Governments need to give Americans an off-ramp to the post-pandemic world. Ending outdoor mask requirements would be a good place to start.
From The Atlantic
By Derek Thompson
April 19, 2021
Last week, I covered my nose and mouth with close-fitting fabric like a good citizen and walked to a restaurant in Washington, D.C., where I de-masked at a patio table to greet a friend. I sat with my chair facing the entrance and watched dozens of people perform the same ritual, removing a mask they’d worn outside and alone. It seemed like the most normal thing in the world. Until, suddenly, it seemed very weird.
The coronavirus is most transmissible in poorly ventilated indoor spaces, where the aerosolized virus can linger in the air before latching onto our nasal or bronchial cells. In outdoor areas, the viral spray is more likely to disperse. One systematic overview of COVID-19 case studies concluded that the risk of transmission was 19 times higher indoors than outside. That’s why wearing a mask is so important in, say, a CVS, but less crucial in, say, the park.
At the restaurant, however, I saw an inversion of this rule. Person after person who’d dutifully worn a mask on the uncrowded street took it off to sit still, in close proximity to friends, and frequently inside. I felt like I was watching people put on their seatbelts in parked cars, then unbuckle them just as they put the vehicle in drive.
Perhaps a bit of weirdness should be expected. Rising vaccinations and burbling variants make for an awkward transition period in which it’s legitimately confusing to know when masking is a necessary and considerate act, and when it’s no more epidemiologically protective than, say, wearing a hat.
Government rules aren’t doing much to help clarify the situation. In places such as D.C., outdoor masking is mostly mandatory and limited indoor dining is permitted, leading to masks in the streets and bare faces in the bar seats. Several dozen states have similar mask mandates for public spaces while also allowing various levels of indoor dining.
The case for keeping outdoor mask mandates starts with the fact that masks are highly effective in general. They block viral spittle and may also warm the nose and mouth to create a humid microclimate that interferes with the virus’s ability to dock with our cells. Requiring masks outdoors, some believe, is also a simple way to enforce usage indoors, where a mandate is most defensible. Finally, one could argue that outdoor mask mandates build a sense of social solidarity around taking the pandemic seriously, which might have all sorts of positive spillover effects, such as visually reminding people that the pandemic isn’t over. States now experiencing significant outbreaks, such as Michigan, would surely do well to keep strict rules in place a while longer.
But as more and more of the population is vaccinated, governments need to give Americans an off-ramp to the post-pandemic world. Ending outdoor mask mandates—or at the very least telling people when they can expect outdoor mask mandates to lift—is a good place to start, for a few reasons.
Requiring that people always wear masks when they leave home, and especially in places with low levels of viral transmission, is overkill. As mentioned, the coronavirus disperses outside, posing little risk to people who are walking alone or even swiftly passing by strangers. In fact, almost all of the documented cases of outdoor transmission have involved long conversations, or face-to-face yelling. The risk calculation changes if you’re standing in a crowd: Some uneven evidence suggests that the Black Lives Matter protests last summer increased local infections. But that’s an easy carve-out. States can end blanket mandates and still recommend outdoor masking by anyone experiencing symptoms, or in crowds. (Extended conversations pose their own risk, but when people are vaccinated, the odds of viral transmission are probably somewhere between microscopic and nonexistent.)
Outdoor mask mandates might also turn people off from obeying better rules. “Given the very low risk of transmission outdoors, I think outdoor mask use, from a public-health perspective, seems arbitrary,” Muge Cevik, an infectious-disease and virology expert at the University of St. Andrews, in Scotland, told The Washington Post. “I think it affects the public’s trust and willingness to engage in much higher-yield interventions. We want people to be much more vigilant in indoor spaces.”
Julia Marcus, an epidemiologist at Harvard Medical School, spoke with several male mask skeptics last year for a piece in The Atlantic. When she explained that masking wasn’t as important outdoors, the men became more amenable to wearing them indoors. By connecting rules to reasons, she got them to see the value of covering their nose and mouth when it actually mattered. Last week, Marcus told me that she’s baffled by the notion that the best way to get people to wear masks inside is to mandate that everybody wear one when they’re alone outside. “We don’t recommend condom use when people are enjoying themselves alone to get them to wear condoms with their sexual partners,” she said.
The argument that outdoor mask mandates create a warm and fuzzy feeling of social solidarity confuses a personal definition of etiquette (“I think my mask makes everybody feel safe”) with a public defense of population-wide laws (“everybody should wear a mask everywhere, because it’s the only way to make everybody feel safe”). Masks send all sorts of messages to all sorts of different people. To some, they’re beacons of safety; to others, they’re signs of imperious government overreach. As Marcus argued, mandating a public-health tool that’s not needed can drive away people who might otherwise be on board with more important interventions. “I think there’s a proportion of the population that believes restrictions will last indefinitely,” Marcus said, “and they are probably one of the hardest groups to keep engaged in public-health efforts.”
Finally, mandating outdoor masks and closing public areas makes a show of “taking the virus seriously” while doing nothing to reduce indoor spread, in a way that often hurts the less fortunate. To deal with its COVID-19 spike, for example, the Canadian province of Ontario instituted a stay-at-home order and closed many parks and playgrounds. “These policies are made by people who have yards,” Marcus said. “If you live in an apartment building and have no yard, and are required to wear masks at all times outdoors, you never get to be maskless outside. And then, where do people gather maskless to socialize? Inside their homes”—where the risk of transmission is higher.
Getting beyond the pandemic in the U.S. will require a portfolio approach that combines hard science with soft persuasion. We need to keep up vaccine administration, combat the hydra of vaccine resistance, monitor isolated outbreaks, maintain high testing levels, and encourage public indoor mask-wearing where appropriate.
But we also need to build a sensible path to the post-pandemic world. A lot of people seem to have embraced an omni-neurotic approach to COVID-19 safety: “Don’t go to the beach, don’t take a walk with friends, don’t go to the park, don’t travel.” I prefer a more targeted-neurotic approach that just tells the truth. And the truth is that COVID-19 is basically an indoor/talking disease: If you’re indoors, or talking with people outside your household, or both, you should be cautious—mask and socially distance. Otherwise, the risk is much smaller, even if it’s rarely zero. So go outside, get vaccinated, and get your life back.
Hyper-neuroticism is a mitzvah during a pandemic. But we really don’t have to live like this forever, and it’s okay for more people to say so. We can learn to look at a well-populated beach and not see a gross failure of human morality. We can see somebody unmasked in a park and not think, I guess that one doesn’t believe in science. We can walk down an uncrowded street with a mask, or without a mask, or with a mask sort of hanging from our chin, and just not really worry about it. We can reduce unnecessary private anxiety and unhelpful public shame by thinking for a few seconds about how the coronavirus actually works and how to finally end the pandemic. Let’s tell people the truth and trust that they can take it. Let’s plan for the end of outdoor mask mandates.
Photo: iStock
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