There were many missteps in the US response to COVID-19, especially at the outset of the outbreak. One that stands out is the early choice to recommend against the widespread public use of masks by the Trump administration, the Centres for Disease Control and Prevention — and even Anthony Fauci.
In hindsight and in light of current pro-mask guidelines, it’s easy to get upset at what feels like inconsistent advice and a delayed reaction, but the ability to change opinions based on new information is what we should want from public-health officials, even while wishing they were faster or right the first time around. That’s how science works, especially during the rapid spread of a previously unknown virus.
It’s easy to forget, but the initial recommendations came from somewhere. There was legitimate concern that recommending mask use could lead to a run on plunging stocks of specialised equipment intended for health workers. On top of that, some worried that people would be too confident in the protective ability of misused masks of varying quality. Mea culpa, I was among those that found these arguments compelling earlier in the year.
There should be a quicker trigger going forward to recommend or require masks when an airborne threat emerges, and robust plans to deploy them as a broad public-health measure.
Since then, the world has learned more about how the virus spreads, and the disconcerting number of asymptomatic infections has helped make the case for the broad use of masks. Multiple Asian countries where mask use was prevalent even before the pandemic have had substantially better outcomes, with various other effective public-health measures likely also playing a role.
In many parts of the US, even in states that are reopening, masks are now required, and wearing them has become more and more routine. New York Governor Andrew Cuomo is enlisting celebrities such as comedian Chris Rock in an effort to turn the practice into a habit. In other areas, wearing a mask is seen as taking a side in a culture war, an issue made worse by Trump’s continued insistence on going barefaced. This attitude should change. The fact is, masks can play a vital role in prevention and containment. People should get used to the idea that they may be necessary at times even after the current crisis subsides.
Surgical-style masks are better
Until now, much of the government-backed effort to produce protective equipment has focused on supplying hospitals. While that should continue to be a priority, it’s worth taking extra steps to boost stocks of better surgical-style masks intended to support reopening states.
Even relatively simple coverings can stop some virus-containing droplets that can spread COVID-19 to others, especially in combination with other hygiene and distancing measures. However, surgical-style masks are better at stopping virus-containing droplets and are easier to wear in summer heat. Any reduction in transmission to others is highly significant in containing the virus. A boost in availability would help in providing effective masks to people in areas and situations of particular concern.
Masks aren’t quite as crucial in uncrowded and outdoor spaces in regions where the virus isn’t circulating much. They’re arguably essential in crowded and poorly ventilated areas, particularly in hot spots, and easy availability and even targeted enforcement should be the rule in those situations. The places where masks won’t do as much good now may be tomorrow’s areas of concern. Authorities in those areas should be ready to respond.
Eventually, the focus can shift to the next crisis, where masks can play a role in prevention instead of catch-up. Pandemic-scale stockpiles for broad public use should be comparatively easy and cheap to manufacture over the long run, once the immediate threat of the epidemic is over. There should be a quicker trigger going forward to recommend or require masks when an airborne threat emerges, and robust plans to deploy them as a broad public-health measure. And hopefully by then, the dangerous politicisation of wearing masks and taking other common-sense health measures that’s occurring in some places today will have been overcome by more effective public messaging and education.
Pandemic preparation is hard and is only effective and durable under good leadership. Learning a relatively easy lesson about masks could help provide at least a bit of insurance.
Max Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care.