Masks probably help when you are in crowded indoor spaces.
That is about the best that can be said for masks at this point. I know this can be construed as being some sort of anti-mask, anti-science yahoo. I’m not. While I don’t like wearing a mask for obvious reasons, I am more than happy to wear one to the grocery store, on flights, or to any indoor public space that requires one during this pandemic.
First off, masks logically make sense. If we reduce the amount of breath exhalations getting out into an enclosed space, then we should have less viral particles and thus less transmission of the virus. And there are studies that show that this does filter out particles even if the virus itself is smaller than the gaps in the cloth, as it is often hitching a ride on the (larger) saliva particles coming out. So from a “first principles” analysis, masks seem to make a lot of sense.
If you do a search for news articles, you are also likely to see a bevy of stories from the summer and early fall claiming that masks do work, and quite often citing the Northeast as examples of that. And that is a semi-reasonable conjecture based on the data at the time.
But… the data changes over time, and thus so do our findings. That is what science is all about. And what has happened since early fall?
Masking rates have increased across the board (source)
Cases have also gone through the roof, as we all know.
But particularly, two large states which were prime proof-points for “masks work, see!” have seen skyrocketing cases: New York and California
Let’s take a closer look at California in particular. 96% of Californians are wearing masks these days:
They’ve also had some of the strictest lockdowns and other restrictions in the country for the duration of the pandemic. And their case totals are… skyrocketing:
We could show a similar visual for New York (or Massachusetts, Connecticut, and New Jersey). Outside of the U.S. we could also show many European countries facing the same phenomena: mask mandates are put in place, but the next wave of the virus comes all the same.
All of these have very high rates of masking (over 95%) and are getting hit quite hard. To stick with California, their hospitalization rate per capita is already inching close to being the highest in the country, and it will continue to grow in the coming weeks. Again, despite some of the strictest masking (and lockdowns) in the country:
Suffice to say, real world evidence isn’t quite substantiating the claim that masks work.
The problem here is a common one for us: laboratory science works one way and humans in the wild work another way. This isn’t anti-science, it’s just recognizing that humans aren’t machines that follow strict lab-based protocols.
Here’s a few ways that we can reconcile the idea that masks should work in theory and in the lab, and that they do not work when scaled to 300 million humans:
People don’t wear their masks properly. This was scoffed at early on, but aside from the classic “hanging nose”, I regularly see people touching the mask with their hands, covering it up with their hands, et cetera. Both of which present obvious problems.
Bad and/or dirty masks – we clearly don’t see everyone wearing N95 masks, and some of these plain cloth masks seem, uh, fairly porous. Beyond that though, people almost definitely rewear masks, something which at least one study suggests could be worse than no mask at all.
This is a hard theory to gather good evidence on, but while masks are probably effective in crowded and enclosed spaces, they probably don’t help at all outdoors, where fresh air is copious and the sunlight kills the viral particles in a matter of minutes. If mixed with the dirty mask hypothesis above, people are continuing to breath in whatever is in their mask rather than fresh air.
If there’s one thing to take away from today’s piece, it’s this: the world is complex, and even if the science seems simple, it will always get complicated when millions of humans are involved. This isn’t “anti-science”. Frankly it is something that comes with maturity: even the best theory will fail if it doesn’t account for how humans, flawed as they are, act.
That is almost certainly the case with masks as we look at it. They work in a lab. And if you wear a N95 and wear it properly it’ll almost certainly work. So it makes sense to wear them indoors and do your best at good mask hygiene.
But it is foolish and immature to act like just throwing a mask mandate at things will solve everything. And yes, I know that’s one of Old Joe’s “brilliant” plans. At the least, we’d have to get more creative with encouraging proper masks and proper mask hygiene. And find a way to convey the nuance that wearing a mask indoors is smart, but wearing one outside is pretty dumb.