Wednesday, 9 Oct 2024

Opinion | Is It Time to End Outdoor Masking?

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Happy maskers are all alike; every unhappy masker is unhappy in his own way. For some, the culprit is maskne. For others, it’s the fog of their breath on their glasses. For me, the irritant isn’t fabric per se but summer, which transforms the thick black cotton of my preferred mask from a convenient winter face warmer into a makeshift lip oven. Still, as temperatures climb, I know my discomfort is a small price to pay for keeping the people I encounter on my silly little walks safe.

But what if keeping people safe isn’t actually what I’m doing? In recent days, a slew of essays — published in the center-leftish magazines Slate and The Atlantic, the more leftish magazine The New Republic and the libertarian magazine Reason — have sought to spark a reappraisal of our legal and cultural norms around outdoor masking.

The argument, or at least one version of it, goes something like this:

Is Mr. Soave right? Here’s what public health experts and journalists are saying.

The case against outdoor masking

What the science says: As Dr. Ashish Jha, the dean of Brown University’s School of Public Health, told CNN last weekend, “We’ve known for a year that outdoor infections are extremely rare.” Exactly how rare?

According to a systematic review of peer-reviewed research published in the Journal of Infectious Diseases, the odds of indoor transmission are about 19 times as great as the odds of outdoor transmission.

Not all outdoor environments are equally safe, though: Unmasked interactions that involved prolonged, frequent contact, for example, were associated with higher risk of outdoor transmission.

“Our takeaway from this is that it’s not impossible to get an infection outdoors, even though from what is published, clearly the proportion of when that happens is much lower,” Nooshin Razani, one of the study’s authors, told The Washington Post.

What this means in practice: “Transmissions do not take place between solitary individuals going for a walk, transiently passing each other on the street, a hiking trail or a jogging track,” Dr. Paul E. Sax, a professor at Harvard Medical School, wrote in NEJM Journal Watch. “That biker who whizzes by without a mask poses no danger to us, at least from a respiratory virus perspective.”

Large outdoor crowds may pose a higher risk, especially if there’s shouting and stagnant air, said Donald Milton, an aerosol scientist at the University of Maryland. But “when I go jogging in my neighborhood, where the houses are separated by 10 meters (32 feet) or more and there are only a few people out walking dogs or kids playing in yards, I carry a mask with me,” he told Yahoo. “Then if I stop to chat with other people I can put it on.”

The vaccine factor: Experts have been preaching the importance of distinguishing between indoor and outdoor transmission risks since the early months of the pandemic. But now that the vaccination drive is underway, the expectation of universal outdoor masking “almost becomes ridiculous,” Monica Gandhi, an infectious disease doctor at the University of California, San Francisco, told Slate. Dr. Gandhi isn’t alone: Several epidemiologists have called for an end to outdoor mask mandates, which some 24 states still have in place.

OK, but are there any downsides to the convention of outdoor masking?

Experts and journalists have articulated quite a few.

It sends the wrong message: “By mandating or normalizing masks outdoors at all times,” the sociologist Zeynep Tufekci argued, “we are miscommunicating about the real risk factors — indoors, especially if they are crowded and poorly ventilated — which means that even a full year after the pandemic, people are not being properly informed about where and how they should increase their vigilance.”

As Ms. Tufekci noted, local governments get part (if not most) of the blame for perpetuating this miscommunication by writing it into public policy. Many states, for example, have resumed indoor dining, which research suggests is one of the most epidemiologically risky activities, even as they retain outdoor masking mandates.

It’s inconvenient: In Reason, Mr. Soave analogized outdoor masking to the system of airport security protocols that emerged after the Sept. 11 attacks. The Transportation Security Administration’s invasive screening process may put some people at ease, “but it shouldn’t, because removing our shoes and belts before we get on a plane doesn’t make us any safer at all,” he argued. “The T.S.A. is a massive waste of time, money and energy, and the American people have put up with it for more than 20 years.”

The inconvenience of wearing a mask is obviously not equivalent to being profiled or patted down at an airport. But “it is annoying — particularly for the acne-prone, or people who wear glasses or lipstick,” Natalie Shure wrote for The New Republic. “It’s frustrating, uncomfortable and considerably less pleasant than having air hit your face” — especially if you’re exercising.

It may come at the cost of more effective public health interventions: Insofar as people have limited budgets of time and energy to spend on Covid safety, critics of outdoor masking argue that people’s time and energy would be better spent on other precautions.

“Given the very low risk of transmission outdoors, I think outdoor mask use, from a public perspective, seems arbitrary, and I think it affects the public’s trust and willingness to engage in much higher-yield interventions,” Muge Cevik, an infectious-disease and virology expert at the University of St. Andrews in Scotland, told The Washington Post. “We want people to be much more vigilant in indoor spaces.”

Why outdoor masking may still be here to stay — for now

Critics of outdoor mask mandates say there are still some situations where outdoor masking is advisable:

“It’s fine to tell people to continue wearing masks outside, especially if they are unvaccinated and are about to engage in a sustained interaction at close distance, especially if it involves higher aerosol emitting activities like talking, yelling or singing,” Ms. Tufekci writes. Farmers’ markets, protests, outdoor concerts and crowded outdoor spaces with little ventilation, for example, would all fill that bill.

My colleague David Leonhardt also contended that the practice can function as an expression of solidarity with the majority of Americans who remain unvaccinated.

Another view: Even in cases where outdoor masking offers little public health benefit, some argue that the practice doesn’t necessarily call for judgment or discouragement. Donning a mask on an empty street may be irrational, as Mr. Soave argued, but so is saying “gesundheit” after someone sneezes. And what reads to one person as a virtue signal or a tribal signifier may function for someone else as a coping mechanism. In a year blighted by mass death and trauma, it’s only natural that some Americans are struggling to relinquish behaviors they were once told would protect them.

Even Dr. Jha found it “psychologically hard” to recalibrate his risk tolerance after getting vaccinated. “There are going to be some challenges to reacclimating and re-entering,” he said. “But we’ve got to do it.”

Do you have a point of view we missed? Email us at [email protected]. Please note your name, age and location in your response, which may be included in the next newsletter.

READ MORE ON OUTDOOR MASK MANDATES

“Does everyone need to wear a mask outside? Experts weigh in.” [National Geographic]

“After fully vaccinating a majority of its population, Israel no longer requires people to wear masks outdoors” [Insider]

“Should you still wear a mask outdoors? Experts say yes.” [Yahoo]

“When should California lift its outdoor mask mandate? Health experts are conflicted” [ABC]

WHAT YOU’RE SAYING

Here’s what readers had to say about the last debate: “Should Covid vaccines be mandatory?”

Margaret: “I think the point that was missed in the article is the obligation of an employer, be it private or government, to provide a safe work environment. By allowing people to blow off being vaccinated and continuing to spread variants in the workplace, a company will face legal exposure. Additionally, employees will find a safer place to work — a company that is willing to put their employee’s safety at a premium.”

Ernest: “I’m curious about the legality of business owners only allowing vaccinated patrons as they now require masks. I’d rather go to a movie theater or concert knowing that everyone around me was vaccinated. Restaurants and bars, where masks aren’t practical, would be especially popular if the patrons felt safe. As a business owner, don’t I have the right to require proof of vaccination to attract business?”

Jeremy: “I think the way to get to herd immunity is to have vaccination sites be everywhere, all the time. Every time you walk into a big box store, a grocery store, a mall, an airport, a stadium, a church or a post office, there should be a tech standing at the door offering vaccinations. … Make it so easy that many of the vaccine hesitant end up finally doing it, and maybe even some of the ‘no vaccination’ crowd eventually does it on a whim.”

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