Opinion: Wear A Mask to Support The War Effort

I am dismayed and disheartened that the American people still broadly fail to understand the cultural and epidemiological importance of wearing masks in public as we move deeper into the COVID-19 Pandemic of 2020.

As the tragic failure of the American response to the early phase of this battle becomes more clear (U.S. Coronavirus Cases Surpass Those of China, Italy), it’s important to avoid compounding our early errors as we fight this war against the virus (on all three fronts).

Covering your mouth and nose can help limit the transmission of the virus, because it physically limits the quantity of “droplets” (tiny pieces of moisture) expelled into the environment when you breathe, cough, talk, or sneeze. It can also reduce the droplets you consume through your nose and mouth that are expelled into the air by others.

Limitation of droplets reduces transmission; reducing transmission saves lives.

Media, health authorities, and public officials hurt public trust and weakened our collective response to the crisis in the early phase of this pandemic by sharing misleading information (perhaps with a misguided strategy of attempting to save the depleted stockpiles of masks we have).

They also told us we couldn’t figure out how to wear masks, which is counterproductive. Of course we can.

This contributed to confusion and is an example of how not to communicate with the public during times of crisis. Transparency and honesty is key: Americans should be told the truth so that they can make decisions for themselves. Otherwise, we’ll figure it out eventually, and trust the government less.

That truth is that all Americans should wear facemasks (medical, homemade, or anything that covers their face) when they are in public.

If masks cannot be purchased, they should be made. And if masks cannot be made, people should cover their nose in mouth with anything else as a substitute — a scarf, a bandana, a handkerchief, or even a diaper. Masks aren’t a panacea and they won’t save you from getting sick, but they help.

Some Perspective

While COVID-19 is new and novel, coronaviruses more broadly, pandemics that sweep across populations, shortages of medical supplies during such times, and crisis communication principles are all age-old, well understood, and heavily studied topics.

We know that the spread of virus droplets the size of a coronavirus can be limited — at least to some degree — by even basic household materials (which makes the “only N-95 masks help” trope foolish). We also know that “viral load” (e.g., how much of the virus you are exposed to) may matter in how sick you get.

We know that a standard part of the epidemic management toolkit is to recommend sick people wear masks during an outbreak.

We know that our doctors and nurses will face a shortage of masks and other medical supplies (without wading into who is to blame for that).

And we know that our early response to the crisis has been tragic.

Bending The Curve

Wearing masks in public places became a part of the public cultural scene in many Asian countries after the outbreaks of SARS in China, Taiwan and Singapore in 2002 and 2003.

Wearing a mask, on a micro level, does more to protect others than it does to protect the wearer, indicating a display of outward societal respect in Asian cultures that has thus far failed to manifest itself in American culture. If you are sick, it’s harder for you to infect others if you have a mask on.

Wearing a mask, on a micro level, does more to protect others than it does to protect the wearer, indicating a display of outward societal respect in Asian cultures that has thus far failed to manifest itself in American culture. If you are sick, it’s harder for you to infect others if you have a mask on.

In early March, Dr. Pak-Leung Ho, the Head of Centre for infection at HKU Med said that the success in Hong Kong in decreasing the spread of the virus there was due to the stepped-up vigilance of the community, and specifically highlighted universal mask-wearing as one of the reasons widespread outbreak didn’t occur.

Other countries that have “bent the curve” and limited the spread, including Korea, China, and Taiwan, through vigilant monitoring, early intervention, and widespread testing, also have another thing in common: the widespread public use of masks.

Medical Supplies For Our Heroes

Many people rightly ask about the morality of wearing or buying masks given the shortage of medical supplies that are needed by our doctors and nurses, the heroes in this battle against the virus fighting on the front lines. Doesn’t buying masks limit the masks available to our heroes?

This is the right question to ask, as now more than ever, society must do all that we can to support our heroes as they enter battle.

Now more than ever, society must do all that we can to support our heroes as they enter battle.

People should not hoard masks, and if you have more masks than you need, you should call your local hospital and donate them, or call your elected officials and ask them where you can bring them. If you are willing and able, you should make your own masks at home and contribute them the same way. Pressuring your elected officials to do more on this front is also effective — call them and tell them this is what you want them to do in Congress.

But public officials must tell the painful truth: that we have failed to build an appropriate supply of medical masks to deal with the pandemic, despite warnings of experts over the years — and the only way to dig out of the hole we have is to manufacture our way out of the crisis.

Our government should make a full-scale “War Effort” — up to and including the outright seizure and nationalization of manufacturing facilities — to get our heroes the equipment they need.

But this is a problem at scale that needs to be solved at scale. Unfortunately, if you have masks available to you on retail shelves (you probably don’t), those aren’t the masks (or enough of them) to solve the problems at our hospitals.

The only solution there is a wartime manufacturing effort.

Furthermore, every person wearing a mask helps reduce the spread of the virus. The best way to save our heroes on the front lines is to send fewer people into hospitals. By encouraging (or even mandating, as they did in China) everyone to wear masks, we help achieve that goal.

Asymptomatic Carriers

One of the pernicious things about COVID-19 is that there can be a long period of time where people with the virus do not feel sick, and there may be massive numbers of people who are “asymptomatic carriers” that can spread the disease but never experience sickness themselves.

The W.H.O. and the C.D.C. both say that facemasks decrease the odds that infected people will infect others, and obviously recommend that doctors and nurses wear masks.

Given both of these facts, the obvious conclusion is that everyone should use them. Assume that everyone has the disease, everyone is a carrier, and behave accordingly.

Wearing a mask is the best way to increase the odds that, if you are carrying the virus, you don’t spread it to others when you go to pick up your groceries or get your medical supplies.

The Uniform of Victory

My guess is that we will finally be riding down the epidemic curve when a preponderance of Americans are wearing masks in public, realizing the importance of communicating communal respect, sincerity, and solidarity in battling the virus to anyone that lays eyes on them.

Right now, when I go out into the community wearing a mask, others look at me as though I am odd. Its the same look I’ve gotten since wearing a mask through airports and train stations since I began to do so in late January (we live in Fairfield County, Connecticut, not far from New York City, which now may be the worst outbreak cluster in the world). It’s the same look I have gotten from people who explained to me in February that this was “only the flu.”

My guess is we’ll be on the right side of the peak when those who don’t wear masks are made to feel uncomfortable by the looks they are getting from those who do. Not wearing a mask should be (and I believe, eventually will be) seen as a sign of putting others in your community at risk.

My guess is we’ll be on the right side of the peak when those who don’t wear masks are made to feel uncomfortable by the looks they are getting from those who do. Not wearing a mask should be (and I believe, eventually will be) seen as a sign of putting others in your community at risk.

The widespread usage of masks signals externally that we are not in a “business as usual” world, and shows solidarity with the rest of our community. Like wars, pandemics demand that we all change the way we live our lives — social distancing, more hygiene, working from home, no school — and the outward demonstration of that commitment from our fellow citizens boosts the morale and team-spirit of that effort.

Much as our public officials helped change behavior by setting good examples and going out of their way to demonstrate “elbow bumps” and “fist bumps” (instead of handshakes) and by standing six feet away from each other at press conferences, they should and will eventually begin to wear masks in their public appearances as well.

So while wearing a mask won’t stop the pandemic, doesn’t replace hand washing or social distancing, and we do have a critical supply shortage to solve, you should absolutely still wear one. Of course they work. Do your part to slow the spread: wear a mask — it is your patriotic duty.