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Dr. Fauci and the Mask Disaster
What we really needed was intelligent advice on when and how transmission occurs.
June 22, 2021 5:56 pm ET
Nobody needs to be shocked that political messaging was going on during the Covid crisis, as seen in the Anthony Fauci emails from early in the pandemic recently released under the Freedom of Information Act. Politicians and officials wouldn’t be doing their jobs if they didn’t measure the effect of their words, beyond merely their accuracy or consistency. And Dr. Fauci, director of U.S. National Institute of Allergy and Infectious Diseases for the past 36 years, has at least been more wink-wink in this regard than many officials.
But the latest furor does underline one thing: what a colossal disaster for public understanding masks have been.
Until November, the official advice was the same that Dr. Fauci gave in a now infamous early email to a colleague—a store-bought mask may somewhat reduce your chance of spreading the disease if you happen to be infected. It will do little to prevent you from catching it if you’re breathing around someone who is exhaling the Covid virus.
Only in the fall did the U.S. government start claiming masks might protect the uninfected too. This appears to have been largely disinformation designed to get more unwitting carriers to wear masks. Even today, the CDC on its website stresses only one claim: “Masks are a simple barrier to help prevent your respiratory droplets from reaching others.”
We should expect government advice to be manipulative. That’s its job. We should also try to be time-consistent in our reasoning.
When Dr. Fauci emailed his advice to a colleague, the virus was not prevalent enough for precautions to be worthwhile. Do the math. Even at the height of the epidemic, if masks mainly stop spreaders from spreading, 300 million-plus Americans were being asked to wear masks to protect against perhaps 1% who might be infectious at any given moment. And this assumes all infected people were out and about when the real risk would have been mostly from the 0.4% who were infected but asymptomatic.
Universal mask compliance (and the U.S. came fairly close), by multiple models, might have slowed transmission by a modest 30%. Add it all up and we were calling on Americans school-age and up to wear masks to have a negligible impact on their own risk in most circumstances, for a disease that’s flu-like in 85% of cases.
This was never a promising incentive structure, however much it infuriates some that calls for self-sacrifice aren’t big motivators. Under rigorous study, it may even be that masks were a net minus if they gave a larger-than-expected fillip to personal risk-taking. When all the memos and emails finally surface, we may find local officials pushed masks mainly as a way to restart the economic engine at the risk of somewhat greater spread. The CDC’s most emphatic advice remains: “A mask is NOT a substitute for social distancing.”
Late in the pandemic I described a public-service ad on a college radio station that tried to labor through the permutations of place, age, circumstance and behavior in which a mask might actually help. The Dr. Faucis of the world might tell us it’s a pipe dream to imagine the public could take on board such a complex message; the best we can do is an over-simple, endlessly repeated message—wear a mask!—devoid of nuance.
Appeared in the June 23, 2021, print edition.
But we never tried. How many times in the past 15 months did you see the three-minute public-service spot showing how aerosol dispersion works, what situations are high and low risk, and offering dramatized examples of people sizing up and responding intelligently to specific sets of circumstances? You never saw such an ad.
Today’s hurricane of blame has an especially perfunctory, dog-and-pony feel. What Covid information wasn’t politicized by the time it reached the public? Discussion of costs and benefits was all but taboo. Our obsession with “confirmed” cases systematically misled us on true prevalence. Nearly deliberately we taught the public to overestimate its death risk and underestimate its infection risk. Bizarrely silenced was any discussion of early-stage treatment, the lab-leak possibility, the futility of outdoor mask mandates, etc., etc.
Unlike the flu pandemics of 1957-58 and 1968, this time politicians judged they needed to be seen reacting, but innovations more potent than handwaving may have to wait for the next pandemic. The U.S. government’s funding and expedited approval of a vaccine was its one truly effective measure. I suspect that a well-funded effort to educate Americans about transmission, rather than trying to scare them into a few rote behaviors, would also have paid dividends. I can find no evidence that such an effort was even contemplated. On Monday, in a state that weeks ago successfully vaccinated its 50-plus population, I saw an elderly couple driving alone in their car masked up like they were venturing into a Yunnan bat cave. Surely we as a country could be doing better than this by now.
Appeared in the June 23, 2021, print edition.
