A Reluctant Message About Masks

You may have noticed that I didn’t say a word about masks in my recent blog post. Because by this point people are already either on Team Mask or Team Naked Face and no one is switching teams. To Team Mask, masks have become an indicator of whether someone is informed/socially responsible or ignorant/narcissist. To Team Naked Face, they are an indicator of hysteria and infringement of basic freedoms.

To be clear, I have no sympathy for anyone who believes masks are an indicator of hysteria or infringement of freedoms. I believe stores are entirely within their rights to require customers to wear masks. But I do believe that the issue of masks has become more emotional than scientific. And the bifurcation of worldviews leaves little room for nuance. Which is unfortunate. Because a more nuanced understanding of what masks can and cannot do would be very helpful in the battle against COVID.

This is all I ask: that people approach masks the same way they approach acai berries. There’s no reason not to eat acai berries. It’s certainly possible these magical fruits reduce the risk of a heart attack. But we can all agree that mouthfuls of red berries shouldn’t substitute for actual lifestyle changes like daily exercise that are supported by real science. Keep in mind that there’s about as much science in support of homemade masks reducing COVID transmission as there is that acai berries will keep you from having a heart attack. Again, that doesn’t mean there’s no scientific support. It just means it’s not very strong. And just as you should be suspicious of any doctor that you can lie on the couch all day as long as you eat berries, you should be equally suspicious of businesses that try to convince you that your family is safe just because people are wearing masks. Masks are not sufficient. I have seen this message too many times: Masks that cover the mouth and nose–when worn by everyone in enclosed spaces–are the most effective means of reducing spread. It’s simply not true. Mask may be a supplemental help. Look instead for real organizational and systemic changes that reduce indoor human interactions. I know, it’s much easier to use masks as a litmus test. Don’t fall for it.

That said, no one should confuse the idea that cloth face masks may not be totally effective against COVID with the truly important problem of PPE shortages for healthcare workers. All masks are not equal. If you enjoyed shaming people for not wearing masks and still want to scratch that itch, maybe direct that energy towards the organizations responsible for healthcare workers needing to reuse PPE.

So why do we overweight our cloth masks? It’s not just because it’s a simple checkbox. It’s also just human nature. Humans are more visual than abstract thinkers. A person wearing a mask provides a stronger visual cue compared to subtler things like the absence of people, invisible contact networks, or ventilation.

So if you think the visual of people wearing masks could be interfering with your risk perception and giving you a false sense of security, do an easy thought experiment. Just pretend that no one around you is wearing a mask. Would you still be in that yoga class? Or that socially distanced happy hour? If the answer is no, trust your instincts and think hard about whether you should be there.

Want to read more about the science of masks? A nice review is provided by the National Academy of Sciences, Engineering, and Medicine’s Expert Consultation on the Effectiveness of Fabric Masks for the COVID-19 Pandemic.

TL;DR: Masks have become a centerpiece of the US strategy to reduce COVID. But scientists know that it will take a lot more than masks to control the pandemic. Masks should be encouraged, but not as a substitute for more important changes in behavior, mobility, and social engineering that are the real key to driving down virus transmission.

6 replies
  1. Kirstin
    Kirstin says:

    I agree on much of this. Masking up is only good for a REDUCTION in transmission, and we all STILL need to stay 6 feet apart (and outdoors if possible). I like your thought experiment and agree.

    To me, if you are in a store or crowded area and you aren’t wearing a mask (or even have one to put on) it screams “I don’t care about you or anyone else” – because a mask is mainly for the protection of others. A sneeze can travel “up to 26 feet away, depending on the room’s humidity, temperature and air flow” according to a WSJ article.

  2. david c unger
    david c unger says:

    Say I have to cross the Atlantic to return home and can only really do that by flying. (I’m not taking a cruise ship or freighter.) Pretend that no one on the plane is wearing a mask. Would I get on that plane? No. And if everyone was wearing a mask? Yes or no, what do you say?

    • Martha Nelson
      Martha Nelson says:

      My advice is to not let the presence or absence of masks factor into any decisions about what is safe or not safe. I would be more interested in factors like (a) how many people are on the plane? (b) how well are they separated (are there lots of free seats)? (c) does the aircraft use a high quality filtration system? There are lots of questions more important than whether people are wearing masks.

  3. Kerry Owens
    Kerry Owens says:

    While acknowledging that you are the scientific expert in the room, the analogy doesn’t work for me. This is my paraphrasing…. (1) Eating berries = wearing masks and (2) Diet and Exercise = considering the behavior of others and not taking any action until you can control it or avoid it? Is that about right? Perhaps (1) eating berries = hand sanitizer (very easy for people) and (2) wearing masks = diet and exercise (much harder for people–for whatever reason, but within their control) and (3) getting your parents DNA and risk factors and determining if a doctor will prescribe you drugs to minimize your risk factors = considering all factors around you and seeing if the airlines will put you on an emptier flight and if the restaurants will seat you at a more distant table (factors not really completely within your control) would be a better analogy?

    • Martha Nelson
      Martha Nelson says:

      The analogy really works best at a societal level. I just posted a whole separate post about risk assessment at an individual level. As a society, we can either focus on addressing health problems through products that are easy to use but of unclear value (eating berries, wearing masks, using hand sanitizer) or we can focus on systemic lifestyle changes and habits that are scientifically validated but much harder to implement (diet/exercise or organizational changes that limit human contacts).


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  1. […] does one depoliticize a face mask? First, don’t make blanket rules. Recognize that COVID risk varies in different settings, and adherence to mask-wearing should be […]

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