Face Masks and Rules

I started out relying mostly on the UK for information for the practical reason that the ONS was doing a much better job providing useful statistics than any equivalent organization in the US. Since then, I’ve found the Johns Hopkins Coronavirus Resource Center, which is a fantastic resource, despite certain states lagging in providing data—or refusing to provide it. But there’s another reason I’ve found it easier to deal with the UK than the US. The UK government, of course, has shown its incompetence, and many UK citizens have shown their indifference to following guidelines. But overall, and with all the Dickensian bureaucracy and shortcomings of the government, there is still a sense, overall, that we’re in this together. We may disagree about the steps already taken, and we may disagree about the rules going forward, but most of us will follow the guidelines—and will understand that we’re following some of those guidelines for the good of others. That’s why the Dominic Cummings incident was so important and so badly handled. It seemed to say that the government believed that they were above normal citizens and entitled to privileges that the rest of us wouldn’t get.

In the US, for a variety of reasons, I don’t see the “we’re in this together” attitude, exactly, even among the most careful adherents to good social distancing policies. There is the same level of bureaucratic incompetence, more in some states than in others. But in a situation in which cooperation is paramount, it’s quite obvious that many people don’t want to see the bigger picture or change their minds as new evidence comes in. People who think it’s all a Democrat conspiracy point to scientists’ changing their advice as “proof” that they have no idea what they’re talking about. People who were already calling for Donald Trump’s impeachment want to try him for manslaughter for what they say is the mishandling of the crisis. And back and forth it goes. And as I said in my last post on face masks, that makes it practically impossible to ask people in some places to even mildly inconvenience themselves for the good of others. Because that seems like an impossible attitude to deal with, I’m going to stick with the issues that both the UK and the US are facing—incompetence and not wanting to tell people what to do.

On the same day that a German study that showed the mandatory wearing of face masks to reduce virus transmission by 40% appeared in several UK papers (the academic paper can be found here), the issue was raised on the BBC morning news, in its unintentionally ironically titled segment “Your Questions Answered.” News reader Annita McVeigh asked Andrew Goodacre, CEO of the British Independent Retailers’ Association, and Cathy Parker, Professor of Marketing and Retail Enterprise at Manchester Metropolitan University, why face masks were not being made mandatory in shops as they open next week. Goodacre said that each shop needed to assess its own risk and do “what it feels comfortable with.” Parker said that “if people want to wear masks because they feel safer, they should be doing that.” No one said, “Hold on a minute. We all know a mask is a lot more effective if the person who has COVID wears it than if a person who is scared about getting COVID wears it. So you’re telling me that I should wear a mask, even though I’m pretty sure I don’t have COVID, but I should be fine coming into contact with people who aren’t wearing masks, including staff who are around the shop all day and would be the most likely people to contract the disease?”

The government has done multiple disservices to people that have ended up with the current mess. The first was lying to people at the beginning of the lockdown—or at least, selectively offering the truth—because of a shortage of masks for healthcare workers. So the government (and the WHO and the CDC in the US) couched their words and said there was no evidence that masks reduced transmission. That may have been true at the time because there was no evidence. Full stop. But there was certainly evidence and guidance about masks stopping the transmission of influenza and other illnesses. Given that the Coronavirus is transmitted in much the same way, and given that it is estimated that upwards of 50% of people with COVID-19 show no symptoms, it seems to defy logic  to say that masks would not inhibit transmission of the virus.  Other reasons for the government’s guidance were reported to be a feeling that people who wore masks would feel emboldened to engage in risky activities, like not practicing social distancing or not washing their hands, and that people who touched their masks would be in danger of unwittingly passing the virus from their hands to their faces. Well, the second reason is just silly, because you’re probably just as likely to rub your bare nose as you are to rub it through a mask, so you’d still be slightly better off with the mask in the event that all those factors aligned. The first reason is part of the government’s general pattern of lying or providing incomplete information because they don’t think people can “handle the truth.” The problem is that this approach invariably backfires. Not telling people that you are still unsure of certain things makes people think you have no idea what you are doing when the data come in and you “change your mind.” Or they think you are lying to them for some nefarious purpose.

This all will become a bigger problem as the country opens up. If people have no confidence that shopkeepers and patrons will take proper precautions, cautious people will be less likely to patronize the shops. We could get back to normal faster if there were uniformity in the way rules and “suggestions” are applied. If we look back at the German data, perhaps the fact that there were rules instead of just slogans is partly responsible for the fact that their economy is opening up and their Worldometer new case graph looks like this:

While the UK’s looks like this:

And the US’s looks like this:

While it’s true that Germany’s peak occurred earlier than either of the other countries, it’s also true that it experienced a much quicker and more sustained decline. Cases in the UK peaked approximately 3 weeks later and a week after that in the US, so let’s compare the end of the UK and US graphs with Germany around May 15, when they were already down in the low 100s of new cases per day. Most worrying, and most expected, of course, is the US’s very long sustained number of around 20,000 per day, or about 2/3 of its peak. In comparison, the UK, with an at least somewhat cohesive message, has, even with all its missteps, managed to sustain a decline in new cases and, with about 1/5 to 1/4 the population of the United States, now has about 1/20 of the number of new cases per day. And, for those who say it’s just because the US has better testing, if we look at the daily deaths in the US, at about 900-1000, the UK numbers, at about 200, might provide some support for that idea. But both are far above Germany’s daily death toll, which is now in the single digits, but even 4 weeks ago, deaths were around 50 per day. (Germany’s population is approximately 84 million, or 18 million more than the UK and more than 1/4 the US population). So with a similar climate and similar demographics, it would appear that the US and the UK could learn from Germany, which has already opened schools and shops.

One thing requiring face masks could do, in addition to bolstering confidence, would be to reduce the necessary requirements for social distancing, which many people in the hospitality industry say are currently unworkable. While the headline for this article would seem to advocate keeping the distance at 2 metres, if you read through, three other bits of information are more interesting. First, being at least one metre away, on average, reduces your risk of catching the virus to 3%, down from 13% if you are less than one metre apart. Going to two metres halves that risk, so you’d be down to 1 1/2%. But wearing masks, at even the closest distance, would reduce your risk from 16% to 3%, or much more than just increasing your distance. It would seem, then, that face masks would allow people to be closer together and still reasonably safe. This has huge implications for theatres, schools, shops, and a host of other businesses. Back to Germany, again, where the distance is 1.5 metres. In China and Singapore, masks are mandatory in many places and the distance is 1 metre. South Korea says 1.4 metres, but theatres are running with additional measures taken before people can attend. Only Spain, Canada and the UK have required 2 metres, although Spain is loosening that restriction as restaurants and pubs reopen, requiring people to remain 1.5 metres apart at bars, for example.   

It’s probably going to be impossible, even after all the data are in, to decide which of the measures countries like Germany and South Korea took are most responsible for the way their countries weathered the pandemic. The jury is still out on the second wave. But it does seem that planning is better than just allowing things to evolve. Providing “advice” without consistency or penalties does not do all that much other than to confuse people and make them think they can make up their own minds. And, unfortunately, some people’s freedom must be curtailed for the good of everybody. We accept that, although sometimes grudgingly, when we talk about speed limits or smoking rules. This is no different. In order for me to have reasonable freedom to go about my day, and in order for people to start to recover economically, you are going to have to obey a few rules. Think of it as the 21st century’s “blackout rules.”

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