult to measure, as there are a billion confounding factors to any measurements, and masks shouldn’t be dismissed just because the data don’t immediately show an obvious benefit.

  6. says

    Medical setting? I mask up. This includes the dispensary.
    Out on the trails? Why bother? Though it might help my allergies a bit.
    Everywhere else, I judge on a case by case basis, and mask or not accordingly. Obviously, I mask up any place that requires it.

  7. says

    There are all these people who got Covid and are saying, “But I did everything right!” But did they? Did they start eating out or going to concerts/movies? Did they still try to social distance? Are there people they are around all the time without masks and are they 100% those people did everything right?

  8. steve oberski says

    @1 While cloth masks are less effective than N95 masks, they still provide a measure of protection.

    You have 56% lower odds of getting infected with a cloth mask (versus no mask), 66% with a surgical mask and 83% with a N95 mask.

    Effectiveness of Face Mask or Respirator Use in Indoor Public Settings for Prevention of SARS-CoV-2 Infection — California, February–December 2021

  9. maggie says

    Here in my part of Canada (Ontario) the last mask mandates are being lifted as of Saturday. Nursing homes and retirement homes seem to be the exceptions. I still mask up for shopping. Actually I double mask -- one for me and one for the general public. I guess I will play the wait and see game.

  10. jrkrideau says

    @9 Maggie
    Yes, Doug at his best again*. It was supposed to be June what? June 23?

    I have been thinking that I may upgrade from a cloth mask to an N95 as I use public transit and taxis fairly often.
    Our vaccination rates are in the low to middle nineties but still I see no reason not to mask in shared in-door spaces.

    Today I was in a deli, 100% staff masked, LCBO, 0% staff masked IIRC, and a Food Basics, maybe 40-50% . Every day the numbers of masked shoppers are dropping precipitous but I still see a lot of people with masks.

    In our Health Unit, area (~pop 200,000), today’s stats say 4 hospitalized, 1 ICU, 0 on ventilators, so things do not look too bad.

    *It’s kind of embarrassing to have to wonder if Rob was the smarter one.

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