Before every fashion retailer sold their own cloth cover, before a piece of cloth over their nose and mouth became a personal political statement, and before Goldman Sachs said a national face mask mandate is so Good as a closure, Lara Martin wasn’t sure if homemade cloth masks were even a good idea.
The executive director of the United Methodist Relief Committee, Martin was one of the people I interviewed in March for a story about mask science. Back then, I discovered that the masks were an excellent example of the scientific uncertainties that revolved around the new coronavirus. Remember, the Centers for Disease Control and Prevention and the general surgeon once told the general public no wearing masks The data that existed on the effectiveness of masks mainly concerned medical respirators and surgical masks. It was unclear how protective a cloth mask would be, and Martin was concerned that wearing masks could make people feel safer than they actually were, and make decisions that increased their risk of contracting or transmitting COVID-19.
Today, many things have changed. But the science around cloth masks has not.
Yes, the CDC now recommends fabric face liners, the surgeon general starred in a video showing how to do them, and many companies, and even cities, require them. Martin herself owns three and uses one each time she leaves. But she told me that it is not because the evidence has improved significantly. “I don’t know enough, I don’t see enough evidence. Nothing has changed except that I care about my neighbors, I care about my colleagues, I care about the people I don’t even know what I find in the grocery store, “he said.” Now I tell my community that I care about them. And that really seems important to me as a scientist. “
Cloth and DIY face masks meet at the intersection where scientific data, public perceptions, and political views collide head-on. Making smart decisions isn’t just about having data, it’s also about how we interpret the data we have. Security moves along a spectrum with different relative levels of risk. Standards of behavior also matter, regardless of the amount of evidence to support them. In the midst of a pandemic, masks are a reminder that science is rarely as simple or as safe as we want it to be, and that reasonable public health recommendations are sometimes based on more than just data.
Do fabric face liners work? Probably, up to a point. But how much they work depends on the material, how they are used and what you hope they will achieve. And regardless of what you’ve seen in highly sharable memes, we definitely don’t know enough to say that using these types of covers will reduce the risk of transmission by a specific percentage, let alone a high percentage. Those were the conclusions of an expert report published by the National Academies of Sciences on April 8, and two of the lead authors of that article recently told me that science has not changed significantly since then. Some studies have been published showing a correlation in certain regions between masking mandates and reduced coronavirus spread, but several of those studies not yet peer-reviewed have been found to have significant flaws, such as failing to account for factors. as well as other behaviors (such as higher rates of social distancing) that accompanied the use of masks in those places.
Instead, experts say what has changed is how public and public health institutions interpret this situation and the data surrounding it.
“In March, it was hard even for someone to take you seriously when the CDC and the WHO said otherwise,” said Jeremy Howard, a data scientist and entrepreneur who has become a leading advocate of universal mask requirements. In response to the lack of support, he launched a bipartisan campaign called Masks4All that lobbied for the widespread use of masks and argued that masks were a crucial, if not the most important, part of the COVID-19 response.
But Howard has also seen changes in the way that political actors interpreted his message. In March, he told me, before not wearing a mask became a signifier of conservative politics, Howard really had the most traction in talking about the need for masks on conservative news shows. “Going against the CDC was very much on the mark,” he said. “I was in” Laura Ingraham’s Angle “talking about important masks and she was ready for it.”
When political alignments changed, that support disappeared. Although most Americans report that they wear masks regularly, those numbers are 16 percentage points lower among Republicans compared to Democrats. In the past week, that started to change again, with Republican leaders advocating the use of masks and criticizing President Trump for not wearing one. The politicized landscape has also made it difficult to have a nuanced conversation about the mask’s effectiveness, experts said. Public health officials who issued mandatory orders to wear masks have been beset by intense criticism and even death threats. More than two dozen have resigned in the past few weeks.
At the same time, Michael Osterholm, a public health and disease expert who fears the mask’s effectiveness will be exaggerated, has also been threatened and harassed. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, told me that he received vulgar emails from people who read his statements questioning the efficacy of cloth masks. Osterholm said his position was not that masks should not be worn (he wears one himself in public), but that there is limited data on how effective DIY cloth masks are to stop small particles, whether they pass through or are seen. forced to leave. sides of the mask. Without that information, he said, physical distancing and isolation remain the most important tools to stop the spread of the coronavirus. But as more Republicans say the worst of the coronavirus is behind us, and the use of mask tracks closely across the partisan spectrum, Osterholm told me that he felt that well-meaning people made him look like a pandemic denialist.
The intermittent, yes, no nature of this debate has also been frustrating for Dr. Marcella Núñez-Smith, professor of medicine and epidemiology at Yale. Circumstances may mean that for some people the benefits of wearing a mask may not outweigh the risks. “There are conversations in many black and brown communities …”[Does] Does the risk and threat in terms of personal safety increase with a mask due to police action and being seen as a threat? “, said.
At the same time, however, Núñez-Smith said that the masks could be more important to those communities because the distancing and isolation favored by experts like Osterholm has not really been possible. Black workers are more likely than other workers to have jobs classified as essential. So reopening means something different for predominantly black neighborhoods than it does for white neighborhoods. That also applies to the idea of social distancing and how practical it is, something that could explain why the use of self-reported masks is higher among non-white Americans, despite the possible police risk. “These are important contextual conversations,” said Núñez-Smith.
Ultimately, experts said, all the nuances and complications surrounding the masks are a challenge that public health messages must face. It is difficult to make one-size-fits-all recommendations for situations that do not lend themselves easily to a one-size-fits-all reality.
The good news is that there is more agreement than disagreement about where to start. Just look at Osterholm and Howard, two experts who could easily be considered to have opposing views in this battle. However, they hold similar positions on one issue: They both wish the CDC had provided nuanced information about the masks to the public in March and hoped they would understand it. Okay, that could mean presenting a complex message to the public, such as: “We don’t know how well cloth masks work, so distancing should come first, but masks are likely to work to some extent and not all. can distance yourself. “It’s a bite and harder to put on a bumper sticker than” yes, you should “or” no, you shouldn’t. “But it all comes down to what builds the most trust: certainty or honesty?
“We owe it to the public to help them understand what kind of protection they are receiving,” Osterholm said. “We owe it to the public to tell them what we know.”
