Today, Explained - The Anti-maskers

Episode Date: July 23, 2020

The United States has now confirmed 4 million cases of Covid-19. Some Americans still don’t want to wear a mask. Transcript at vox.com/todayexplained. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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As of today, we've got over 4 million reported cases of COVID. And as you surely know by now, That's an undercount. The CDC says that some regions might have 10 times the number of cases they're reporting. On Tuesday, the United States reported 1,000 deaths in a single day. It was the first time that had happened since May. States are dialing back their reopenings, and yet the country is still fighting about something that's pretty basic. You know what it is. You literally cannot mandate somebody to wear a mask knowing that that

mask is killing people. It literally is killing people. And my the people, we the people are waking up. In Michigan, the face mask rule at a family dollar store turned deadly. Police say a security guard was shot after getting into an argument with the customer. Internationally today, immediate backlash after Georgia's Republican governor, Brian Kemp, banned cities in his state from mandating the wearing of masks in public. In Alabama, an off-duty officer was seen body slamming a woman at a Walmart when she allegedly refused to wear a mask. A councilman in Scottsdale under fire after appearing to mock the dying words of George Floyd and Eric Garner as he protested wearing a mask. I can't breathe! I can't breathe!

He later apologized. On today's show, we're going to try and figure out why Americans are still struggling to mask up when they go out. Dr. Julia Marcus is here to help. I am an epidemiologist and assistant professor at Harvard Medical School. And it felt like a good time to have this conversation because this week the president finally came around to masks. We're asking everybody that when you are not able to socially distance, wear a mask, get a mask. Whether you like the mask or not, they have an impact, they'll have an effect, and we need everything we can get. Yeah, you know, better late than never.

And hopefully that will push some of his constituents who have been more resistant to start wearing masks themselves. Do you think it'll work that way? Like after people have become so divided on this issue, him finally just saying in a press conference, maybe wear a mask will turn people around on it? It might help some of the people who were maybe less entrenched in their position. But I do think some of the damage has already been done in terms of politicizing masks and creating this very polarized debate. What do you think took the president so long? I mean, things have been bad for months now. Lockdowns were happening in March and April and in July, he says, maybe wear a mask? Yeah. I mean, my question is almost the opposite of why did he shift his position? I wasn't all

that shocked that he went against CDC recommendations on this, given his whole response to the pandemic in general. And so I'm kind of curious what happened now to push him to finally say, okay, fine, wear a mask. That was my next question for you. Do we have any idea how he was convinced? I don't know, but I would guess that it felt to him based on polling data he's seeing or pressure from other Republican officials that maybe this was a better way to go in terms of his election prospects. I wonder, is the quote-unquote debate a sort of distinctly American thing, or have other countries dealt with the same resistance that we're seeing in this country?

I don't know that it's a distinctly American thing, but it certainly has a lot of undercurrents of some of the themes we tend to see here around a focus on individual freedoms and concerns that public health recommendations are paternalistic or infringing on people's civil liberties. So either wear the mask. And I'm not doing it because I woke up in a free country. Have a great day. So anyone harassing me to wear a mask, you guys are violating federal law. Did you get that? Get that on camera. Hell, I would rather die from coronavirus than to live the rest of my life in fear and wearing a damn mask. And I do think there's a long history

of new public health interventions encountering some resistance in the public. So that's nothing new and public health people are used to that. But I think what's a bit different here was seeing a sitting president flouting those recommendations. This is voluntary. I don't think I'm going to be doing it. I don't know I'm going to be doing it. I don't know that we've seen that happen before. And so I think that created a bit more, it added fuel to a fire that, you know, would have already been there a little bit,

but I think it made it a bit more politicized than it usually is. Hmm. How much of the country is suffering from this sort of mask aversion? Do we have any idea? I don't think it's a huge proportion. I think based on some survey data that are available on mask wearing that most people are on board with masks, that it's not a huge chunk of the population that is avidly against them. But, you know, it's a vocal group and it has created this whole debate around masks when perhaps there isn't a huge debate and we're focusing a bit too much on this discussion. But I do think it is important to

try to increase adherence to masks and try to understand why people are resistant to them. Do we know who tends to be anti-mask? Is it libertarians? Is it people who support the president? Do we know? Well, some surveys have suggested it's more likely to be men than women. It's more likely to be white people than people of color, and that it's more likely to be conservative people than liberal people. and that it's more likely to be conservative people than liberal people. Are there people out there who are too pro-mask? The people who are out there screaming at people on the sidewalk for not wearing masks, policing beaches, just sort of trying to conduct citizens arrests for people who are not wearing masks? Yeah, I think it's a it's a great question.

I think when we say polarized, we really mean polarized. It's not just that there are, you know, these avid anti maskers, but there is some very binary messaging on the other side as well. Wear a mask every single time you leave your house at all times. Just wear a damn mask. And you think you have the right to take your mask off to get everyone else sick. Meanwhile, you just threatened to cough on me during a global pandemic. Are you for real? Is that funny? You're funny. It's super funny. I swear to God, if you touch me again, I will knock you out. That kind of messaging, I think, isn't necessarily ideal either. And there can be a middle ground that's like, masks are important. Yes, some of the messaging was confusing.

Now we're in a place where it seems like they really can help. And here are the situations where they are most important. I think people can handle some nuance. So it's not that you necessarily need to be wearing a mask when you're out on a walk in your neighborhood alone and nobody is within 30 feet of you. But if you're, you know, in a crowded grocery store, yeah, wear a mask and let's make it easy for people and put a mask dispenser in the front of the grocery store with a sign that says, please wear this for the 10 minutes that you're in here.

And if you need to dispose of it on your way out, fine. But make that ask focused on the situations where it's most needed. You mentioned that initially the messaging was confusing. I remember that we didn't all need to wear masks at first, but now we should. Was that just the science evolving? Well, the message was always, if you have symptoms, wear a mask. But there wasn't an initial understanding of asymptomatic transmission. And I think as that became clearer, it became more of a consideration in terms of recommending masks for people who weren't having symptoms, who may be unknowingly transmitting the virus. I think that what really contributed to some confusion was that that non-recommendation around masks actually went further with some public health officials saying masks could do more harm than good. tend to buy masks and don't know how to wear them properly, as a healthcare provider, I have to get

fit tested. Folks who don't know how to wear them properly tend to touch their faces a lot and actually can increase the spread of coronavirus. You can increase your risk of getting it by wearing a mask if you are not a healthcare provider. And I think that that message probably contributed somewhat to the sense that there was more than just an evolution of science in the messaging around masks, but that people were being lied to. And of course, there was also a concern around the shortage of PPE for healthcare workers who were being exposed on a daily basis. So I think there was probably a lot going on there with why masks were not initially recommended. And I'm not as clear on why there were concerns that masks would do more harm than recommended. And I'm not as clear on why there were concerns that

masks would do more harm than good, because I'm not sure that there is evidence of that. But this has all been cleared up now. Guidelines are consistent? Guidelines, of course, are all over the place, depending on where you live. But at a federal level, the recommendation is to wear a mask when you can't socially distance from people. It's not a mandate. Some places have mandates, and those mandates differ depending on the community. And maybe they should differ depending on what's going on with community spread in that area. But I think we would benefit probably from a federal mask mandate, but it's not that easy. If you think about a mandate and how it would be enforced everywhere at all times, on every train, every bus, you know, it's just not possible, not feasible and not equitable usually.

So I think we need both things. We need mask requirements, but we also need, especially in the places where they're most needed, indoor public spaces in particular. But we also need to be thinking about what the resistance is, what makes it hard for people, and working with them to overcome those barriers. More with Dr. Julia Marcus after a quick break. Thank you. spend management software designed to help you save time and put money back in your pocket. Ramp says they give finance teams unprecedented control and insight into company spend. With Ramp, you're able to issue cards to every employee with limits and restrictions and automate expense reporting so you can stop wasting time at the end of every month. And now you can get $250 when you join Ramp.

You can go to ramp.com slash explained, ramp.com slash explained, R-A-M-P dot com slash explained. Cards issued by Sutton Bank. Member FDIC. Terms and conditions apply. Dr. Marcus, I was wondering if we could talk about some mask best practices, because I think we've all seen the bros out there wearing them under their noses, under their mouths, on their necks. There's a lot of innovation going on, but clearly not all innovation is good. I think the best way to wear a mask is over your mouth

and nose when you are near other people, and especially when you're indoors. And I don't think it has to be a whole lot more complicated than that. And I think the reason people have their masks, well, there may be many reasons why people have their masks worn as chin straps instead of over their face. But you know, in some cases, like if I'm out for a jog in a fairly spacious area, it's pretty uncomfortable to wear a mask the whole time you're jogging. And it's also unnecessary if you're not near anyone. But I do always have one available and visible and ready to pull up. And I think maybe there are times when everybody's kind of thinking that way and they're well-intentioned. And, you know, I've written about how masks are in some ways like condoms and sometimes people have a condom on their bedside

table and they just never use it. So it's like a good intention, but doesn't quite happen. So I think the important thing is just making sure that it actually makes it onto your face, covering your mouth and nose when you're close to other people, especially indoors. I think when we did our initial mask episode, we cleared up that, you know, an N95 mask is probably one of the better masks you could possibly have, but the best practices were to just try and use something to cover your nose and mouth. But has that thinking evolved at all? I've heard that, you know, bandanas really aren't doing the job because they aren't as tight on the bottom. And so you're missing some real covering there down below. Is that factual? Well, I mean, there's going to be a spectrum of how much different kinds of face coverings reduce the risk

of transmission. And I think the data are still evolving on that. But a bandana is going to be better than nothing. And a close-fitting cloth mask is going to be better than a bandana. And an N95 is going to be better than a cloth mask. So it's, you know, it's a matter of what is going to reduce transmission enough in the community to get us to a place where we can live our lives again. And I think if everybody were wearing cloth masks when they're most needed, we may be able to make a real dent in what's going on right now. And of course, it's not a panacea. And we do need particularly public health infrastructure around testing and tracing to also make that impact. But masks can help. How much can they help? Do we have any data that

suggests the difference mask wearing can make? There are some studies that have suggested that if a certain proportion of the population was wearing masks, new infections would be reduced by a certain amount. A recent study by a group of Cornell University scientists showed that when quarantines are lifted, if 80 percent of the population wears masks with social distancing, the virus could be eliminated. I think there's a lot of assumptions there and a lot of unknowns, but I think it's pretty clear that masks can help. And we should use, I think, every prevention tool at our disposal to try to make an impact. And so, again, it's not absolutes and it's not the only intervention we have, but I think it's worth trying to get people on board as much as possible, especially where it counts. Like in places like Florida, Texas, Arizona? Yep, places with high community spread,

but also indoor public spaces where people gather. But some of these places have still really struggled to mandate mask wearing. Do they not have public health officials who see the importance of masks, or is it more of a political problem? I think in some places it is clearly a political problem. You know, in Georgia in particular, we've seen active interventions on the part of elected officials to make sure that mask mandates aren't happening.

So it's not just leaving it up to localities to make the decision themselves. It's actually interfering with their ability to enforce a mandate. But that's where this becomes sort of just indecipherable to me. I mean, we have the data that shows community spread. You're saying that we have some data that suggests masks reduce that community spread. And then you have politicians who are saying, we'd rather have community spread than tell people to wear masks. Yeah. It's hard for me as a public health person to make sense of it all as well. Yeah. It just feels like there's something going on there that might even be beyond politics. I mean, especially now that the president is saying, you got to wear a mask. What are the politics of this after he says it? I truly believe there's going to be a really

interesting book written about what happened with masks in 2020. And I look forward to reading that. But I do hope that this shift in tone from the president will, you know, if it, I don't know if it's going to have an impact for his constituents who are feeling resistant to masks, but I wonder if it will have an impact for, let's say, the situation going on politically in Georgia, that Republican elected officials who have been resistant to mask mandates, you know, may soften a bit if the president is softening as well. In the meantime, while, you know, may soften a bit if the president is softening as well. In the meantime, while, you know, we wait to see whether the politics of this shifts throughout the country, I wonder, you know, what do you say to someone in your family who's maybe

showing resistance to wearing a mask at a grocery store or a Costco or something like that? Is there something you've heard that works when you're trying to have these conversations with people who are resistant to this idea still? Yeah, I mean, I wrote a piece about masks and particularly not just people who find them to be an inconvenience, which is understandable,

but also people who are ideologically opposed. And I had a lot of people contact me and I talked to some of them about what's going on for them. And I think that they were very open to hearing what I had to say about why masks are worth wearing simply because I hadn't kind of yelled at them in my piece that I wrote. And I think it was a learning moment for me that, you know, if you, as a public health person or as somebody who's trying to convince somebody in your community to wear masks, if you hear what their concerns are and you take the time to acknowledge them, you can have a much more productive conversation. And I think it does take more time. And I think some people see it as coddling

to engage with people who are ideologically opposed to masks or having a hard time wearing them. But actually, this is how public health ends up being effective, is acknowledging what people's barriers are, taking the time to understand them, and then trying to figure out how we can overcome them, both through our messaging and through interventions. So I would encourage people to take that approach rather than a shaming approach, which we know doesn't really work very well in

public health. So it's going to take a lot of conversations, and it's still a conversation worth having. That's my sense. Okay. Julia, thanks so much for your time. Really appreciate it. Thanks for having me. I think we got to look ourselves in the eye. We got to look in the mirror and ask ourselves, how can I be better? How can I expect more of myself and others? How can I be more responsible? How can I have more compassion? How can I have more courage? How can I be more fair? How do I make sure I wear the damn mask? We individually make these changes.

That's how we make a collective change.