On holiday in Devon last week, I hurried out of a shop wearing a mask, with a package under my arm. Getting into our car, I said to my fellow passengers, “We need to go, fast!” No, I had not just pulled off a diamond heist. I had bought a family pack of ice cream, and we needed to get it to a freezer. But masks add a certain charge to moments like this, a hint of mystery and subterfuge that I’m determined to enjoy, if only to compensate for having to wear these annoying, fiddly bits of fabric that make you feel like your head is in a bag.
The best part of wearing a mask, of course, is that it makes it less likely I will infect you if I am, unknowingly, a carrier of the virus. This is common sense, and you don’t need to be a scientist to understand it. In fact, it might be helpful if you’re not.
In early March, as it became clear that Covid-19 was a pandemic, news reports showed people in Asian countries, which were at an earlier stage of the outbreak, wearing masks. Many here wondered if we should be doing the same. Our government’s scientists were clear: we shouldn’t. The chief medical officer Chris Whitty said, “We do not advise that”, explaining that wearing a mask does not protect people from the virus. Jenny Harries, the deputy chief medical officer, explained masks can pick up germs when left on surfaces and trap the virus close to your face. Jake Dunning, an epidemiologist at Public Health England, said there was “very little evidence of a widespread benefit” from wearing masks.
By July, mask-wearing was mandatory in enclosed public spaces. The government’s swift reversal on masks in schools on 26 August – when Boris Johnson said that face coverings should be worn in confined spaces in secondary schools in “hot spot” areas – was merely the capsule version of the slow-motion U-turn it has been performing since March. In terms of evidence, little has changed – no game-changing new study has been published. All that happened is we arrived slowly at a decision that countries which dealt with the virus most effectively arrived at quickly. Politicians must answer for this, ultimately, but perhaps public health authorities might learn lessons from it too.
First of all, they should accept there are different kinds of evidence. Not all policies need to be supported by randomised controlled trials (in which participants are randomly split into groups and studied under different conditions), or indeed by hard data at all. The wearing of masks has always been part of the standard response to dealing with infected people. We don’t need a scientific trial to tell us that face coverings, however imperfectly made or used, are going to present airborne droplets with an additional obstacle in jumping from one person to another. In places such as Hong Kong and Taiwan, which were experienced in dealing with coronavirus epidemics, health officials strongly advised wearing masks. That is also a form of evidence.
Some scientists can display a strange form of tunnel vision on questions like this. I recently found myself laughing at a sober article on the pros and cons of plastic visors. An epidemiologist who had been asked for comment expressed wariness, telling the reporter: “We don’t have the research to say they will offer protection for those around you.” A pro-visor scientist responded by explaining that, well, we kind of do: “Everything that flies out of your mouth is going forward, and it’s hitting a giant piece of plastic. It just physically can’t go through.” Yes, that should do it.
Second, in a crisis, policymakers should follow what we might call the “Nike principle”. If the cost of doing something is relatively low, and the cost of not doing it may be very high, just do it. Don’t wait for more evidence to come in, because by the time it does, it’s too late. Masks are easy to produce, cheap to buy and – hot breathing aside – not hugely inconvenient to wear. As the government guidance now recognises, they do not have to be PPE standard to do a job, which is why the idea that the public would put NHS staff at risk by acquiring masks was always dubious. Even if they slow transmission only a little, masks can have a large benefit at scale.
Third: trust in the public. When Whitty and Harries explained that masks won’t stop people catching the virus, they must have known the point is to stop carriers from passing it on, but perhaps felt that was too complicated to explain. The authorities may also have been concerned that masks would create a false sense of security; that people would use them as a licence to start shaking hands again, and throw away the soap. Yes, some mask wearers might feel emboldened to take more risks, but masks also serve as a public reminder of the problem. By wearing a mask, I send a silent, visible message to those around me, and to myself, to be careful. It’s a useful virtue signal.
The scientists’ flawed attempts to second-guess the public mind are of a piece with the way that concerns over “behavioural fatigue” delayed lockdown. Perhaps experts in public-facing roles should recognise they simply aren’t very good at predicting how citizens will behave in a crisis and that, despite the best efforts of sociologists, there isn’t any hard evidence to turn to in that area. The best they can do, then, is be straight with the public, and hope that people react responsibly, which, most of the time, most of us will.
These days, when I’m on a train or in a shop, the majority of people around me are wearing a face covering. Some are not, however, and although I wish they would, I find it hard to blame them. After all, they probably heard the scientists saying, not long ago, that masks don’t do anyone any good. So what to believe?
That’s the danger of not trusting the public – eventually, it stops trusting you.