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‘Mask Up, America’ Made Sense in 2020. Now? Not So Much.

‘Mask Up, America’ Made Sense in 2020. Now? Not So Much.

Sunday, 14 November, 2021 - 05:30

The importance of masks to public health is fading as other pandemic-fighting tools emerge: highly effective vaccines, better tests and now powerful antiviral drugs. So it’s time to consider making masks optional in most settings.


It made sense to turn to masks when Covid-19 was spreading fast in the spring of 2020. The benefits weren’t (and still aren’t) measurable with the same kind of rigorous science that’s been applied to vaccines, but it was reasonable to assume that universal masking could slow the spread of disease and death when little else was available.


Vaccines aren’t perfect, but most of the 68% of Americans who are fully vaccinated are very unlikely to get sick enough to need to go to the hospital — and those who are more vulnerable because of their age or health problems can increase their protection with a booster shot.


More good news came this month. Pfizer Inc. announced Friday that its new Covid-19 pill reduced hospitalizations and deaths in high-risk patients by 89%; an antiviral medication developed by Merck & Co. won approval for use in the UK last week. Rapid testing is easier to get, so people can reduce the risk of spreading the disease to others if they want to visit vulnerable friends or attend a gathering. Other perceived risks can be safely discarded: Nobody is going to get sick by touching a grocery bag or going for a bike ride.


The number of hospitalized patients has fallen to half of the latest summer peak. The virus isn’t going away, but its menace is subsiding. That should make it possible to reconsider the shrinking benefits of masking and especially mask mandates against real costs that public-health authorities have been loath to acknowledge.


Even many of the experts who pushed for universal masking are calling for a reversal. “This isn’t about whether masks work,” said Joseph Allen, an assistant professor at the Harvard University School of Public Health. “I wrote a piece in April 2020 saying everyone needed to wear a mask … but now we have other tools in place, and this is why I don’t think mask mandates make sense anymore.”


It’s not that people should stop caring about the virus. But as risk-communication expert Peter Sandman has said, any policy people don’t follow is a bad policy, and at this point, people are unlikely to follow a policy that asks them to wear a mask in all work and social situations for the foreseeable future. What was a minor inconvenience for weeks and months looks a lot more burdensome as a new way of life.


Masks can make people unhappy. They stifle communication and human interaction — affecting business and social activity. That’s why people — even those making the rules — often take them off in private to interact and socialize. Along with other restrictions, unnecessary masking is contributing to an epidemic of isolation, loneliness and poor mental health.


Many experts think masks interfere with education as well. “As someone who has been out and about in the world, and I have young kids, I see that it impacts socialization and learning,” Allen said.


Masking also amps up resistance to returning to the office, which many employers consider a necessary part of restoring prosperity and business efficiency. Just let the worried stay home.


There’s strong consensus that unvaccinated adults should still use masks, and those who are still fearful even after three shots can feel even more protected if they wear a high quality mask such as an N95. There may be a need for temporary mask mandates in places where an outbreak threatens to overwhelm the hospitals.


There are ways to make life safer without counting on mask mandates. Public health authorities could provide more useful information to estimate risk and minimize it by avoiding the most dangerous situations. It’s still not clear, for example, if supermarkets really pose much danger. And better information is needed on when and how to use rapid tests.


But it’s past time to stop acting as though everyone must be treated as equally imperiled. Reality-based policies that take into consideration the way humans behave and interact should replace one-size-fits-all dogma.


Young, healthy people who are fully vaccinated are very unlikely to end up hospitalized with Covid-19. And the risk a vaccinated person poses to others is very small, said Amesh Adalja, a senior scholar at the Johns Hopkins School of Public health. “For fully vaccinated people, I think there’s marginal benefit to mask wearing,” he said.


Listen to an interview with Dr. Amesh Adalja in an episode of Faye Flam’s podcast, Follow the Science, which explores the distinction between scientific ideas and chatter, speculation, sanctimony, hype and noise.


Harvard’s Allen said he finds it shocking that there’s so much pushback against exploring de-masking even as most Americans of all political stripes privately interact without masks.


He and Adalja agreed that trust in public-health leaders matters, and that trust has been eroded by months of restrictions that made no sense or were counterproductive — such as closing down parks and beaches or making people wear masks while far away from others outdoors. Most public health officials failed to tell people for many months that they were extremely unlikely to get the disease from the mail or groceries.


Adalja said he favors what he called a harm-reduction approach to public health rather than abstinence-only. The terms originated in the earlier years of the AIDS pandemic, when abstinence-only advocates thought HIV-positive patients should give up sex. That wasn’t going to happen, nor will humans let Covid-19 force them to abstain from many other forms of human interaction. There are too many rules and not enough clear, science-based advice about which activities are riskiest.


“I think it’s important for people to learn to live with this virus,” Adalja said.


That means people who are still fearful or vulnerable should be free to work from home. As for the rest of us, living with risk is just part of living. It reasonable for people to want to go back to showing their faces and living their lives.


Bloomberg


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