Given what I have seen of mask usage in practice, I do not think they will be helpful in the U.S. except maybe to delay infections by a few weeks. I agree with the Swedes and the WHO that this is likely to be a multi-year experience with the coronavirus. And there will likely be another similar virus right behind this one. So I think we would slow down viral spread more effectively by restructuring our physical environment so that it isn’t relevant whether people are using a bandana improperly (or wearing a mask with an exhaust valve, which I see regularly among the righteous of Cambridge), etc. More stuff could happen outdoors under shade structures, for example.
I wonder if the mask is like Linus’s security blanket in Peanuts. People like to believe that they can control their fate. We hear that someone died of cancer and ask “Did he smoke?” The person is dead so it shouldn’t matter, but we want to know because we want to be assured that we won’t be killed by a random cancer and that we can extend our lives by clean living. The “science” as of March (and through early June at the WHO!) was that masks wouldn’t protect 8 billion humans from spreading coronavirus. But we didn’t like that answer so “science” gave us a new answer. It is highly comforting because we are controlling our fate, not living or dying depending on the whims of the virus and the accidents of geography (Maine versus Massachusetts, for example, a 14:1 difference in death rate).
Like most people, I hope that the universal mask laws can have some beneficial effect. But I fear that we are setting ourselves up for yet another disappointment and we will whip ourselves for not doing a good enough job. Yes, we wore masks, but too many of us did so without covering our noses. Yes, we wore masks, but that led too many of us to abandon the 6′ social distance. We wouldn’t have had a death rate comparable to Sweden’s if only we had…
This is kind of like the difference between Greek/Roman religion and Christianity. If the barbarians attack and burn your Greek/Roman city, you say “That was a terrible experience, but the gods are capricious sociopaths so we will just have to rebuild as best we can.” If the same thing happens to a Christian, he/she/ze/they must say “God is benevolent and omnipotent, so it must have been our wickedness that led to this bad outcome.”
I wonder if there is a mask experiment happening for us right now. Massachusetts and New York had a big surge in infections and then deaths back before any mask laws went into effect (May 6 here in what is now “Maskachusetts”). Florida and Texas have come out of shutdown. They are pretty well masked. We would expect the arc of the epidemics there to be less dramatic than in NY and MA due to (a) a bunch of restrictions still in place, e.g., no mass gatherings, (b) nursing homes much better protected than in MA or NY. But is the arc yet more attenuated in a way that we can perhaps attribute to Floridians and Texans being under mask orders?
- “Flu Masks Failed In 1918, But We Need Them Now” (HealthAffairs): In 1919, Wilfred Kellogg’s study for the California State Board of Health concluded that mask ordinances “applied forcibly to entire communities” did not decrease cases and deaths, as confirmed by comparisons of cities with widely divergent policies on masking. … Second, the review of practices in 1918 demonstrates masks must be worn correctly and consistently, fully covering the nose and mouth, with sufficient layers to prevent the spread of droplets. Advocates for masks in 2020 can use this historical lesson to argue that masks must be worn properly, or they will not achieve their objectives. [Summary: this time it is different and Americans will be as good at using masks as surgical nurses]