‘Mask Up, America’ made sense in 2020, not so much now

The importance of masks to public health is diminishing as other pandemic 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 spread rapidly in the spring of 2020. The benefits were not (and still are not) measurable with the same kind of rigorous science that has been applied to vaccines, but it was fair to assume that universal masking could slow the spread of disease and death when little else was available.

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

More good news came this month. Pfizer Inc. announced on Friday that their new COVID-19 pill reduced hospitalizations and deaths in high-risk patients by 89%; an antiviral drug developed by Merck & Co. won approval for use in the UK last week. Quick 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 disposed of: No one will get sick from touching a shopping bag or going on a bike ride.

The number of hospitalized patients has dropped to half of the recent summer peak. The virus does not go away, but its threat diminishes. It should make it possible to reconsider the shrinking benefits of masking and in particular masking mandates in relation to real costs that health authorities have been reluctant to recognize.

Even many of the experts who pushed for universal masking demand a turnaround. “This is not 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 that said everyone should wear a mask … but now we have other tools in place and that’s why I do not think mask mandates make sense anymore.”

It is not the case that people should stop worrying about the virus. But as risk communication expert Peter Sandman has said, any policy that people do not 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. foreseeable future. What was a minor hassle for weeks and months looks much more stressful as a new lifestyle.

Masks can make people unhappy. They stifle communication and human interaction – affecting business and social activities. This is why people – even those who make the rules – often take them off privately to interact and socialize. Along with other restrictions, unnecessary masking contributes to an epidemic of isolation, loneliness, and poor mental health.

Many experts believe that masks also interfere with education. “As someone who has been out in the world and I have young children, I see that it affects socialization and learning,” Allen said.

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

There is strong consensus that unvaccinated adults should still wear masks, and those who are still scared, even after three shots, may feel even more protected if they wear a high-quality mask, such as an N95. Temporary mask mandates may be needed in places where an outbreak threatens to overwhelm hospitals.

There are ways to make life safer without counting on mask mandates. The public health authorities could provide more useful information to assess the risk and minimize it by avoiding the most dangerous situations. For example, it is still not clear whether supermarkets really pose a great danger. And there is a need for better information on when and how to use rapid tests.

But it’s past time to stop behaving as if everyone should be treated as equally threatened. Reality-based policies that take into account how people behave and interact should replace uniform dogmas.

It is very unlikely that young, healthy people who are fully vaccinated will end up being admitted with COVID-19. And the risk that a vaccinated person poses to others is very small, said Amesh Adalja, a senior researcher at the Johns Hopkins School of Public Health. “For fully vaccinated people, I think there is a marginal benefit to wearing a mask,” he said.

Harvard’s Allen said he finds it shocking that there are so many setbacks to exploring unmasking, even though most Americans of all political stripes interact privately without masks.

He and Adalja agreed that trust in public health leaders is important and that trust has been eroded by months of restrictions that did not make sense or were counterproductive – such as closing parks and beaches or getting people to wear masks while they were far away. away from others outdoors. Most public health officials failed for many months to tell people that it was extremely unlikely that they would get the disease from the mail or groceries.

Adalja said he is in favor of what he called a harm-reducing approach to public health rather than just abstinence. The concepts arose in the earlier years of the AIDS pandemic, where proponents of abstinence only believed that HIV-positive patients should give up sex. That would not happen, nor would humans allow COVID-19 to force them to refrain from many other forms of human interaction. There are too many rules and not enough clear, science-based advice on which activities are most risky.

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

This means that people who are still scared or vulnerable should have the opportunity to work from home. As for the rest of us, living with risk is just a part of life. It is fair that people want to return to show their faces and live their lives.

This column does not necessarily reflect the opinion of the editorial staff or Bloomberg LP and its owners. Faye Flam is a Bloomberg Opinion columnist and host of the podcast “Follow Science.” She has written for The Economist, New York Times, Washington Post, Psychology Today, Science and other publications.

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