What’s the big deal about masks? In exchange for slight inconvenience and discomfort, we save lives. Basic human selfishness explains why many would fail to comply. Anti-authoritarian scruples might lead some to oppose government mask mandates. But how could anyone sincerely disagree with the principle that wearing masks is a good thing?
The obvious place to start is: Almost no one thought that wearing masks was a good thing before Covid-19. Yet contagious respiratory diseases that kill have been around longer than humans. So if the “In exchange for slight inconvenience and discomfort, we save lives,” argument were airtight, we should have been wearing masks all along – and should plan on doing so forever. Which seems crazy.
You could reply, “That’s a straw man. The real argument is that masks pass a cost-benefit test.” If so, that leaves anti-maskers with two obvious margins to think about.
1. The degree of effectiveness. The most popular version of this objection is that masks don’t save lives. But once you start doing cost-benefit analysis, it is sufficient to claim that masks don’t save enough lives. The evidence from Randomized Controlled Trials (RCTs) is surprisingly supportive of this position. (And if you deem the RCTs subpar, please join me in calling for large-scale Voluntary Human Experimentation to settle the question once and for all). Ultimately, however, I still suspect that masks reduce contagion by 10-15%.
2. The degree of inconvenience and discomfort. Many people plainly don’t much mind wearing a mask. But despite Social Desirability Bias against convenience and comfort, plenty of others plainly do mind. Since we’re doing cost-benefit analysis, the key question is: How bad is mask-wearing for the average person?
Nothing good googled, so I ran this Twitter poll.
Holding duration equal, wearing a face mask is X times as uncomfortable as wearing a seat belt.
X is…
— Bryan Caplan (@bryan_caplan) February 5, 2021
Millions of people bet their lives every day to avoid the discomfort of wearing a seatbelt, yet the median respondent considers masks far more uncomfortable. Furthermore, note the long right tail of people who find masks massively worse than seatbelts.
The upshot is that we are not talking about saving hundreds of thousands of lives per year by making the average person 1% worse off. We are talking about saving tens of thousands of lives per year by making a quarter of the population miserable.
On reflection, however, this simple analysis overlooks a major factor. A veritable elephant in the room. Namely:
3. The degree of dehumanization. Personally, I only find masks marginally uncomfortable. But I hate wearing them, and I dislike being around people who wear them. Why? Because a big part of being human is showing other people our faces – and seeing their faces in return. Smiling at a stranger. Seeing your child laugh. Pretending to be angry. Seeing another person’s puzzlement. Masks take most of those experiences away. At the same time, they moderately reduce audibility. Which further dehumanizes us. How many times during Covid have you struggled to understand another person? To be heard? Indeed, how many times have you simply abandoned a conversation because of masks? I say the dehumanization is at least five times as bad as the mere discomfort. And if you reply, “Want to see other people’s faces and hear other people’s voices? Just Zoom!,” I will shake my head in sorrow that you’re dehumanized enough to say such a thing.
Am I just being a big baby about this? I think not. Suppose humanity could eliminate all disease by wearing bags over our heads forever. Would you be willing to go through life not seeing the faces of your children? Would you want your child to go through life not seeing the faces of their friends? Well, during Covid we’ve moved at least 25% in that dystopian direction. The word “hellscape” is not out of place. I’ve never been a fan of the veiling of women, but I had to live through Covid to realize how horribly dehumanizing the custom really is.
What if the choice was between masks and a 50% annual chance of death? The reasonable reaction would probably be, “Fine, we’ll be severely dehumanized, but we’ll survive. Just like war. I guess I’ll take it until a better deal comes along.” When the choice is between masks and a 0.5% annual chance of death, however, the reasonable reaction is rather, “I’ll take my chances and live like a human being.” Indeed, once you’re old enough, even a 50% annual chance of death starts to look like a good deal. My considered judgment: If another Covid strikes when I’m 80, I do not want my grandchildren to wear masks around me. I want to enjoy their laughter while I still can.
P.S. I’m curious to see if social media’s “independent fact checkers” flag any of this. I suppose they might point to this study showing that masks don’t dehumanize, but if you read the piece you’ll see that it deliberately ignores everything I’m talking about.
READER COMMENTS
Alex
Aug 24 2021 at 10:30am
Determining discomfort via a Twitter poll, huh?
Evan Sherman
Aug 24 2021 at 11:13am
To be fair, I’m pretty sure (*leans back in my armchair-expert armchair*) that just about all single issue polling sucks for a lot of reasons.
To name just three: 1) Difficulty with collecting a representative sample, as mostly weirdos respond to polls 2) How one phrases the question has huge impact on outcomes for otherwise comparable polls and 3) People are pretty good at inferring tribal affiliations implied in issue-based questions (e.g. team red or team blue?) and they vote for the outcome that they percieve to be the most supportive of their team.
Doing it on Twitter exacerbates these problems to some extent, but I really don’t take any single issue polling seriously in any venue.
Gene
Aug 24 2021 at 3:14pm
Hey, hold on a minute there … I’m a wierdo but I never answer polls.
perfectlyGoodInk
Aug 24 2021 at 10:49am
As a social scientist, I’m surprised you didn’t mention the results of natural experiments, such as in Germany, Kansas, and across the U.S.
Mask-wearing was already pretty commonplace in places like Taiwan and other countries in Southeast Asia due to their experience with the Avian Flu (a topic I recall Tyler and Alex used to blog about pretty often), and I’m rather doubtful that us Asians are just more resistant to discomfort than other people.
perfectlyGoodInk
Aug 24 2021 at 11:01am
Sorry, I didn’t mean to imply that I am a social science, as I am not. I meant to say that I’m surprised that you, as a social scientist, didn’t mention those natural experiments.
Also, one obvious confounding variable in the survey results is that masks have been politicized in the U.S., so how are you controlling for this?
Joel Pollen
Aug 24 2021 at 11:24am
I suspect there are big differences between mandated masks in, for example, the US, and the pre-COVID mask-wearing culture of east Asia. Do people in Taiwan wear masks during church services, neighborhood parties, or in restaurants? In those environments where the dehumanizing aspect of mask-wearing really bites, I would guess people are much more likely to take them off. Not being able to see the expressions of strangers on the subway isn’t much of a loss, but not seeing the faces of your close friends certainly can be.
perfectlyGoodInk
Aug 24 2021 at 6:23pm
Looks like Taiwan has had a mask requirement in churches since January.
https://www.loc.gov/item/global-legal-monitor/2021-01-06/taiwan-fall-winter-covid-19-prevention-program-implemented-requiring-masks-in-high-risk-places/
And I mispoke. The public began wearing masks after SARS, not the Avian Flu. But mask-wearing has been the norm there for decades.
https://www.voanews.com/science-health/coronavirus-outbreak/not-just-coronavirus-asians-have-worn-face-masks-decades
Evan Sherman
Aug 24 2021 at 11:18am
While I might disagree to some extent about baseline values, I think Caplan’s broader point is solid: People (over-?)emphasize the benefits of wearing masks in order to moralize the issue – but usually fail to really account for the costs. And I do tend to agree that if basically everyone dislikes something for reasons that are hard to articulate, then that thing is probably costing us something substantial (even if we cannot yet adequately explain it). Not promoting superstitious belief in hard-to-measure costs, but we can still respect the costs as a serious known unknown at the very least.
Thomas Leske
Aug 24 2021 at 11:20am
Face shields would provide a much less invasive alternative. They do not protect against aerosols. However they protect against ultraviolet radiation, so one could easily implement Upper Room Air UVGI to keep infections by aerosols in check.
If something goes wrong, UV-C radiation will not cause permanent harm: https://doi.org/10.1111/php.12093
Upper Room Air UVGI is very effective (equivalent to about 60 air changes per hour): https://doi.org/10.1111/ina.12063 , https://ajph.aphapublications.org/doi/10.2105/AJPH.2006.096214
Government regulations on Upper Room Air UVGI should be lifted during a pandemic.
Alan Goldhammer
Aug 24 2021 at 11:31am
Finally, a post from Professor Caplan that I can support. Masks do work and there is ample literature on them that don’t need to be rehashed here. I covered all of this in my newsletter last year. The best source of information on masks comes from Aaron Collins who is a aerosol engineer and has numerous YouTube videos on the topic along with a spreadsheet on over two hundred masks he has personally tested. He has good data on kid’s masks as well. There are lots of different styles of masks he covers and the Korean KF94 masks that he endorse perform extremely well. We are using them now in our choir practice (all of us have been vaxxed and this is just an added control).
Evan Sherman
Aug 24 2021 at 12:02pm
Two things:
While I may well spend the time to watch some of Collins’ videos (thanks!), I wonder if you could provide a quick summary of his answer to this question: How effective are most cheap consumer-grade cloth masks vs. no masks? I know that, for those situations in which masking is appropriate, I should upgrade to some N95s, but I’m wondering just how bad (or not bad) your standard 3 for $10 USD cloth only masks are.
It may be worth reading the whole Caplan article. I think he reaches different conclusions than the ones you think he is reaching.
Alan Goldhammer
Aug 24 2021 at 12:45pm
I wore cloth masks almost exclusively last year. They were made by the same woman who makes my bow ties (you can go to my Covid-19 web page for a picture). I felt that these worked fine in a physical distancing environment that we had in our county during the first outbreak. I would not do this today with the Delta variant as the levels of expelled viral particles are likely much higher which is why it is more infectious (remember the old adage, ‘the dose makes the poison’).
I wear masks when going into all stores and have done so even when the number of new cases was way down before Delta. I’ve been vaxxed but as a senior, I don’t want even risk a case of mild Covid-19.
JFA
Aug 24 2021 at 2:58pm
“I felt that these worked fine.” This seems to be the issue. When asked for evidence, people have been answering with feelings.
Nick ronalds
Aug 25 2021 at 7:23pm
Alan,
The other crucial issue (besides those noted by others here) that you completely overlook is that the performance of masks in lab conditions is far from the whole story. What if people keep wearing the same mask day in and day out? What if they think mask wearing gives them license to get out and socialize more than they would otherwise? What if they touch their faces more often because of the mask? Etc. etc. In other words, lab conditions are next to worthless as a guide to the efficacy of masks. More relevant: what happens in the real world? Do places with strict mask mandates dramatically reduce the spread of disease? Well?
Phil H
Aug 24 2021 at 11:41am
This is pure nonsense. You can make up a psychological fairy story about literally anything: People will never agree to having their children cooped up inside for hours every day! (school) Cutting parts off the human body is fundamentally weird, and imposing it on a whole society could never work! (circumcision) Covering the breasts is/is not bizarre, a poll of my friends agrees with me! (adjust for the culture you live in)
As noted above, any single issue poll is nonsense. Psychological fairy stories are the antithesis of science.
Henri Hein
Aug 24 2021 at 12:30pm
Pure nonsense? I will also come out as agnostic as to the effectiveness of masks, but I can tell you at the personal level, I am really tired of them. So based on experience, Bryan’s piece rang true.
Evan Sherman
Aug 24 2021 at 1:18pm
No… When you have a known unknown (e.g. when you know that you cannot yet measure something very well, but you have to guess at it for practical reasons), there is a difference between guarding against hyperbolic and fantastical guestimates and presuming that the value/qty of the known unknown is zero just because it hasn’t been measured yet. Qty zero of anything (that people are trying to guess in cost/benefit analysis) is actually pretty rare.
You and I, like Caplan, can really only guestimate at the value of the psych cost of masking. But the necessity of guestimating does not mean that it is reasonable to just assume that the value is zero. (BTW, I would guestimate the cost is somewhat lower than Caplan would if he assumes that the cost is 25% of the cost of wearing a full paper bag over one’s head 24/7.)
Of course, as measurements/data become more and more available, a rational person should subordinate their guestimates. But just assuming the qty is zero until we have the data seems obviously short-sighted.
Mark Z
Aug 24 2021 at 1:22pm
I took the point of the post to be more normative than analytical, in which case, your response is nonsense. The fact that most American males are made to get circumcised is no more convincing that this is ok and we should keep doing it than the fact that most Saudi women have to wear burkas is convincing that that too had no psychological cost and they should keep doing it. That something is widely done proves that the purported psychological cost of having to do it is a fairy tale?’ How does one reach that conclusion?
Philo
Aug 24 2021 at 12:14pm
I agree with your thesis, but with uneasy doubts about whether I am being rational in doing so. The cost-benefit analysis is very hard to carry out: both the values and the probabilities are hard to estimate.
Jon Murphy
Aug 24 2021 at 12:20pm
This is a good post. One thing you’ve always emphasized in the PhD course I took with you is that economists must consider all costs, including psychological costs. Ignoring them and focusing primarily on monetary costs, we cannot easily explain differences in opinion. We quickly run into a problem of ad hominem.
Thomas Lee Hutcheson
Aug 24 2021 at 12:35pm
“Dehumanize” is pretty strong downside to claim. I certainly don’t like wearing a mask, especially it makes singing in church difficult, but to know that by doing so I can somewhat reduce the risk of infecting another person and show them that I’m trying to do so is worth it.
The unfortunate part of the mask debate is that is detracts from the much more important thing that we should do to protect others: get vaccinated.
Evan Sherman
Aug 24 2021 at 1:26pm
“The unfortunate part of the mask debate is that is detracts from the much more important thing that we should do to protect others: get vaccinated.”
Yes, this. I wouldn’t go so far as to say that the masking debate is a red-herring, but almost. Just get people vaccinated, and the whole masking question loses oxygen pretty quickly.
It’s like exercise vs. dieting in one’s effort to reach one’s healthy weight. Exercise ain’t nothing, but, if you have to (eventually) lose 40 pounds to reach healthy weight, your priorities should be 1) Diet 2) Diet 3) Exercise.
Christophe Biocca
Aug 24 2021 at 3:59pm
I wish it were so, but there’s clearly a trend towards “even if we strictly verify everyone involved in an activity is vaccinated, we’ll still have everyone mask up anyways”. See the LA and NYC school systems for an example. Polling suggests this policy is widely supported (majority of overall population, near-majority of parents). And that’s on top of students being at much lower risk than the overall population, so that’s effectively stacking masking on top of 2 massive risk reduction factors (low age and universal vaccination).
And that’s the logical conclusion of doing a cost-benefit analysis while pretending the cost is 0: any benefit, no matter how minute, instantly clears the bar. Reducing the net benefit does not change this, short of eliminating it entirely.
Evan Sherman
Aug 24 2021 at 5:07pm
Sure- while it is logical that near-universal vaccination should suck a lot of the oxygen away from the masking debate, it is fair to project that, as a political matter, the masking debate will rage on regardless.
Personally, I wonder if the masking zeal will really survive the results of near-universal vaccinations (presuming that happens), though. Right now, some ideologues are more-or-less successfuly leading the political charge, in some parts of the US, to impose masking on vaccinated people, but if/when vaccinations reach a point that the spread goes down, hospitalizations go down, deaths go down, etc., I feel like that has to take the energy out of that movement. But I guess we’ll see!
Thomas Lee Hutcheson
Aug 24 2021 at 9:26pm
While inconvenient, knowing that I can do even a little beyond getting vaccinated to reduce my chances of spreading the disease makes mask wearing worth it.
Evan Sherman
Aug 25 2021 at 11:38am
On the one hand, I am inclined to be sympathetic to this attitude. I was raised with fairly WASP-y values and cultural mores, so stoicism appeals to me. And if I frame the issue as ‘the only costs are my own discomfort, and I think this helps others, even if only a little bit’, then I tend to accept the duty gladly.
I’d invite you to consider, though, the costs imposed on others (degradation of specific social interactions, degradation of social graces over time, etc.) by wearing the mask. I think Caplan is overstating them, but they are not nothing.
Accordingly, when I think about it as a cost/benefit analysis in which costs to others are more than 0, I tend to play masking by ear. If I’m going into a store with a lot of people, but I do not think I will have any sustained interaction with anyone, I’ll generally mask. If I’m at a house party with 15 people, I’ll hold off. There are lots of scenarios in between with different cost/benefit scenarios.
Don Boudreaux
Aug 25 2021 at 1:41pm
Mr. Hutcheson:
You write:
Would you, then, also write?: “While inconvenient, knowing that I can do even a little beyond driving safely to reduce my chances of accidentally killing other people with my automobile makes my not driving a car ever again for any reason worth it.”
Another commenter on this post noted that cost-benefit analysis done on the assumption that cost = $0 leads to bad conclusions. More generally, unfortunate conclusions are also reached when cost-benefit analysis is done by underestimating costs and overestimating benefits.
Because (1) the vaccines are indeed quite effective at protecting those who are vaccinated from suffering serious consequences from Covid; (2) in the U.S. the vaccines are readily available to all adults who want them; and (3) children are at virtually no risk from suffering from Covid, why should any of us – you included – have to suffer even a minor inconvenience of wearing masks? Pointing out that incurring this inconvenience has some potential upside to others carries no more weight than does my pointing out that if you incur the inconvenience of walking to the supermarket rather than driving to the supermarket you will create some potential upside to others.
The effectiveness and widespread availability of the vaccines should seal the deal in favor of casting aside any and all Covid restrictions.
Thomas Lee Hutcheson
Aug 24 2021 at 9:45pm
“students being at much lower risk”
But they can be vectors. Infection is a chain. That’s why we need FDA to hurry up with certifying vaccination for younger children, too.
Christophe Biocca
Aug 25 2021 at 1:35pm
They’re still vectors when they wear a mask, just with an even-further reduced likelihood of transmission (and not by much). Which in turn could be lowered further by switching them to N95’s, sticking them in individual tents, running in-person classes on a rotating 1/5th capacity metric, using hard-UV lights everywhere etc.
robc
Aug 25 2021 at 3:16pm
If we have learned anything from the last year with “natural experiments” in different school environments, they are pretty sucky vectors for covid. This is a good thing. I havent heard of any major superspreader events caused by unmasked elementary schools. Maybe there were some, but not enough to register on my radar.
Brian
Aug 26 2021 at 4:35pm
“Just get people vaccinated, and the whole masking question loses oxygen pretty quickly.”
Evan,
With the Delta variant, this is unfortunately untrue. In terms of transmission, the Delta is sufficiently contagious and the vaccines sufficiently ineffective that a vaccinated person carries about the same risk of infection by Delta as an unvaccinated one did from the original (wild-type) COVID-19. There is no way to bring down the spread of Delta, even among the vaccinated, without taking additional measures, such as mask wearing, or letting everyone just get infected.
robc
Aug 25 2021 at 9:10am
Not at all. Value is subjective. The fact that it isn’t dehumanizing to you says nothing about whether it is dehumanizing to Bryan.
I probably fall somewhere in between the two of you.
Except in rare circumstances (flying primarily), I haven’t worn my masks since 2 weeks after my 2nd vaccine. And I am not going to start back up. Either the vaccine works or it doesn’t and I will get us to herd immunity the old fashioned way. I am healthy and not that old (I am at an age where I was literally ambivalent about whether I got the vaccine or not, my cost/benefit calculation came out dead even – I got the vaccine when it was literally no trouble to me), so am not overly concerned if I get it.
Thomas Lee Hutcheson
Aug 25 2021 at 11:14am
I agree that you have to do your own c-b analysis, but your post seems to ignore the good you do to others by wearing a mask indoors when there many unvaccinated people around and cases are rising — you reduce your own risk of transmitting and you set a good example for others.
robc
Aug 25 2021 at 8:13pm
If sick, I wont be around people, and I the risk of asymptomatic transmission is small ( but not zero).
I dont care if other people are masked or not, so value setting a good example at zero.
Torrey
Aug 25 2021 at 3:07pm
dehumanize: deprive of positive human qualities
I think that fits. However, I believe many think of something more like “degrading” when they hear the word “dehumanize”. Wearing a mask might no be degrading, but it most certainly deprives us of the positive human qualities that Bryan does a good job of articulating for us.
Monte
Aug 24 2021 at 12:37pm
Do you suppose the deleterious effects of long-term mask-wearing ought to be included in any discussion by militant advocates of mask mandates?
https://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-6-130.php?jid=jide
https://www.bmj.com/content/369/bmj.m1435/rr-40
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072811/
Chris E
Aug 24 2021 at 4:16pm
Which of these constitutes evidence for “the deleterious effects of long-term mask-wearing”?
Rosner 2020 provides survey evidence for increases in acne, skin breakdown, and headaches among healthcare workers (whose shifts are normally 12 hours). The author doesn’t distinguish between N95s and Surgical masks in determining the effect of wearing a mask, and since N95s fit substantially tighter, so lumping them together hampers extrapolation to the effect of mask mandates.
Lazzarino 2020 is a letter to the editor, speculating that masks are a danger insofar as people may wear them improperly, or be provided a false sense of security, or stand closer together to hear each other. These should be understood as “reasons to wear masks properly and remember to distance”, not “reasons to not wear masks”, and certainly doesn’t constitute a “deleterious effect of long-term mask-wearing”.
Kisielinski et al 2021 has the virtue of being recent, but the negative effects they measure (decreased blood oxygen concentration and increased blood carbon dioxide concentration), while statistically significant, do not move mask wearers outside of the normal range for those two metrics.
Monte
Aug 29 2021 at 1:04pm
Thanks for your response, Chris.
You seem to be taking a rather pedantic view of the details, but, in general, I think these citations speak clearly to the adverse effects of long-term mask wearing, as minor as some of them may be.
Another reason I’m opposed to mask mandates (in addition to those referenced above), is that there is very little hard evidence that masks work to mitigate risk to the wearer or to those within close proximity, as they are currently worn to guard against the transmission of Covid-19.
Are you prepared to make a case for mask mandates based on the available research? CBA?
Resects.
Chris E
Sep 1 2021 at 4:48pm
Thanks for the reply, Monte.
I think closely scrutinizing how bad the effects of mask wearing really are is important for weighing the pros and cons of mask mandates. That the effects are fairly minor and transient (i.e. neither long-term nor deleterious) lowers the threshold at which mask mandates pass a cost benefit analysis.
GiveWell’s Masking RCT just got published yesterday, where they did a pro-masking campaign in some but not other places in Bangladesh, for which the headline results are a 9.3% reduction in COVID-19 spread, as the result of an increase from a 13.3% to a 42.3% masking rate in those areas. The impact of near universal masking with a mandate would necessarily be higher. Also, they find (contra Lazzarino) that masking did not increase high risk behavior due to a false sense of security. This intervention cost between $10k and $50k on a per (statistical) life saved basis, but importantly, most of the costs associated with the project were spent on paying in-person mask promoters to supply people with masks and persuade people to wear them. Without those costs (i.e. a mandate rather than paid promoters), the per-life-saved cost would be between $500 and $2500 — well below the cost of a statistical life in Bangladesh ($205,000) and negligible compared to the US’s $10,000,000.
Even granting that some people find masks to be 26 times worse than wearing a seat belt (an idea for which some skepticism is in order), and that those who have to wear tight fitting N95 masks may experience skin breakdown and headaches, I think masking clearly comes out ahead as one of the cheapest life-saving interventions on offer.
Thanks,
-Chris
Monte
Sep 5 2021 at 11:24am
I think closely scrutinizing how bad the effects of mask wearing really are is important for weighing the pros and cons of mask mandates.
OK, let’s scrutinize. Beginning with the study you cited above, I assume you’re aware of the limitations of Cluster Randomized Control Trials (CRCTs) vs individually randomized trials (cluster trials are inefficient and have less statistical power), as well as those limitations specifically identified in this trial, the most glaring of which is the absence of statistically significant decreases in symptomatic seroprevalence in the <50 years of age group. Additionally, there is a strong likelihood that the social distancing encouraged during the trials influenced the results as much as, if not more than, mask wearing. And simply put, a case study of rural Bangladesh villagers isn’t exactly representative of the global community and hardly justifies an extrapolation of strictly enforced mask mandates on a scale of this magnitude, particularly given the (probably much higher) net cost estimated at $500-$2500 per life saved. Notwithstanding the fact that only 3% of covid cases in the <50 age group actually die from covid, a demographic which constitutes approximately 2/3 of the U.S. population.
That the effects are fairly minor and transient (i.e. neither long-term nor deleterious) lowers the threshold at which mask mandates pass a cost benefit analysis.
I think you’re over-trivializing the adverse effects of long-term mask wearing. To suggest that they are minor and transient is a bit short-sighted, IMO. Taking the long view, I can’t help but be persuaded by the following:
Masks are Harmful: 17 Ways That Masks Can Cause Harm, Jim Meehan, MD, 10 Oct 2020 (ratical.org)
The Dangers of Masks – AIER
http://livingwitnesstv.com/7-long-term-side-effects-of-wearing-face-masks/
https://ca.childrenshealthdefense.org/school/ca-still-masking-children-despite-proven-physical-psychological-danger/
https://www.city-journal.org/masking-children-unnecessary-and-harmful?wallit_nosession=1
Please understand that I’m not opposed to mask-wearing, per se, just mask mandates. I think a more balanced approach to managing the pandemic is warranted and I whole-heartedly agree with this piece by Dr. Kevin Pham:
https://www.dailysignal.com/2020/06/23/using-face-masks-is-still-a-good-idea-mandating-them-isnt/
Monte
Sep 5 2021 at 6:22pm
I think closely scrutinizing how bad the effects of mask wearing really are is important for weighing the pros and cons of mask mandates.
OK, let’s scrutinize. Beginning with the study you cited above, I assume you’re aware of the limitations of Cluster Randomized Control Trials (CRCTs) vs individually randomized trials (cluster trials are inefficient and have less statistical power), as well as those limitations specifically identified in this trial, the most glaring of which is the absence of statistically significant decreases in symptomatic seroprevalence in the <50 years of age group. Additionally, there is a strong likelihood that the social distancing encouraged during the trials influenced the results as much as, if not more than, mask wearing. And simply put, a case study of rural Bangladesh villagers isn’t exactly representative of the global community and hardly justifies an extrapolation of strictly enforced mask mandates on a scale of this magnitude, particularly given the (probably much higher) net cost estimated at $500-$2500 per life saved. Notwithstanding the fact that only 3% of covid cases in the <50 age group actually die from covid, a demographic which constitutes approximately 2/3 of the U.S. population.
That the effects are fairly minor and transient (i.e. neither long-term nor deleterious) lowers the threshold at which mask mandates pass a cost benefit analysis.
I think you’re over-trivializing the adverse effects of long-term mask wearing. To suggest that they are minor and transient is a bit short-sighted, IMO. Taking the long view, I can’t help but be persuaded by the following:
Masks are Harmful: 17 Ways That Masks Can Cause Harm, Jim Meehan, MD, 10 Oct 2020 (ratical.org)
The Dangers of Masks – AIER
http://livingwitnesstv.com/7-long-term-side-effects-of-wearing-face-masks/
https://ca.childrenshealthdefense.org/school/ca-still-masking-children-despite-proven-physical-psychological-danger/
https://www.city-journal.org/masking-children-unnecessary-and-harmful?wallit_nosession=1
Please understand that I’m not opposed to mask-wearing, per se, just mask mandates. I think a more balanced approach to managing the pandemic is warranted and I whole-heartedly agree with this piece by Dr. Kevin Pham:
https://www.dailysignal.com/2020/06/23/using-face-masks-is-still-a-good-idea-mandating-them-isnt/
In any case, thanks for the discussion and I will give you the last word.
Best regards.
Monte
Aug 29 2021 at 1:06pm
Respects, that is.
Rodrigo
Aug 24 2021 at 2:09pm
Wow… this article pretend to be something moralistic and a telling off. But the level of the arguments are so low that feel embarrrased of the author.
1. There aren’t comercial masks capables of stop the virus. Just because its size is really smaller than every microscopical net a mask can provide. Moreover, masks are designed mostly to stop emissions from your mouth, not to block income.
2. During the 80s and 90s many surveys were done with flu in order to analize if in a flu pandemia mask would help. And the answer was NO. Thats why even in the hardest flu pandemia no country stablish mandatory masks. By the way, masks creates other problems because of bacterias shettel in the tissues.
The other arguments about selfissnes… ok, just topics to avoid a real scientific debate.
regards!!
Stephen McKinney
Aug 24 2021 at 4:12pm
I think a better Twitter poll would be: Pre-Covid, how much would someone have had to pay you to wear a mask in public for a year? My answer would be ~$1000.
Thomas Lee Hutcheson
Aug 24 2021 at 9:32pm
You alone? And with no benefit to anyone else? Perhaps $1000 is not a bad guess, but pretty irrelevant.
What about how much would you pay to be the only person not wearing a mask that reduces your risk of transmitting a disease that is deadly to some people.?
Stephen McKinney
Aug 25 2021 at 3:22pm
The point of asking about wearing a mask pre-Covid, with no benefit, is to isolate the cost. Pro-maskers frequently assert that wearing a mask has no cost (or an insignificant cost); this question shows how false that is. Of course if wearing a mask has some benefit, it must be weighed against the cost. I think the benefit is slim to none; you obviously disagree. We need more and higher quality research before we can make a strong claim about the efficacy of masks for preventing the spread of disease in any case.
astew
Aug 24 2021 at 4:45pm
It’s worth pointing out that a cost-benefit analysis of a person or population wearing masks is not the same as a cost-benefit analysis of mask mandates.
If the idea is that we should wear a mask when we think ourselves to be sick, I’m content to do that (if I need to go out at all). I’m not eager to go out and make people sick when I have good reason to believe I might be infectious.
If the idea is that we should all wear masks all the time whether or not we have any specific reason to believe we’re sick, just because we might be asymptomatic and other people can’t be certain we’re not infectious… That I’m just not going to do.
I’m not really interested in indulging anyone’s paranoid fever dreams in that way.
Thomas Lee Hutcheson
Aug 24 2021 at 9:41pm
“just because we might be asymptomatic and other people can’t be certain we’re not infectious…” When the “probability of the “might be” has increased and the number of those most vulnerable to an asymptomatic infection is near 50%, and assuming few people enjoy being a jerks, per se, the small inconvenience of a wearing a mask indoors ought make a mask mandate worth it (but not worth putting real resources into punishing violators).
Daniel Klein
Aug 24 2021 at 6:05pm
The great Swedish liberal Erik Gustaf Geijer referred to “the personality principle,” which he associated with Christianity and respect for individual dignity: “With Christianity the concept of human personality first arose.” I’m still not sure what Geijer meant by the personality principle. But I’m pretty sure he’d feel that masks efface personality and are, indeed, an assault on the personality principle.
Adam Smith would be mortified by mask despotism. How is the ecology of sympathy supposed to function without seeing the lower half of the person’s face?
Michael Rulle
Aug 25 2021 at 10:17am
I hate masks. And if I were confident they worked I would want them to be worn. You mention an RCT study that shows they work. There are a dozen or so RCT studies done re: flu in the last decade that show they do nothing. One would have to say flu viruses are smaller is size than Covid viruses to say the studies are apples to oranges. There are also the issue of wearing masks the wrong way and not doing all the things necessary to maximize the probability they help. Pence used to go thru his “wash hands”, “wash masks or wear once”, “don’t touch your mask or your face”, don’t scratch your eyes. When the Flu RCT tests were done they tried to control for those factors and they still did not work.
How many do the above? Your answer might be they should. But we don’t. Can we “mandate they do the above?”. No. Of course not. Since masks help others, and not yourself—-unless everyone wears them—-under the assumption they help at all——just wear your mask to do your civic duty. But just realize it is unlikely you will be protected—-and if the RCT tests on Flu are right, it unlikely they do anything.
Maybe the placebo effect? 🙂
Henri Hein
Aug 25 2021 at 12:58pm
I also see people do the actively wrong thing with masks: put them down on the table at meal time, string them on their wrists, etc. This seems like a sure-fire way to spread virus contamination.
Tim H
Aug 25 2021 at 11:16am
Doesn’t the “big deal” about masks have to be evaluated in terms of the risk of the pathogen as well? I get that by the poll is attempting to get to everyone’s evaluation of that risk. But given that the perceived risk vs the actual risk to almost all groups except those over 65 is significantly different, isn’t it incumbent on the mask advocates to make a much stronger case for masks than we have so far heard? (Source: https://www.franklintempleton.com/investor/article?contentPath=html/ftthinks/en-us-retail/cio-views/on-my-mind-they-blinded-us-from-science.html)
In line with the suggestion above that it’s about $1000 inconvenience to wear a mask for a year, how about letting establishments run the experiment.
It’s clearly an inconvenience for some and a good for others. If it’s a good, then people should be willing to pay for it, right? So maybe stores, restaurants and so forth can put a mask surcharge on their bills where all staff and patrons then agree to wear masks on the premises and those who wish to frequent those establishments can do so. And vice versa for those who choose not to.
Knut P. Heen
Aug 25 2021 at 11:48am
I have only used a mask once, for about 30 minutes when I got my first shot of the vaccine. I have always hated needles, but wearing a mask is far worse. I did not even notice the needle because I was too occupied with the annoying mask.
I hate wearing seat belts too, but I rank shots at least 50 times worse than a seat belt, and masks at least 10 times worse than a needle. I guess that is 500 times worse than a seat belt. I felt I could not breath in that thing. A really uncomfortable feeling.
I actually think 500 times is about right. I would rather wear a seat belt 2 hours every day of a year than wearing a mask for one hour a year.
Given the results of the poll, I guess people in the US really hates seat belts.
Richard Wallace
Aug 25 2021 at 1:30pm
One of the fundamental inclinations of Darwinism is to look for function (Stephen Jay Gould notwithstanding.) Given the amount of facial muscle control and associated brain capacity in humans compared to other animals, there is strong reason to suspect some sort of functional social value of facial display.
Michael Stack
Aug 25 2021 at 2:44pm
My frustration is that it is impossible to have a civil discussion about masks right now. You have folks on the right who confidently claim they do nothing, and folks on the left who act as if they are enormously effective protection against COVID.
It appears to me that the truth is somewhere in between. It looks like masks are marginally effective. You can derive a variety of policy recommendations from the fact that they’re uncomfortable yet offer marginal protection. In my experience, suggesting that the evidence is a bit equivocal is a recipe for a social media blow-up.
Torrey
Aug 25 2021 at 3:14pm
“It appears to me that the truth is somewhere in between. It looks like masks are marginally effective.”
I agree 100%!
robc
Aug 25 2021 at 3:20pm
I think this is why the old (2016?) WHO standard was “in case of pandemic, don’t try to ban masks. They don’t do much, but let people who want to wear them wear them.”
That wasn’t actually a quote, but a paraphrase. And mandates weren’t even on their radar. The issue was than a mask ban would cause more trouble that its worth.
Quiet Wyatt
Aug 26 2021 at 7:22pm
I feel like I’ve read a thousand studies on the effectiveness of masks and they all pretty much conclude the same thing: They don’t do much, but it’s better than nothing. That’s a TERRIBLE premise for developing any sort of policy or mandates. You know what else won’t do much but is better than nothing? Screen Doors on Submarines.
KevinDC
Aug 25 2021 at 4:52pm
I can see a few points of contention here.
For one, I’m not sold on the Twitter poll data. Caplan himself has taken pains in previous writings to point out that what people will say in polls rarely reflects reality. He’s provided examples where people will say to pollsters that “X is critically important in my life!” but also barely make any efforts to support/participate in X. Masks have, unfortunately, become an emotionally valenced issue as of late, with all kinds of tribal signaling and countersignaling wrapped up in how people respond to masks. Given that, I think it’s extremely likely that people who are upset by masks and especially by mask mandates would greatly exaggerate the costs it inflicts on them in a Twitter poll. I’d be more convinced by something measuring peoples willingness to pay (actual willingness, not professed willingness!) to be exempted from masks. Something like “For $X a week, you can be exempted from mask mandates and all proceeds will to Covid-19 related causes.” I’d be much more persuaded by seeing lots of people who actually pay a high X number of dollars, rather than making costless claims on Twitter polls.
Second, Caplan draws our attention to “the long right tail of people who find masks massively worse than seatbelts” and says this suggests masks are therefore “making a quarter of the population miserable.” This doesn’t follow. For me, for example, seatbelts cause no discomfort. If I pay attention to my seat belt I notice I’m wearing it, but it’s not causing me any unpleasantness. And if I’m not actively paying attention, I don’t even notice it’s there. Given that, in that Twitter poll, I’d probably have selected that masks were over 25 times more uncomfortable than a seatbelt – but only in the sense that “practically zero times twenty five” is still practically zero. So I don’t think the claim that the people who claimed the higher thresholds of discomfort are therefore in abject misery is justified.
Lastly, there’s an important disanalogy between masks and seatbelts. As Caplan correctly notes, people who forgo seatbelts are putting themselves at risk. Masks, on the other hand, are mostly about reducing the risk one imposes on others. Caplan estimates that masks reduce the spread by 10-15% – if wearing seatbelts also reduced the injuries you inflicted on other drivers/pedestrians during a car accident by 10-15%, the analogy would be much more solid.
None of this means I’m contending that masks or mask mandates do pass the cost benefit test. I don’t have any opinion on that point, mostly because I’d need a lot more knowledge than I actually have. I’m comfortable with not having opinions on things though! But this post doesn’t move me at all away from my agnosticism.
Todd Kreider
Aug 27 2021 at 3:00pm
” Caplan estimates that masks reduce the spread by 10-15%”
Yet no RTC study supports Caplan’s guess about even surgical masks while the 2015 study shows no effectiveness for cloth masks that most wear.
Nick R
Aug 25 2021 at 7:09pm
1. Wearing a mask is not a slight inconvenience, but a considerable one.
2. Example: Exercise with masks is uncomfortable. Intense exercise becomes close to impossible.
2. It’s unhealthy even under ordinary conditions: the concentration of carbon dioxide inhaled in each breath is increased. One of the European countries, I believe Germany, determined that the concentration of CO2 inhaled was several times what had been determined to be “safe” for children. The same is true for the old.
There are I’m sure other issues with masks, but the long and short of it is that your premise is false, or certainly highly debatable. Perhaps masks are just a “slight inconvenience” to academics and others who spend their days at desks writing or doing research. But that’s not how everyone spends their day.
In short, why are you so confident that everyone must share your personal preferences?
Mark Bahner
Aug 25 2021 at 11:33pm
Consider this possibility: Your grandchildren have have a mild COVID-like illness. They transmit it to you, in part because they aren’t wearing masks. It kills you. How might that change their laughter in their whole lifetime?
Student of Liberty
Aug 26 2021 at 6:46am
It may not even be an option. I know somebody who prefers working from home because of a mask mandate in her office whereby they keep having zoom meetings with other people working from home or in other locations. Try zoom with a mask!
Mark E W
Aug 26 2021 at 10:38am
I would prefer we not have mask mandates at this point in the pandemic, but to steel man the argument in favor a bit: A true cost-benefit analysis must take into account all costs and all benefits. I know multiple people who (irrationally, in my opinion) are highly afraid to be in close proximity with those not wearing masks. I see many commenters dismissing such people as paranoid, which may well be the case, but why are your feelings about the dehumanizing nature of masks valid and a legitimate “cost” while the feelings of people who are afraid to be near the mask-less ignored?
Don Boudreaux
Aug 26 2021 at 12:06pm
Mark E W:
Your question is good. I believe the correct answer turns on the background presumptions in use in a free society.
In a free society, the burden of persuasion falls on those persons who propose initiating coercion to alter peaceful actions. Those persons bear the burden of persuading the rest of us that their proposed measure is justified (i.e., that the proposed measure passes a plausible cost-benefit test). It follows, I think, that in our society individuals who are afraid of being around unmasked people bear the burden of proving that their fears are such as to justify mask mandates. This burden does not fall on those of us who wish to go about life normally – that is, unmasked.
I’ll add that because each such fearful person has the option of individually choosing just how much personal contact to have with unmasked people, for the fearful to satisfy this burden of persuasion would be very difficult. After all, if Jones is terrified of being around unmasked people, Jones can stay home and, when he absolutely must venture out into public, he can wear a hazmat suit (or whatever other level of personal protection is sufficient to calm his fears). It seems unjust for Jones to insist that his unusual fears justify government compelling everyone else to accommodate him.
Mark Bahner
Aug 26 2021 at 11:16pm
This is an excellent comment because it addresses something every good engineer knows…technology can solve anything. 🙂
Before vaccines, I often made the point that we absolutely know that *some* type of protection would be very effective against COV?ID-19…even if it was something as drastic as a hazmat suit (which would actually need to be modified to filter *output* air, in addition to input air).
One of the real disappointments to me is how little advancement this pandemic has prompted regarding air filtration devices. I certainly expected at least some percentage of the population to be wearing the equivalent of a motorcycle helmet with positive pressure filtration of incoming air, in addition to filtration of exhaled air.
We’ve let a crisis go to waste.
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