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Why Masks? Because Powerless Citizens Rarely Emerge.
Why masks? I think the answer to that is fairly simple, and fairly obvious as well.
I have just finished — much to my dismay — reading the 20th and final (not including the unfinished 21st) book in Patrick O’Brian’s amazing Aubrey/Maturin “Master and Commander” series. In a recent book, Steven Maturin discusses an old sailor who he is treating. He knows exactly what the problem is, and he treats it as best he can. But he notes that the sailor is absolutely convinced that the problem stems from the consumption of meat and alcohol. Therefore, the sailor self-prescribes total abstinence from these two things. Maturin comments that sailors are stubborn, especially with respect to their own health, and that the abstinence does no great harm, so he goes on treating the sailor as he would, and he doesn’t argue with him about the diagnosis. Later in the book, the sailor dies, as Steven knew he would.
This is partly why everyone is wearing masks. People are stubborn when it comes to things that are unknown and over which we have no power. Irreligious people are especially stubborn in this respect, and we live in a particularly irreligious time and place.
At the beginning of this pandemic, our politicians acted. Of course, they acted. They couldn’t just stand there. They acted on the best information they had, which was terrible, and they acted in the only way they could, which was clumsy, overbroad, and devastating. The more we know, the more we are learning that it is quite possible that these actions, for all their costs, were certainly ill-advised (on balance), and even without their costs, may have been almost entirely ineffective for their stated purpose.
But a terrified public went along. They were told that death waits around every corner and that the only way to beat it is to hide in their homes. They hid in their homes, obsessively refreshing their Twitter and Facebook feeds, eyes glued to the television. And deaths piled up in spite of the fact that they were all obediently cowering in their homes.
There is no way out of that.
The truth would be to say that, well, we were wrong. That is a phrase that appears in no government handbook ever printed, and in no media guide ever consulted. We were wrong. As far as we can tell, the outcomes resulting from this virus were inevitable and unavoidable — we may have mitigated them somewhat (especially by keeping people out of hospitals), and, then again, we may also have simply traded one harm for another. We’ll never know the outcome of that impossible balance between “lives saved” as a result of our actions, and “lives lost” as a result of our actions.
But there is still no way out. My local hospital lied to the public when it said that we would be overrun with COVID-19 deaths by April 8, and would be turning people away to die in their homes or in the streets. This was a noble lie because a terrified citizenry is most likely to be complacent. It wasn’t just my hospital, it was nationwide. Instant death lurks around every corner. Anyone could have it and is likely contagious. Even you. You probably have it and you don’t even know that you have it. Not only is instant death lurking around every corner, but instant death emanates from your very being.
Turns out we were wrong. This is a virus, and it is worse than some other viruses that we are used to, and it is not as bad as some other pandemics that we have experienced. It is dangerous for some, and we really do now have a pretty decent grasp on who those people are. It is either widespread and not very deadly, or it is not very widespread and pretty deadly … or, it is becoming more and more widespread, and less and less deadly. But it cannot be all of these things. Death is not lurking around every corner, and it is extremely unlikely that you have it, and even less likely that you will give it to someone else. It is even less likely that you will get it when you pass by your neighbor on the street or in a store, or when you eat at a restaurant or play in a park or go to the beach or earn money at your job or barbeque with your friends or watch your kids play baseball. It is less dangerous for children than most dangers they face on a daily basis (even at home!) and there is virtually no evidence that it spreads from children to adults, or even from children to one another.
There is still much that we don’t know. But what we do know is that we were wrong. Our CDC guidelines were wrong and continue to be wrong. Our models were unbelievably wrong, and they are only getting worse. Our politicians were wrong. Our Twitter and Facebook feeds were wrong.
And that’s why we need masks. We are not willing to admit that we were wrong. We are not prepared to accept that we were powerless and that we continue to be powerless. We are not about to crawl out from under the house simply because somebody tells us that we were mistaken to crawl down there to begin with. We cannot just stand there, knowing how little we know – we must do something! We must exercise control, and if we don’t have control, we must exercise what little control we can muster, even if it is only control over our own behavior.
The rationale for that behavior is itself filled with contradictions. If the virus is so contagious that masks will help prevent its spread, then we are too late to start wearing masks, and if it truly is that contagious, then “running its course” is the best and only thing we should be doing. If it is not so contagious that masks will help prevent its spread, then we are wearing the masks just for fun. Same thing is true if asymptomatic aerosolized spread is not a meaningfully important mode of transmission, even if such a thing is scientifically possible in some circumstances.
Even the best case for masks seems to be a pretty silly one. There is a small percentage of people infected; there is a smaller percentage asymptomatic; there is a smaller percentage asymptomatic and contagious; and there is a possibility that the subgroup within that subgroup may possibly sneeze, which is about the only thing cloth masks are designed to mitigate, and even then, they mitigate only slightly, so that at the end of the day, what masks accomplish is the slight reduction of contagion that could possibly come from the small percentage of asymptomatic contagious within the small percentage of asymptomatic within the small percentage of infected. But to be absolutely safe, we need to make laws that cover everyone. No, it’s not just like using a chain-link fence to catch mosquitoes, it’s like using TNT to catch a minnow when the minnow really wasn’t your problem to begin with. But, we’re not really concerned with the minnow. We are concerned with human nature.
Masks are the placebo that allows us to feel like we are still in control of a situation where all of the evidence tells us that we have never been in control. If you are the CDC or a politician and saying “sorry, I was wrong” is simply out of the question, it is essential that you have a plan (for, as we know, all smart people have plans, so if you want to be smart, you must first have a plan). If there is one thing a patient most dreads — and which most patients simply will not accept — it is to walk away from the doctor empty-handed, without a plan. Virtually all doctors know and understand this. Doctors in the 18th century understood this very well, especially where sailors were concerned.
I have heard and read interviews with doctors … fear is debilitating. It is not all of these doctors who have stoked and built and endlessly perpetuated that fear. But they do understand that fear is debilitating, and they have not lost the wisdom of Steven Maturin.
Should I wear a mask?
Sure, why not. If it will make you feel better.
Published in General
Where Hammer and I disagree it is on whether is appropriate to be courteous to others by wearing a mask.
Where Hammer and I agree is on the tyranny of expecting everyone else to wear a mask because you have an irrational fear of dying by walking by someone in the aisle of a grocery.
I think stores should be allowed to require masks or not and I can choose to go to stores that don’t require masks and you are free to go to stores that require masks.
I will choose free market over government compulsion every time, but I accept people disagree. It’s just that in the time of COVID, more self-professed conservatives believe in government compulsion and central planning of the economy than I thought.
The basic problem is this:
We have very good evidence that this virus is much more dangerous than any seasonal flu – not just incrementally, but categorically. It is showing real signs of being considerably more deadly than any pandemic since 1918.
We also have very good evidence that this virus is much less dangerous than the “benchmark” 1918 pandemic – not just quantitatively, but qualitatively.
Yet we still have very little good evidence about exactly where the risk posed by this virus lies on that scale. Making matters even more complicated, that scale is neither linear nor static.
So you are correct that it is not a simple dichotomy of dangerous vs. not dangerous. But it’s perhaps worse from a societal point of view: a) because societies have a difficult time dealing with non-binary situations and b) societies have a hard time dealing with unknown risks.
In many ways, this problem would be easier to manage were it indeed of a 1918-size magnitude.
But you acknowledge that we would save tens of thousands of lives every year if we mandated social distancing every flu season and forced all the bars to close and banned indoor dining? I’ve been using 10x more deadly than the typical flu. If my 10x number is correct, we would save a similar number of lives over decade by mandating these things every year.
Isn’t that worth it? Imagine the politicians campaigning on saving tens of thousands of lives every year.
Your information is inaccurate.
Apart from the outdated statistics, both statements “Sweden did not lock down” and “Sweden’s economy are fully intact” are not correct. Sweden’s government did shut down some parts of society (albeit much, much less than most other countries) and “recommended” that its citizens stay at home. Because Swedes have a tradition of following their government’s recommendations, many of them did exactly that: studies of mobility show that the Swedish people actually stayed at home just as much as in many American states with official stay-at-home orders.
And their economy is paying the price. I read the major Swedish newspaper almost daily, and they are also experiencing wave after wave of layoffs. Certainly not as bad as the US (so far), but the statement that their economy is fully intact is absolutely not true.
As a more broader point, Sweden and many other countries (and US states) have also conducted numerous seroprevalence studies in the past weeks which show the virus to have a fatality rate between 10x and 20x of seasonal flu, which would also make it more lethal than any pandemic respiratory virus since the 1918 flu.
I agree with this completely.
My main disagreement with many people here is this: many are arguing “because the virus is not that dangerous after all, we need to reopen society so as not to destroy ourselves.”
My argument is: “despite the fact that the virus is indeed potentially very dangerous, we need to reopen society so as not to destroy ourselves.”
That is idiotic, Roderic. Sorry to be so blunt. If that is the best you’ve got, then we really do need to push very hard against masks. Because I’m a sense you’re right- it is not really about covid, it is about making a statement. As I see it, that has no place in our society. I guess I’m just a dick…
That is a gross misstatement. Please reread this entire post, my last post, and all of my comments.
“It’s been proved” is simply a false statement. If that is your standard of proof, you would do us all a favor by going back into your house and never coming out. Stay home. Stay safe.
Not sure you got that right. How about: ‘even though the virus is dangerous people still have to cope without destroying themselves’.
Except the evidence is that masks WORK to decrease transmission-so opposing them is much more likely to be idiotic than wearing them. It is a respiratory virus-how do suppose it spreads? Decreasing the opportunity to come into contact with respiratory secretions (droplets, aerosolised -ie fine droplets) will decrease transmission. Ample evidence exists that masks DO reduce the spread of respiratory viruses. Since so many infected are asymptomatic we cannot rely on symptoms to avoid people with it- therefore the urging of widespread use of masks when in close/confined contact.
I’ve been saying since the beginning that I hope when this is all over, someone tries to measure the economic cost per year of quality life saved. I hope the numbers demonstrate the cost was worth it, but I am skeptical.
And this is before we consider the giant leap towards socialism that this crisis enabled. Plenty of libertarians have conceded that it is perfectly legitimate for the government to mandate which businesses are allowed to operate and which must shut down by government fiat. If that doesn’t scare you more than the virus, we aren’t on the same playing field.
We don’t have any good options, but we have to balance inevitable deaths from COVID against the inevitable deaths and ruined lives from the economic shutdown. Problem is, politicians know that they will directly receive blame for deaths from COVID and won’t directly receive blame from deaths from the economic shutdown. So, they will rationally choose to lock down the economy far longer than is necessary or appropriate. This was obvious in the beginning to anyone that actually thought about it, and experience has proved the deep truth of this beyond any reasonable doubt.
Sure, so not walking in the aisle of a grocery store. That is where we differ.
I hope you’re right – especially if a second wave comes around in the fall as some are predicting.
It’s quite possible, yes.
Please note, though, that I am not forcefully advocating the use of masks. The scientific evidence for their effectiveness remains slim (on the other hand, there is no evidence that they actually make the situation worse – see all the eastern Asian countries which had widespread mask adoption before the pandemic started).
I’m also not making a judgment call about when a life is worth saving. It’s clear that if this present epidemic had naturally dwindled out around 100,000 total deaths many people wouldn’t have even noticed it.
I am advocating forcefully against the vehement rejection of low-cost pragmatic measures that might help accelerate our re-opening of society. These measures include more systematic testing, voluntary tracing and isolation, testing of municipal water supplies, maintaining temporary prohibitions on very high-risk settings, increasing testing in long-term care facilities, and yes, masks.
People have been spooked by this virus in a way that is not comparable to seasonal flu. We need to simply accept that as a fact. Some of that fear is misplaced hysteria, but enough of the threat is genuine that we won’t be able to convince people to re-emerge from their houses without providing some reassurance that the virus won’t start spreading wildly again. And if people don’t have that confidence, our economy will tank even if we drop all official mandates.
We are losing several million jobs a week. The number one priority needs to be convincing people that it is safe to fully re-engage in society. If masks help convince people to embrace re-emergence into society by even a week earlier, they will have paid for themselves millions of times over.
Works for me.
I don’t entirely disagree. I said in my other post that I’m on record saying that if virtue signaling will make the paranoid feel safe enough to open up the economy, I will grudgingly virtue signal. One problem is that the media won’t let people feel it is safe until after the election.
All the discussions on a right-leaning website in the world won’t change that.
While paranoia and virtue signaling are certainly heavily involved in the US, those aren’t the only reasons for masks (or testing, or plexiglass shields at cash registers). There is also a basic level of pragmatism involved.
We do know that the virus still has the potential to kill quite a few people, and we don’t yet understand enough about how it is transmitted. Hence, many of our ideas about how to break the chains of transmission will eventually turn out to be incorrect.
But if they are relatively low-cost but could plausibly save dozens of lives (say, at a county level), I see reasonable justification for adopting them without the cynicism of “paranoia” or “virtue signaling”.
I’ve long argued that infectious disease management is a relatively weak spot in modern conservatism.
A situation in which one person can easily harm (or even kill) another person through passive, innocuous behavior, and in which such behavior can increase in a non-linear fashion, present thorny scenarios for a system of interaction that assumes that interpersonal harm generally results from deliberate action and that reasonable preventive or punitive measures can be taken.
One surprising observation to me has been how much better many European social democracies have reacted to Covid (at least in my view). Austria, Switzerland, Germany, the Netherlands, and Denmark all shut down fairly early in the pandemic. They then ramped up their public health infrastructure to quickly build pragmatic tools to stem the spread of the virus without destroying the economy or intruding too deeply into private affairs. All of those countries are now re-opening much more aggressively than almost any states in the US.
Here in Germany, we’re not only more open than almost any state in the US (for example, schools have been open for over three weeks now), but we will even be more open than Sweden in many meaningful ways starting next week. And all the while, we have had very open and vigorous discussions about the sanctity of human value and freedom and the need for the state to stop controlling its citizens at the earliest time point possible.
It puzzles me that “big government” countries have been simultaneously more pragmatic and more respectful of human autonomy than most states in the “freedom-loving” US.
Sure, but it is the paranoid that are keeping the economy locked down.
And it is paranoid politicians willing to destroy the economy ruining lives to avoid being blamed for deaths by the paranoid that are keeping the economy locked down.
Convincing the pragmatists isn’t the problem, if you are pragmatic, you don’t need mandatory masks to reopen the economy.
I don’t know why this is surprising.
Why have we gone from “slowing the spread” to “saving lives?”
The dark truth behind all of this is that we really don’t care about lives. Nobody cares that 100,000 people have died, except the families of those who have died. As I said, 650,000 people die every year just from heart disease. That is the leading cause of death, but it is not alone – how many people die of all causes every year? I don’t know the exact number, but it is a hell of a lot higher than 100,000, and nobody bats an eye.
The only reason people are concerned with covid is because it is a communicable disease, and they have an disproportionate fear with the respect to their personal risk. That is why there is so much anger over masks – what did Roderic say? “Don’t be a dick.” The anger is because people believe that they are at risk from other people.
But the fact is, the actual risk is extremely low. Even if you catch the stupid thing. Your risk from dying in 100 other ways is the same as it always was, and we accept those risks on a daily basis. I don’t think this pandemic is fake, or that it doesn’t exist, or that it is less dangerous than it is – but overall, it is just another risk, and it remains pretty low on the list of things that are trying to kill you.
With all of this talk about “saving lives,” we are not quite being honest. A virus like this will run its course and disappear, ultimately killing maybe even a lot of people, unless we find a cure – when we talk about saving lives, we are really talking about delaying deaths, and the only realistic way to turn that into “saving lives” would be to delay death long enough that a cure will ultimately save them…
(continued…)
The core question here is one of cost/benefit.
Hammer thinks the costs of mandatory mask wearing outweighs the benefits, especially once second-order effects are considered.
Others think the cost is low and the benefits are huge.
I think the costs of second order effects are higher than the pro-mask crowd is willing to acknowledge, but I probably also thinks the benefits are higher than than Hammer thinks.
Regardless, COVID has convinced that we are finished as a country. It’s all over but the shouting.
This is exactly how I feel. I don’t like wearing a mask and I don’t like going to places where people are wearing them.
So I don’t go anywhere where they are required.
How can you claim we are not concerned with other deaths when the America LEADS the world in healthcare expenditures EVERY year? The main difference is that CV disease isn’t contagious so we don’t apply techniques to reduce contagion to prevent it- but we do spend billions every year on cath labs, statins, echo labs etc. Furthermore, unlike CV diseases, we had a chance to essentially stamp this out (like SARS & MERS were contained) by taking action.
(…continued)
And that may or may not be a pipe dream. So what we’re left with is a fundamental change to the way we live our lives, the way we value our lives and our freedoms, the way we view ourselves in relation to everyone else and to the state, the way we approach the idea of mortality, the way we approach the idea of risk. And these are permanent changes.
On the other hand – as I said, the virus will run its course and some people will end up dying. That the people most likely to die are also people most likely to die of virtually everything else is apparently lost on us. The fact that some young and healthy people can die terrifies us enough (and is widely publicized enough) that we believe ourselves to be in peril (and that was one of the points of the OP), and any “collective action” to mitigate our personal risk is therefore worth it. But as I said, the dark truth is this: if we consider this to be a one-off event – and no less a tragedy – and we did absolutely nothing, we would lose a certain amount of lives. Nothing we’ve seen actually indicates that the millions of lives scenario would actually play out, but let’s say that it did. That would be tragic, and it would go down in history books as one of the hundreds of times that tragedy has struck and thousands or even millions of lives were lost. It might even amount to several months worth of total deaths. And then it would be over. Even then, most of the people who would die of this are then not available to die of something else – so our total numbers would certainly rise, but enough that any of us would really notice? You notice if it’s you, or someone you love – but when it’s you or someone you love, you notice heart disease and cancer, too.
Really – we don’t care. We don’t care that people will die. People die every day, and we don’t care. 650,000 due to heart disease every year, which adds up to hundreds of thousands more than the worst possible scenario from covid – and we don’t care. We don’t care, because we don’t feel personally at risk. So all of this high-minded bulls**t is nothing more than just that.
Roderic summed it up perfectly. “You’re scaring me. Stop being a dick.”
The last several years have given us an unprecedented level of narcissism and entitlement. Someone like Bernie Sanders can only emerge in a population that believes “everyone owes me something.” You owe me school, you owe me an income, a home… you owe me a feeling of security and self-worth. Only in this setting do people respond to something like covid with the sheer level of panic that we’ve seen…
I fully agree that this is about little more than cost-benefit.
My personal take is low cost/unsure benefit but possibly moderate to substantial.
I agree that troubling second-order effects exist. But a) they are still miniscule compared to the second-order effects of so many of the other measures currently in place (that masks et al. would hopefully replace), and b) the first-order damage caused by the lockdowns is so great that we may not be alive to deal with the second-order effects of masks if we don’t rescind the lockdowns soon.
Interestingly, there is much reason to believe that it will naturally dwindle with not a heck of a lot more than 100,000 deaths. Maybe 150,000. That is literally a drop in the bucket. Nobody would notice it. It would get some headlines, where reporters have pictures of tired doctors and filled hospitals for that week in New York – and other than that, it would go completely unnoticed.
That is the problem with all of those “mitigation in order to open society” actions that you listed above – and it was the whole damned point of this post, if you had bothered to read for content instead of criticism. How many times have I heard “if it helps us reopen?!”
Contact tracing, testing and testing and testing, masks – these things, if they change those numbers, will change them only on the margins. Roughly the same number of people will die regardless of what we do. But when you say “in order to reopen,” all you are doing is saying exactly what I said in my post. It is to make people feel better so that they are willing to crawl out of their holes.
The problem, here, is that it shifts from addressing a present crisis to providing assurance against a potential future threat. And that threat is always looming. Did you read those insane CDC school guidelines? Do you see these stupid blue lines taped to the floor of every store? Have you ever actually tried having a barbeque with friends while staying 6 feet apart from everyone, outside, wearing masks? Sure, lives are important – but what about quality of life?
I absolutely refuse to bring up my children by indoctrinating them to be terrified of living their lives, of contact with their friends – that is not a life worth living. Especially because none of these measures actually keep people safe – they make people feel better. As you say: “so we can open up.”
People don’t need to be assured that we’re doing everything humanly possible to keep them safe. People don’t need to be placated. They need to accept that life is fragile, and that danger and risk exists everywhere, and that they need to accept it or mitigate it as they see fit, but they’ll never be rid of it.
One thing socially that has always bothered me personally has been the absence of visibly effective policies to alleviate the conditions prevailing for urban minorities. And they are among those hit hardest by this virus. I know we always suggest that they might get a different result if they would trust someone beyond the Democrats they help to put in charge of public policy. The result still saddens me.
You’re moving to an extreme position that isn’t defensible.
We have a very complicated relationship to saving other peoples’ lives.
Lots of chatroom philosophers love to bring up the analogy that we could save lots of lives by reducing the speed limit to 5 MPH, but we accept those deaths for the sake of convenience. Of course we do.
But then why do we have a speed limit at all? Because there’s some cost-benefit balance between ultimate safety and ultimate convenience.
Or to take your example here: if we don’t care about trying to prevent old people with comorbidities from dying, why is Medicare so popular and why do conservatives pop a fuse when Obama suggested trying to save money on heroic end-of-life care?
So on the one hand nobody bats an eye when the number of seasonal flu deaths doubles from 35,000 to 65,000, but on the other hand we’re willing to fork over a lot of our hard-earned money to keep the same type of people alive for another few days.
We don’t have a national all-or-nothing policy when it comes to when the community sacrifices to save a particular life. We have a hodge-podge that roughly approximates some balance between preventing death (even among the old and infirm) with making life liveable. My proposed response to the Covid crisis attempts to take exactly that path: find the happy medium between saving others’ lives and saving ourselves.
You are making many statements here based on scientific certainty that doesn’t exist.
There are many, many plausible scenarios that a) the virus won’t die out naturally after 150,000 deaths, and b) that testing/tracing/masks/whatever actually can make a meaningful difference in both the spread of the virus and the number of people who die before we find an effective drug or vaccine. Your postulations above are also plausible, albeit in my opinion less likely.
But I have neither the time nor the energy to expand this into a grueling scientific debate over this.
I will simply summarize that I truly believe that a combination of light-touch interventions would give us a very good chance at BOTH a) reducing the morbidity and mortality of Covid AND b) reassuring the skittish in society that they can partake in normal life again. It’s not just a psychological issue.
This is a great example of not understanding how to interpret and actually use evidence. It is kind of like observing that compound X kills the virus in a petri dish and then thinking that you’ve found the cure. You are vastly overstating your case. And in that one comment, you’ve made no less than 5 claims of fact – confidently – that you simply cannot take for granted.
I suppose you’ve had the flu, no? I have. I had it twice last year (or maybe I had covid, who knows?). I got it because my kids got it, and when they are sick, they lay on my chest and I rub their hair until they’re asleep. When they get sick, I usually get sick. But of course, I don’t always get sick when they get sick. My wife and don’t always get each other sick, and we sleep face to face. As far as I know, I have never gotten sick – with any respiratory illness – by walking through the fog of some person in a grocery store. Just because something makes theoretical sense when you list out a bunch of assertions and then try to fit them into a theory, does not make it actually true. As A-squared pointed out, if people were getting sick from maskless infected shoppers in grocery stores, we would have seen millions upon millions of cases. Your R number wouldn’t be 2 or 2.5, it would be up in the hundreds. But it’s not, because we have absolutely no evidence of that ever happening. Even totally unchecked, this virus has spread in dense living and working situations, and it shows its face when it hits at-risk populations, mostly in nursing homes.
Masks work in labs and in your mind, just like all of the anti-viral and vaccine candidates that work in labs and on paper, and which will ultimately prove to be useless. But do masks meet any actual, existing, present need? No, they do not.