Biden’s choice of masks as a leading item on his agenda illustrates a possible early win in tackling the virus and the challenges he faces in trying to turn around the nation’s response to the coronavirus and reduce its devastating death toll. It’s also a break from the Trump administration’s handling of the issue.
Masks represent the lowest-hanging fruit of public health measures that could put a dent in the outbreak, as science shows how dramatically they reduce transmission of the virus.
“It is, in some ways, our best medical tool,” said Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington. “It can save hundreds of thousands of lives without the need for surgery, drugs, no side effects and readily available to everyone.”
Mask-wearing is a measure that Biden’s predecessor repeatedly shunned and politicized as unnecessary, laughable or a sign of weakness. Large swaths of the country have become stubbornly resistant to the practice.
Airline workers have described the dangerous results of passengers refusing to follow mask requirements issued by airlines. Safety reports filed with the federal government show flight attendants being repeatedly taunted and verbally abused by passengers, including some who called the virus a “political hoax.”
The new order calls on a variety of federal agencies to “immediately take action” to require passengers to wear masks, although details of when that would take effect and how strictly it will be enforced were still being hashed out Thursday. The order gives agency leaders one week to update Jeffrey Zients, coordinator of the White House’s coronavirus response, on their progress toward implementing the mandate.
Similarly, the order on federal property mandates that federal agencies take immediate action to require masks, but leaves it to agencies to determine how to implement the requirement.
As important as the practical implications, public health experts say, is the symbolic weight of the orders. By mandating masks on federal property, for example, it could force masks on Republican members of Congress who have made a point not to wear them.
“We are in a moment where symbols are important,” said Matt Seeger, an expert at Wayne State University who helped the Centers for Disease Control and Prevention develop a manual for crisis communications. “By reducing the number of leaders and people in authority refusing to wear masks, you reduce the feeling that this is acceptable behavior. It’s the same reason we banned smoking in Hollywood movies and TV, to stop the promotion of smoking as normal or somehow cool.”
Biden on Thursday signed the transportation mask order and a stack of other measures to battle the coronavirus with Vice President Harris, Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, and others looking on.
“The brutal truth is it’s going to take months before we can get the majority of Americans vaccinated,” Biden said, adding that the death toll is likely to exceed 500,000 next month. “So, while we increase vaccinations, we’re going to take steps necessary now to slow the spread of the disease as well.”
Among them are the mask orders.
“The experts say by wearing a mask from now until April, we’d save more than 50,000 lives going forward,” Biden said. “50,000 lives. So I’m asking every American to mask up for the next 100 days.”
A welcome change for transportation
The mask mandate was greeted as a long overdue step in the transportation industry.
“It’s about damn time our government lived up to its obligations to public health,” said John Samuelsen, president of the Transport Workers Union of America, AFL-CIO, which represents more than 150,000 railroad, transit, airline and other workers.
Sara Nelson, president of the Association of Flight Attendants-CWA, had called on the Trump administration to take such a step last April. On Thursday she said in a statement, “what a difference leadership makes!” The move provides “much needed back up” for front line aviation workers, she said.
Flight attendants have faced a stream of obstinate and foul-mouthed passengers since the beginning of the pandemic, according to safety reports filed with the federal government.
One was called a Nazi. A man who had repeatedly refused requests to wear a mask stuck his head in the aisle, “making a total mockery out of me,” a flight attendant wrote.
The risks have, at times, gone beyond the increased potential for coronavirus infection. One pilot, distracted by mask violations, descended to the wrong altitude, though there was no conflicting air traffic, according to a safety report.
For months, the Trump administration rejected calls from Congress, unions representing transportation workers and public health experts within the CDC to require masks.
Biden’s move marks a clear break from that dismissal. His order also requires masks “on certain public modes of transportation and at ports of entry to the United States,” according to a White House strategy document released Thursday.
Biden had said before his inauguration he would require masks for “interstate travel on planes, trains and buses,” and CDC officials had indicated that interstate travel is where their existing authority lies.
Biden’s pick for transportation secretary, Pete Buttigieg, appeared Thursday before the Senate Commerce Committee for a hearing on his nomination. He pointed to the need to face the broad dangers stemming from the pandemic.
'You have to overcome fixed attitudes'
Public fatigue with pandemic restrictions will probably be a main stumbling block to Biden’s push for more mask-wearing.
In recent weeks, even as some state officials have tightened rules, there has been greater resistance than ever — from law enforcement and politicians who reject crackdowns, businesses that refuse to close, ordinary people who protest mask mandates and courts that show decreasing tolerance for constraints. Enforcement has been spotty.
For months, Mokdad — the University of Washington epidemiologist — and other researchers at the Institute for Health Metrics and Evaluation have tracked through surveys how many people wear masks. Mask-wearing in many countries, like Singapore, Japan and Argentina, has reached 95 percent. In the United States it has been a comparative slog, rising from 40 percent in April to 76 percent. In Wyoming, mask-wearing remains at an abysmal 53 percent.
Thirty-five states require people to wear masks in public, according to the White House’s new coronavirus strategy document. Some state leaders have proudly crowed their refusal to enact such ordinances, such as South Dakota Gov. Kristi L. Noem (R), a Trump ally. The hope, public health experts say, is that Biden’s actions will make such mandates more widely enacted by making it the default position of federal government.
Many aspects of the two executive orders weren’t clear Thursday. It’s unknown whether masks will be required at outdoor federal properties like national parks. Social distancing and masks are now strongly encouraged at most national parks, but the National Park Service under the Trump administration had not made them mandatory.
As those parks became crowded with visitors last fall, communities surrounding them accused tourists of sparking outbreaks. A Biden administration official said some decisions will be left to their overseeing agencies to implement, while also following science.
Biden’s order also seeks more aggressive action by the Occupational Safety and Health Administration, including considering emergency standards on mask-wearing. “Biden is taking steps to cover workers not typically covered by OSHA . . . by directing agencies like the Department of Transportation to keep workers safe,” according to the strategy document.
Biden’s order, called “Promoting COVID-19 Safety in Domestic and International Travel,” also instructs agencies “to develop options for expanding public health measures for domestic travel and cross-border land and sea travel and calls for incentives to support and encourage compliance with CDC guidelines on public transportation,” the White House noted.
The CDC previously outlined the reasoning behind its “strong recommendation” to wear masks during travel.
“Traveling on public conveyances increases a person’s risk of getting and spreading COVID-19 by bringing persons in close contact with others, often for prolonged periods,” the CDC said, adding that “local transmission can grow quickly into interstate and international transmission” without masks.
Experts in psychology and decision-making have said resistance to masks, including on planes, has been driven by politicization at the highest levels of the U.S. government and is also fueled by the inconsistent messaging and the insidious nature of a virus, which can be spread by those who don’t know they are infected.
“It’s unfortunate we’re a year into this and still trying to convince people to wear masks,” said Seeger. “This really should not be a difficult conversation, but the problem now is you have to overcome fixed attitudes that have already been developed against it.”
One shortcoming from the past year, public health experts said, has been the lack of a carefully coordinated public health message.
“This inconsistent messaging contributed to a national patchwork of mask regulations, which is damaging because it sows confusion,” said William Hanage, a Harvard University infectious-diseases researcher.
Biden White House officials said their strategy will include “world-class public education campaigns” on mask-wearing, testing and vaccinations, which will be coordinated at the federal, state and local levels and include the private sector.
“They will be anchored by science and fact-based public health guidance,” the strategy document says. “The Administration will work to counter misinformation and disinformation by ensuring that Americans are obtaining science-based information.”
Karin Bruillard contributed to this report.