The logical attractiveness of the argument makes its failure all the more striking

Stripping away all the partisanship for which the dispute is often just a proxy, face-masks are an interesting case study in public decision-making.  

During a pandemic, face masks are a logical step in reducing the transmission of disease.  Of course they must be beneficial.  They are a barrier.  No, they might be less than perfect.  Sure, some people will pick up the virus anyway.  But if it reduces transmission by 5%, surely it must be indisputably worthwhile?

And look at some of the early Asian countries such as Japan, Singapore, South Korea, Taiwan - all countries with a pre-existing cultural disposition towards public mask wearing for transmission control.  They all wore masks extensively and suffered far fewer Covid-19 cases.

All this is brought to mind by an opinion piece out of Ireland.  Europe has been, in general, more amenable to masking than some parts of the US and it has been perhaps more widely and more diligently practiced it seems.  But they are in a second wave with mass expansion of cases despite wide-spread mask wearing.  From Real talk: Have facemasks failed? by John McGuirk.

There’s probably been no more contentious subject in Ireland over the past six months or so than the question of mandatory facemasks. There are bigger questions, sure, on which the population is more evenly divided – lockdown or no lockdown; schools open, or schools closed; the infernal debate about “wet pubs”, and so on.

But no subject provokes more passionate disagreement from a minority of Irish people than the question of wearing a facemask. For most of us, it’s a common sense healthcare measure – we feel safer, we feel like we’re doing our bit, and we feel like it’s not a huge imposition.

For a minority, though, this has been the number one cause of resentment and disagreement. To them, facemasks have always been medically useless, as well as an unconscionable imposition on a person’s bodily autonomy. They’re nothing less, in this telling, than a symbol of tyranny.

Most people have little sympathy with the latter part of that argument. But what about the first part of it?

As an aside, the second part of the argument in paragraph three brings to mind something I had not considered over the past eight months of the pandemic.  For those of us who lived through the abortion debates of the seventies and early eighties, there was a powerful feminist argument - "Our bodies, our choice!"

It had a powerful native logic.  Not ultimately the best argument, but a good one.  Here in the US, mask resistance has been much more anchored in human rights or efficacy arguments but "My body, my choice!" has a certain persuasive ring to it.  Communal health obligations versus individual health choices are not a good analog for one another but the utility of the argument makes it strange to me that there has been little reference to that long ago slogan.  

I have been agnostic on masks here.  Wait for the evidence.  I can see good arguments on both sides.  I am only out for necessities and do wear a mask primarily out of respect for those with whom I am dealing, not because of any great confidence that the masks actually work.  

One of the striking elements has been the course of the argument which apparently was paralleled in Ireland.

First, remember what the argument against masks was, back in the Spring:

Here in Ireland, HSE lead for infectious diseases Prof Martin Cormican recently reviewed guidelines on mask-wearing for hospital staff and came to the conclusion that there was no evidence to support the wearing of surgical masks by healthcare workers for close patient encounters and staff meetings.

Citing WHO advice, Prof Cormican suggested mask-wearing by people with no symptoms could create unnecessary cost and create “a false sense of security”.

That’s the HSE lead for infectious diseases, warning that masks might actually be counter-productive, saying that wearing them could lead to people dropping their guard.

A very similar argument was made here in the US at the beginning.  It was a muddied message in that it seemed sometimes to be a simple "Masks don't work" argument and sometimes it was "Masks work but only for high exposure situations like hospitals so public, please don't hog the supplies" argument.  We had this from WHO, CDC, and others.

And then the advice changed as the supply chain adapted, as some states began adopting track-and-trace, as lockdowns became more prevalent.  

But societies run on trust and that was a hard transition.  Experts cannot be declaring masks don't work one day and then be demanding that masks do work the next.  Not, at least, without showing their work.  

My reading of the evidence over the years has left it as an open question.  It has always seemed that masks ought to work but the compelling evidence that they do work at a societal level is limited.

I recall the elaborate masks used in Europe in medieval times when beaked masks were the style with cleansing or filtering herbs in the beak which were supposed to protect the wearer.  The conviction of efficacy was far greater than the measured results would support.

Just as today.  We are eight or ten months into this and we still don't know the degree to which required communal mask wearing actually reduces transmission at all.  Seems like we ought to have good empirical evidence at this point.  

Instead, we seem to be moving in the opposite direction.  Countries with prolonged and forcefully imposed mask wearing are now seeing dramatic transmission increases in second-waves.  

I can craft a number of plausible reasons why that might be but none of them fit easily into the track record so far.  

We are left in a position where it seems increasingly clear that the experts don't know what they are talking about, that the efficacy of mask wearing is under increasing empirical threat, and that the argument for emergent order decision-making by citizens might be superior to coercive decision-making by remote experts.

Like I say, an interesting case study.  We don't have the answers yet.  But there is a logical attractiveness to "Wear a mask to stop transmission" and the fact that there is increasing evidence that that is not true makes the counterpoint all the more striking.