Behind the mask: Health experts say face coverings help prevent the spread of COVID-19, so why are they so controversial?
STEAMBOAT SPRINGS — Fashion is no stranger to controversy.
Style magazines and internet pages abound with last year’s fashion flops — last summer it was the flip-flop high heel — and other creations that are seen as racist, sexist or otherwise polemical.
But in the summer of COVID-19, it is the face mask that has taken the runway by storm, met with both supportive applause and fierce condemnation. While some, particularly medical experts, say the masks are an easy way to limit the spread of the virus, opponents see masks as ineffective, and the laws requiring them as government overstepping its boundaries.
Fights and rights
The mask debate has been raging in Routt County since officials passed a public health order in April requiring everyone to wear face coverings at indoor, public places. It ruffled some feathers.
The Steamboat Springs Police Department received numerous calls, initially on a near-daily basis, about people seen not wearing a mask, as Police Chief Cory Christensen explained in a previous interview. Other calls were about people arguing about masks, arising either from someone wearing one or from someone refusing to do so.
Lisa Popovich, executive director of Main Street Steamboat Springs, experienced similar pushback during the first few weeks of the Main Street Steamboat Farmers Market. To keep people safe, the market requires everyone to wear a mask. Some did not like that rule, Popovich said.
“When we first started, there was lots of resistance, bargaining, arguing and threats,” she explained in an email.
At each market, staffers have had to ask six to 10 people to leave after they refused to wear a mask, according to Popovich.
“It really is a simple thing to do as a patron to wear a mask for the 20 minutes you are at the market in order to keep ourselves and our neighbors safe,” she said.
Amid a rising number of COVID-19 cases in recent weeks, Gov. Jared Polis made masks a statewide requirement July 16. This helped provide consistency to health guidelines and buttressed the local order.
“Hospitalizations are up. Case counts are up,” Polis said during the news conference where he announced the mandate. “This is the least costly and the simplest intervention that we can do.”
Before the governor’s mandate, some saw neighboring counties like Moffat and Rio Blanco, places where masks were not required, as havens for laissez-faire shopping. They claimed to avoid local business primarily for the sole reason that they did not want to be told what to wear.
With mask laws becoming increasingly common in and around Colorado, the country is entering a new era of health, freedom and fashion — whether or not people like it.
Debunking some myths
Amid the mask debate, several misconceptions and outright lies have circulated on social media, throwing even more confusion into an already muddled state of affairs.
One of the most common misunderstandings is the health logic behind the wearing of masks. According to the Centers for Disease Control and Prevention, cloth face coverings can help prevent people who have COVID-19 from spreading the virus to others.
Masks act as a simple barrier to stopping a person’s respiratory droplets — the often imperceptible spew of germs that leave someone’s mouth when he or she coughs, sneezes, talks, breathes or really does much of anything — from traveling into the air and onto someone else. They are not, as disclaimers on certain masks explain, a way to prevent a person from getting the virus.
The CDC goes on to say face coverings are most likely to reduce the spread of COVID-19 “when they are widely used by people in public settings.” This is one of the reasons why making masks a statewide mandate is seen as an effective measure.
The people who should not wear a face covering, according to the CDC, are children younger than 2 or people who have trouble breathing, are unconscious, incapacitated or otherwise unable to remove the mask on their own.
Some mask designs don’t serve their intended purpose by either not being made of cloth, as the CDC recommends, or having openings in the mouth and nose that defeat the purpose of wearing it.
A more bizarre hoax, which came in the form of an internet meme, is the claim that wearing a mask disqualifies a person’s concealed-carry permit. Sergeant Evan Noble with the Steamboat Springs Police Department debunked this falsehood.
“There is no law in Colorado or locally that prohibits someone from wearing a face mask and legally carrying their concealed weapon,” Noble said.
Politics of health
Public health does not exist in a vacuum. Other forces, from economics to culture to politics, have sway on how a country responds to health crises. Stephen Kunitz, in his book “The Health of Populations,” argues that politics is among the strongest variables when it comes to the health of a country. As he writes, “political culture and institutions have a profound effect that may well be more significant than the standard of living as measured by income per capita.”
On the national level, mask wearing has experienced a tumultuous symbolism. For months, President Donald Trump refused to wear a face covering in public appearances and shared a tweet mocking his Democratic rival, Joe Biden, for doing so. During a news conference in April, he suggested wearing a mask would tarnish his presidential prestige.
“I don’t know, somehow sitting in the Oval Office behind that beautiful Resolute Desk — the great Resolute Desk — I think wearing a face mask as I greet presidents, prime ministers, dictators, kings, queens, I don’t know,” Trump said. “Somehow, I don’t see it for myself. I just don’t. Maybe I’ll change my mind.”
And change his mind he did. On Monday, he tweeted an image of himself wearing a mask with the presidential seal, describing it as an act of patriotism.
“We are United in our effort to defeat the Invisible China Virus, and many people say that it is Patriotic to wear a face mask when you can’t socially distance,” he tweeted. “There is nobody more Patriotic than me, your favorite President!”
His politicization of face masks has done little to quell the debate over wearing them.
Many voters, health experts and politicians have criticized Trump for his lack of leadership over the pandemic. Recent polls have shown broad disapproval for how the president has handled the pandemic. They say his refusal to respect health recommendations undermines the authority of longstanding organizations, including the CDC.
Striking a balance
Distrust in public health is nothing new. It is nearly impossible to find a widespread public health campaign, be it against malaria, smallpox or any widespread disease, that did not face some degree of pushback from the population. Some people still refuse to get vaccines. Others opt for alternative medicines, such as naturopathy and elixirs, rather than put their trust in doctors and hospitals.
To an extent, public health campaigns do require individuals to make sacrifices for the good of the whole. This tends to put Americans on edge in a nation that prides itself on liberty and, at least relative to many other countries, a hands-off government approach to the way people go about their daily lives.
As news sites described in the spring, some of the countries that best battled the pandemic, such as South Korea and Vietnam, were also those with more restrictions on individual freedoms compared to the U.S. In Vietnam, for example, the government maintains control of the media, which has sparked concerns over furtive human rights violations in the name of public health.
American culture and ideologies put much more importance on individual freedoms.
Back in the nation’s founding, the ratification of the Bill of Rights, which lists specific prohibition on government power, was essential to securing the votes necessary to draft the Constitution. Protection of these rights often has served as the ammunition for people opposing the public health orders.
Protecting the self, protecting the nation
One of the most vocal residents speaking out against some of the COVID-19 restrictions is Jennifer Schubert-Akin, founder and chief operating officer of The Steamboat Institute, a conservative think tank. Many of her criticisms revolve around the Bill of Rights and certain individual freedoms therein that she argues Americans are losing in the name of public health.
“In general, governments often use crises as the pretense to expand their power at the expense of the general population,” Schubert-Akin said in an email.
In April, she signed a letter along with 96 others asking the Routt County Board of Commissioners to amend the mask order. As the letter to the commissioners said, “your decision seems extraordinarily heavy-handed and intended to sow fear and distrust, rather than to stop the spread of disease.”
Around the same time, a local group of residents and business owners, including Schubert-Akin, created a survey about the local mask requirement. Of the 252 respondents at the time, many of whom were customers, employees and others in the network of contributing businesses, 80% did not support the order, according to the survey.
Of customers, 35% said they had done more shopping in other counties where masks were not a requirement. Many business owners who responded, 70%, said the face mask mandate has negatively impacted their business.
The county conducted its own survey, the results of which were released days after the previous poll. Of the 814 respondents, 75.1% said they feel comfortable wearing face masks at local businesses, according to a county news release.
When it comes to mask requirements, Schubert-Akin’s predominant issue is with the steep fines and jail time that a violator could face. In Routt County, violating the mask requirement could result in up to 18 months in prison or a $5,000 fine, though local law enforcement and the district attorney have said maximum punishments are rarely sought, and the emphasis is on education and compliance.
Regardless of how likely a person would ever face the maximum punishment, Schubert-Akin considers its potential a violation of the Eighth Amendment. Among other things, it prohibits the imposition of “excessive fines.”
Schubert-Akin takes issue with other restrictions she said are being enforced with political preference. She pointed to the gathering limits, a perceived attack on the First Amendment, which have halted many events but have not stopped thousands of people from convening in protests for racial justice and police reform.
These gatherings continue to be a source of concern for certain health officials.
Other medical experts say structural racism is a pandemic in its own right and argue the protests are worth the risk of spreading COVID-19. In June, a group of almost 1,300 health professionals from across the U.S., including a handful from Colorado, signed a letter of support for the protesters, whom they said are calling attention “to the pervasive lethal force of white supremacy.”
As Schubert-Akin believes, a more responsible public health approach would rely more on the private sector and individual responsibility to combat COVID-19.
The Steamboat Institute recently published a “Stopping the Stampede on Civil Liberties” tool kit, which Schubert-Akin said is a way for concerned citizens to make their voices heard and urge officials to uphold civil liberties in their pandemic responses.
“The government has a legitimate role in responding to a public health threat, but it must not overreach,” she said.
Lessons from “Typhoid Mary”
When it comes to public health, there are certain historical examples during which the government curbed individual freedoms for the sake of the general population. Among the best-known is the case of Mary Mallon, New York’s “Typhoid Mary.” A self-employed cook, she worked in several households between 1900 and 1907. Those homes eventually became stricken with typhoid, a bacterial infection typically spread through food and water contaminated with salmonella.
After Mallon tested positive for the bacterium that causes typhoid, a legal battle ensued over whether or not to force her into confinement. The case, which weighed conflicting principles of public health and individual liberty, eventually made its way to the Supreme Court. The justices decided Mallon must be quarantined on an island off the Bronx, with the court saying, “it must protect the community against a recurrence of spreading the disease.”
To the health world, it served as one of the first understandings of how symptom-free people could still spread diseases.
While Mallon eventually was freed on the condition she stop working as a cook, she did not follow those orders, unconvinced she posed a danger to anyone. When an outbreak of typhoid infected 25 people at a maternity hospital where Mallon was working as a cook, she was sent back to the island. She died of a stroke in 1938 after a quarter-century of quarantine. At least 51 people caught typhoid from Mallon, three of whom died.
While the story of Typhoid Mary is a more extreme example of public health encroaching upon individual liberties, it shows how utilitarian arguments largely win out when it comes to combatting diseases. It also shows the importance of following health directives. Self-isolating for two weeks or wearing a mask is much less of an intrusion on one’s life than spending 25 years in quarantine.
Masks, but make it fashion
With COVID-19 showing no signs of disappearing anytime soon, masks likely will continue to be a common sight in the weeks and months ahead. But with time, people have tended to accept the rules.
Even before the governor’s mandate, people seemed to be warming up to the idea of masks, or at least did not throw as much of a fuss about wearing them. At the farmers market, Popovich has noticed fewer arguments and better compliance. For those who forgot a mask, free ones are available at the entrances.
“Now, those who do not wish to wear a mask are staying away,” Popovich said.
Some have embraced masks’ sartorial potential, using floral patterns or sporting the logos of their favorite football teams.
At a Board of Routt County Commissioners meeting Wednesday, the commissioners tabled a vote to extend the local mask ordinance. As they explained, the main difference between the county’s order and the governor’s is the age limit. According to the local order, based on CDC guidelines, everyone 2 and older must wear a mask. According to the statewide order, people 10 and older must wear a mask.
When it comes to enforcement of these rules at local businesses, Commissioner Beth Melton stressed the focus is on education and compliance, not punishment. The ultimate goal is to continue the road to recovery and prevent a surge of the virus, particularly come flu season.
“This is not about being the mask police,” Melton said. “This is about enforcing the protocols that make the most impact in limiting disease spread.”
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