It is telling, isn’t it, that the Biden administration did not immediately commit to filing an emergency appeal after a federal judge in Florida overturned the Centers for Disease Control and Prevention’s mask mandate for travel settings?
That’s bureaucratese for “we don’t feel too strongly about this.” I suspect some in the Biden administration have come to the same conclusion that much of the country has reached: It is time for indoor mask mandates to end. They had to end sometime, after all, and if not now, when?
“When people stop dying!” says a voice from the back. But that ceased to be a workable answer last summer when it became clear that the vaccines were not providing the sterilizing immunity that might have allowed us to eliminate the virus, the way we have done with smallpox and polio. Anything short of that requires us to figure out how to live with a virus that will continue to circulate. And by “live,” I mean full, normal lives, not the severely restricted public activities of the past couple of years.
Such measures were acceptable as temporary delaying tactics to keep hospitals from being overwhelmed. They bought doctors time to figure out how to treat the virus and gave scientists the precious months they needed to develop vaccines and treatments. Before those vaccines and treatments arrived, I was a strong advocate of stringent social distancing, and once the vaccines became available, I supported making them mandatory. Liberty is precious, but it does not include the right to spread deadly viruses to other people.
But now that we have vaccines and treatments, it’s time to reconsider the trade-offs we made. Policies that were appropriate when the infection fatality rate was 1 in 200 do not necessarily pass a cost-benefit test after vaccines and treatments have reduced those risks 20-fold, especially since further improvements will likely be somewhat slower and less dramatic.
One could argue, of course, that masks on planes still pass muster. Isn’t the inconvenience small, compared with the catastrophic risks faced by people who can’t get vaccinated, or whose immune systems are too compromised to mount a strong response to the vaccine?
Fair enough, but then one also has to ask about the other side of that cost-benefit equation: Exactly how many coronavirus cases are being prevented by requiring people to wear masks on planes? Airplanes are extremely well ventilated, which is why there have been so few outbreaks traced to air travel compared with other indoor environments. And while masks do offer some added protection against whatever risk remains, the cloth and surgical masks being worn by most people aren’t really all that effective — even before you consider how often they are pulled down to eat, or drink, or just gulp a little air.
Those masks also have costs for the people forced to wear them, as I recently found out when a series of badly timed connecting flights sent me sprinting through airports in my mask. (Or attempting to sprint; I missed my planes.) And while this is a minor consideration, some of the side effects of mask mandates are not; a relative with chronic obstructive pulmonary disease cannot fly because it is too hard for them to breathe in a mask.
Yet the largest cost may be to the already crumbling authority of public health institutions. As we have discovered, public health measures have to bear some relationship to what the public thinks is reasonable. Otherwise, no matter how sound their logic or scientific basis, they will fail because people will not comply. A nation resentfully wearing masks pulled down under its noses isn’t doing anyone much good.
Mask mandates and the like were sold as temporary measures. Remember “flatten the curve”? Every time public health experts promised a short-term solution that turned into a long-term lifestyle change, their credibility took a hit. It cannot afford many more.
Public health works best when authorities are seen as assisting the public by making the same risk-reward calculations the public would, if only it had the time and expertise to sort through all the data. If authorities instead come to be seen as martinets, forcing the public to hew to their own extremely risk-averse preferences, they will meet fierce resistance the next time they urge us to adopt some costly measure.
As the experts keep warning us, there is likely to be another pandemic at some point. Our global economy makes a too-excellent superhighway for pathogens. We need to prepare for that next contagion by recognizing when it’s time to let go of the extraordinary measures we needed to fight the last.
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