Last week, like a good burger, I covered my nose and mouth with a close-fitting fabric and walked to a restaurant in Washington, DC, where I unmasked at a patio table to greet a friend. I sit with my chair facing the entrance and watch dozens of people perform the same ritual, removing a mask they wore outside and alone. It seemed like the most normal thing in the world. Until it suddenly seemed very strange.
© Getty / Adam Maida / The Atlantic Ocean
The coronavirus is the most contagious in poorly ventilated indoor spaces, where the aerosol virus can linger in the air before it clings to our nasal or bronchial cells. In outlying areas, the virus spray is more likely to spread. One systematic review of COVID-19 case studies concluded that the risk of transmission indoors was 19 times higher than outdoors. That is why wearing a mask is so important in, for example, a CVS, but less important in, for example, the park.
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At the restaurant, however, I saw an inversion of this rule. Person after person who dutifully wore a mask in the uninhabited street, it decreased to sit still, close to friends and often inside. I felt like I was watching people put on their seat belts in parked cars, and then loosen up while driving the vehicle.
[Ask Dr. Hamblin: So when can we stop wearing masks?]
Maybe a little strangeness should be expected. Increasing vaccinations and faltering variants create an awkward transition period in which it is legally confusing to know when masking is a necessary and thoughtful act, and when it is no more epidemiologically protective than, for example, wearing a hat.
Government rules do not help much to clarify the situation. In places like DC, outdoor masking is mostly mandatory and limited indoor dining is allowed, leading to masks in the streets and bald faces in the bar stools. Several dozen states have similar mask commands for public spaces, while also providing indoor dining areas.
The issue of holding mandates for outdoor masks begins with the fact that masks are generally very effective. They block viral saliva and can also warm the nose and mouth to create a humid microclimate that interferes with the virus’ ability to connect in our cells. Some believe that wearing masks outdoors is also a simple way to enforce indoor use, where a mandate is best defended. Finally, one could argue that mandates for outdoor masks create a sense of social solidarity to take the pandemic seriously, which can have all sorts of positive consequences, such as visually reminding people that the pandemic is not over. States now experiencing significant outbreaks, such as Michigan, would certainly do well to keep strict rules in place for a while longer.
But as more and more of the population is vaccinated, governments must give Americans a headway to the post-pandemic world. Ending outdoor mask assignments – or at least telling people when they can expect outdoor mask assignments to cancel – is a good place to start for a few reasons.
It is too much to require people to always wear masks when leaving the house, and especially in places with a low level of viral transmission. As mentioned, the coronavirus spreads outside, and it poses little risk to people walking alone or even passing by strangers quickly. In fact, almost all of the documented cases of outside transmission involved lengthy or face-to-face conversations. shout. The risk calculation changes when you are in a crowd: some unequal evidence suggests that the Black Lives Matter protests have increased local infections this past summer. But it’s an easy cut. States can terminate a disguise and still mask outside recommended by anyone experiencing symptoms or in crowds. (Extensive conversations carry their own risk, but when people are vaccinated, the chances of viral transmission are likely to be between microscopic and non-existent.)
Mandates for outdoor masks can also keep people from better rules. “Given the very low risk of transmission in the open air, I think the use of an outdoor mask, from a public health perspective, seems arbitrary,” said Muge Cevik, an expert in infectious diseases and virology at the University of St. Louis. Andrews, in Scotland, said The Washington Post. ‘I think it affects the public’s confidence and willingness to engage in interventions with a much higher return. We want people to be very vigilant in indoor spaces. ”
Julia Marcus, an epidemiologist at Harvard Medical School, spoke to several male mask skeptics last year for a piece in The atlantic ocean. When she explains that masking outdoors is not that important, the men become more comfortable wearing it indoors. By linking rules to reasons, she showed them how important it is to cover their nose and mouth if it really matters. Last week, Marcus told me that she was amazed at the idea that the best way to get people to wear masks inside is to instruct everyone to wear one when they are outside alone. “We do not recommend the use of condoms if people enjoy themselves alone wearing condoms with their sexual partners,” she said.
[Read: Why aren’t we wearing better masks?]
The argument that mandates for outdoor masks create a warm and fuzzy sense of social solidarity confuses a personal definition of label (“I think my mask makes everyone feel safe ”) with a public defense of laws over the entire population (“everyone should wear a mask everywhere as this is the only way to make everyone feel safe”). Masks send all kinds of messages to all kinds of different people. For some, these are beacons of safety; for others, they are signs of an extremely important government. As Marcus argued, the obligation of a public health instrument that is not needed can drive away people who would otherwise be on board with more important interventions. “I think there is a section of the population that believes that restrictions will last indefinitely,” Marcus said, “and they are probably one of the most difficult groups to keep themselves busy with public health efforts. . ‘
Finally, the mandate to ‘take the virus seriously’ in outdoor masks and the closure of public spaces, while doing nothing to reduce the spread of indoors, in a way that hurts the underprivileged. To deal with the COVID-19 peak, for example, the Canadian province of Ontario has placed a home order and closed many parks and playgrounds. “This policy is made by people with plots,” Marcus said. ‘If you live in an apartment building and have no garden and you always have to wear masks outdoors, you can never be maskless outside. And where do people gather without a mask to hang out? Inside their homes ”—where the risk of transmission is greater.
To go beyond the pandemic in the US, a portfolio approach is needed that combines hard science with soft conviction. We must sustain the administration of vaccines, combat the hydra of vaccine resistance, monitor isolated outbreaks, maintain high test levels and wear public masking, where appropriate.
But we must also build a meaningful path to the post-pandemic world. Many people seem to have taken an omni-neurotic approach to the safety of COVID-19: ‘Do not go to the beach, do not go for walks with friends, do not go to the park, do not travel. I prefer a more targeted-neurotic approach that only tells the truth. And the truth is that COVID-19 is basically an indoor / talking disease: if you are indoors, or talking to people outside your household, or both, you need to be careful – mask and social distance. Otherwise, the risk is much smaller, even if it is rarely zero. So go outside, get vaccinated and get your life back.
Hyperneuroticism is a mitigation during a pandemic. But we really do not have to live like that forever, and it’s good that more people are saying that. We can learn to look at a populated beach and not see a serious failure of human morality. We can see someone in a park unmasking and not thinking, I think the one does not believe in science. We can walk in an unpopulated street with or without a mask, or with some kind of mask hanging from our chin, and we do not really have to worry about it. We can reduce unnecessary private anxiety and unhelpful public shame by thinking for a few seconds about how the coronavirus works and how to end the pandemic. Let’s tell people the truth and trust that they can accept it. Let’s plan for the end of mandates for outdoor mask.
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