Evolving views about mask wearing by populations (as opposed to vulnerable individuals)

https://www.theatlantic.com/newsletters/archive/2023/02/a-new-turn-in-the-fight-over-masks/673104/

The (Still) Unsettled Science of Masking

A new paper casts doubt on masks as a surefire COVID precaution—and people are already fighting about it.By Isabel Fattal

A masks-required sign is displayed on July 09, 2022 in New York City.
John Smith / VIEWpress / Getty

FEBRUARY 16, 2023, 5:34 PM ET

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“Masking has widely been seen as one of the best COVID precautions that people can take,” my colleague Yasmin Tayag wrote this week in The Atlantic. But a new review paper suggests that population-level masking might offer far less COVID protection than was previously thought—and, as Yasmin points out, the findings are already fueling Americans’ mask wars. I called her to find out more.

First, here are three new stories from The Atlantic:

A New Turn

Isabel Fattal: What do you make of this new review?

Yasmin Tayag: First of all, it’s done by Cochrane, a really well-regarded institution. So there are not that many concerns about this being a dubiously designed study. What it tells us is that the research on population-level masking suggests that that doesn’t really work. This means that mask mandates, or requiring an entire population to wear a mask, don’t do much to actually stop the spread of disease. This is different from individual-level masking, which we know a lot more about. If I wear a mask or if you wear a mask, we know that it’s still likely to be protective.

Isabel: You write in the piece that “the pandemic has presented many opportunities for the U.S. to gather stronger data on the effects of population-level masking, but those studies have not happened.” Why not?

Yasmin: There haven’t been a lot of those studies in the U.S. or worldwide. Part of the reason is that they’re difficult to set up because they require huge groups of people and are expensive. And they’re hard to do in practice, because to really look at whether wearing a mask can stop the spread of the coronavirus in a group, you would have to make sure that everybody in that group wears their mask properly all the time. But people are bad at wearing masks. It’s so hard to control for every single moment. Any instance in which someone might slip and take their mask off for a minute is a chance to confound the results. They might get the virus in that moment.

Isabel: Why is it so easy for Americans to fight over masking?

Yasmin: Unfortunately, masking has become so tied up with people’s political identity: Either you’re pro-mask or anti-mask. I personally have always been pro-mask, and so it can feel really unmooring to see a study like this done by a reputable group showing that what we believed to be true about masking may not actually be true. I think people at this point are unwilling to take in new information because it’s tough to change your mind yet again, or to grapple with new information yet again. And we’re tired of thinking about it.

RECOMMENDED READING

Isabel: You write in your article that the best time to learn more about masking is before we’re asked to do it again. What does this mean for future pandemics?

Yasmin: The Science desk at The Atlantic is very on top of the bird flu right now, which is showing some troubling signs of being able to jump to humans. If it does, we as a society will have to figure out, again, What are our mitigation strategies? Because bird flu is also a respiratory virus, like the coronavirus, masking would seem like an obvious choice. But now we don’t know whether telling everybody to mask makes sense. And if we don’t know that for sure, then enforcing a policy like that could just risk raising everyone’s ire again, for maybe not a good-enough reason.

Isabel: Right. And if public-health officials do recommend something that turns out not to be necessary, then they lose some of their capital to get people to do other things they may need to do.

Yasmin: Totally. Where we want to be is in a place where we can confidently enforce a public-health policy and know that it works, and be able to show the evidence that it works, so that there’s less public squabbling over it.

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