In an op-ed in the Wall Street Journal Scott Gottlieb calls for mandates to wear facemasks:
Masks would help. As a practical matter, it’s easier to wear a mask in the winter than the summer. A mandate can be expressly limited to the next two months. The inconvenience would allow the country to preserve health-care capacity and keep more schools and businesses open. Studies show widespread use of masks can reduce spread. But even if masks are only incrementally helpful, they are among the least economically costly and burdensome options for reducing spread.
This is the part of the op-ed that caught my attention:
There’s a presumption that a mask mandate would have to be backed up with fines and set off scuffles with law enforcement. Not necessarily. States should be able to choose how to enforce a mandate, but the goal should be to make masks a social and cultural norm, not a political statement. There are lots of things we do because there is a community expectation of civil behaviors: No shoes, no service. Clean up after your dog. Many of these are even codified in city ordinances.
I believe he must be thinking about some other country. I walk my dog multiple times a day, always on a lead and I have never in the 20+ years I’ve been walking my dogs left one of my dog’s stacks on the ground. Not only that so far this year I must have picked up more than 100 lb. of other dogs’ poop from my neighbors’ lawns, left there by owners who are not as observant as I. Chicago has ordinances, punishable by substantial fines, against off-lead dogs and requiring you to pick up after your dog.
Nonetheless, every damned day I come across multiple off-lead dogs and stacks of dog poop that someone has left behind. The reality is that the only way that “no shoes, no service” is heeded is if, when you’re not wearing shoes, you aren’t served. This is an entire country just full of people who don’t believe that the laws apply to them. 41 million speeding tickets are issued every year. 1.5 million people are arrested for drunk driving a year. Everyone knows those are just the tip of the iceberg. They’ll believe they should comply with unenforced mandates if they’re troublesome to them? They don’t comply with the laws that are at least partially enforced if they get in the way of what they want to do.
Let me make my views very clear. I wear a facemask. I maintain social distancing. I have cut way back on the number of times I go to the store (normally I’m a daily shopper). I do these things because a) I think that in combination in particular they’re, as Dr. Gottlieb puts it, “incrementally helpful” and b) to encourage other people to do the same. I think that every mandate and every law should, at the very least, have a good faith level of enforcement. Otherwise the sheer multiplicity of laws and mandates and the lack of enforcement generally erodes the rules of law. If you’re not going to enforce the law, don’t have it.
And, for goodness sake, don’t overstate the effectiveness of these measures. That does nothing but create unrealistic expectations.
Would it also help if our elected leaders were better role models? Sure but I don’t expect them to. They’re arrogant schmucks.
The problem with mask mandates is again it wouldn’t apply to where it is most needed; at home.
If one does not focus their efforts on where the majority or plurality of transmission is occurring; the effectiveness of any tactic or strategic will be limited.
I am of the mind that moral suasion and information would be more effective in encouraging face mask use at home than any law or legal mandate.
At no time in U. S. history have moral suasion or information been less useful in persuading Americans to do or not to do anything than today. Not only do too many note believe in any morality or, worse, do believe in a morality that equates personal wealth and welfare with moral superiority, backgrounds are just too diverse. And information is already coming at them at too high a volume and rate of speed.
Mask-wearing has already become the norm in a lot of places. There are certainly plenty of Karens who will raise a fuss to socially enforce mask wearing for those who choose not to wear them for whatever reason.
Most states already have some sort of mandate. But a lot of states have a very limited ability to enforce it since enforcement personnel and resources are controlled at the local level. Federal action doesn’t change that reality.
So how much more can federal action be expected to increase mask-wearing? I don’t know, but I think the number is pretty small. Those who believe federal action is important or even critical to increasing mask-wearing and stopping the virus need to show their work.
I know most here probably disagree with me, but a bigger problem remains testing. We’re almost 8 months after the start of this pandemic and it still takes many days and up to a week or more to get the test results. This delay causes people who are still working and depend on a paycheck to be incentivized to lie about symptoms so they can keep working.
In our school system, we have hundreds of students who are quarantined at home because one staff member or student showed “covid-like symptoms.” ~99% of the time it’s not Covid but everyone still has to be isolated while waiting for test results, which are taking a full school week or more. This is hugely disruptive to school and teacher administration, student learning, and parent schedules.
The lack of timely testing as well as the expense also incentivizes people not to get tested if they start showing symptoms in the first place. People don’t want to admit this, but I know a few instances of where that’s happened. I know one person in particular who didn’t get tested because he didn’t want to pay the $30 copay and thought that if he just wore a mask out of the house and didn’t go out as much it would be no big deal.
It seems obvious to me that testing should be widely available and free so that individuals and families can get a timely test when they think they need one. The side benefit is that health departments and agencies get more data regarding the actual current state of the pandemic. The reality is that results often come too late to matter.
I’m confused, I think most states have mask mandates. The first website that I found which had been updated recently was this one from AARP:
https://www.aarp.org/health/healthy-living/info-2020/states-mask-mandates-coronavirus.html
33 states have mandates, but looking at the list of the non-mandate states, it appears that (a) local governments in some states have mandates; (b) some non-mandate states still recommend masks; and (c) non-mandate states tend to be less populous, Florida and Georgia stand out as exceptions.
I’m not sure what can be seen about mandates beyond people will comply them or not, whether or not they exist. State governments typically don’t have a police force well-adopted to enforce them punitively and local governments have made some effort to restrict jailing people as a safety precaution.
I continue to believe that those touting quick, easy, cheap at-home testing as a solution to the problems posed by SARS-CoV-2 are whistling in the dark. IMO such tests will remain too prone to both false positives and false negatives for the foreseeable future to be as useful as they believe.
Not only do I not oppose greater testing capability, I support it but I suspect that the problem with increasing lab testing capacity is more personnel than it is materiel and that problem will take longer to solve.
“I suspect that the problem with increasing lab testing capacity is more personnel than it is materiel and that problem will take longer to solve.”
That very well may be the case, but I’m not seeing much action on that front. Unlike mask mandates, increasing our testing capacity is something the federal government can materially affect.
Why I said moral suasion and information is because masks and coronavirus seem like an analogue to condoms and HIV.
The government never mandated condom use; but the campaigns about ‘safe sex’ or ‘safer sex’ were fairly effective in changing behavior.
They key problem the government has right now is a muddled information message — it should be use masks whenever one is with people; at home or in public — not use masks whenever one is in public.
The testing issue is hard to generalize. Around here, the most popular pediatrician practice use 15 min PCR tests, and appointments are next day.
“The testing issue is hard to generalize.”
Which I think is a problem.
“Around here, the most popular pediatrician practice use 15 min PCR tests, and appointments are next day.”
I didn’t know there was a 15-minute PCR test. The quick tests we have in our area are antigen tests using the same basic method as quick result strep tests. My doctor told me they are about 90% accurate for those who have symptoms, less so for those who don’t. Around here those are tightly controlled and only given in specific circumstances that vary from provider to provider.
For example, I went to a local urgent care clinic to get a rapid test and the provider on duty wouldn’t do it even after I explained I had recently been in contact with several people. But the desk secretary said the provider at their other location 15 minutes away would do it, so I went there.
I did end up getting the 15-minute test (which was negative) and the provider went ahead and did a full respiratory profile which includes the lab PCR Covid test. 4 days later they told me I had rhinovirus (common cold) which by that point I had already figured out on my own (my insurance was billed ~$350 for all of this).
Anyway, the lab PCR tests in my area are taking 4-7 days and that seems to be the only test available for the vast majority of people. The drive-through community sites are gone, so the only way to get even that test is urgent care or making a primary care appointment. All-in-all it’s neither convenient nor timely for most – and that’s for those with decent insurance.
@andy, I’m with you on the testing. I think the rapid test needs to be distinguished as something to be used to figure out if a person is infectious, not whether they are infected:
https://marginalrevolution.com/marginalrevolution/2020/08/infected-versus-infectious.html
We are already using questionnaires and temperature checks as very poor proxies for telling someone might be infectious.
Our city’s public school system appears to be the only one within a hundred miles that is not open to any on-site learning. The board member most opposed to reopening has at least met with the local university about extending their testing program to the schools. They would be able to do a saliva test with a six hour turnaround for $20 per student, up to 10,000 tests per day. Too expensive as of now. In any event, without testing more suited to opening schools, its possible they won’t reopen. But I do see other schools yo-yoing btw/ open and closed because they don’t know what to do when something happens.
Similarly, my wife’s employer won’t allow in-person therapy even though her office situation is very conducive to social-distancing. Hospitals in state of crisis don’t give a shit about mental health, they pushed the older therapists out the door and dedicated more money to suicide hotlines. Every week my wife’s clients ask when they can see her in person and why it takes so much longer to get an appointment. My modest proposal is basic anti-anxiety/ anti-depression medication should be available without a prescription for the foreseeable future, just have people fill out a questionnaire and have their temperature checked at Walmart / Target.
PD,
Yeah, I agree.
I’m lucky that our school system is doing in-person. A lot of schools aren’t. Her elementary is 100% full-time 5 days a week. If someone has symptoms then they switch to remote learning for the quarantine period or until a test comes back negative. We’ve had to do that one week so far.
For middle and high school, students are divided into two cohorts. Cohort A is in person Monday and Tuesday. Cohort B is in person Thursday and Friday. Students do synchronous online learning on the days the other cohort is in class. Wednesdays are a kind of online catch-up day. Staff cleans the schools on that day as it separates the cohorts.
Students also have the option to all synchronous online or they can transfer to the dedicated online school the district opened a couple years ago. The vast majority of parents and students are opting for as much in-person learning as possible.
The schools don’t have testing, however, except for staff. So if someone has symptoms, it’s up to parents to get them tested.
Our district is in an upper-middle-class suburban area. The urban districts, like Denver, have closed completely and many kids aren’t showing up at all for online learning. There are thousands of “missing” kids who either didn’t enroll at all this year or are “missing” from online learning.
Politicians are panicking because less students = less federal and other education dollars.
It’s pretty much a clusterfuck overall.
I have been complaining about tests taking too long since the beginning, so of course I agree with you guys. My sense is that the problem is reagent and kit shortages but even when they are plentiful reporting is also an issue. A test can finish at 1:00 PM Tuesday and you not get results until 4:00 PM Wednesday.
On masks I still dont think out door spread is likely at all, not enough to arrest people over or fine them. So just add no mask to no shoes no service. Make the penalty the same.
“I am of the mind that moral suasion and information would be more effective in encouraging face mask use at home than any law or legal mandate.”
Since it would be unenforceable it would be the only way. There are some older studies looking at mask use at home to decrease flu spread that showed some modest success. I would expect it have fairly limited success and only with homes with older kids or no kids. Best to keep it from getting into the home to begin with.
Steve
@andy, yeah we have missing children. The last school board meeting they said there were hundreds of missing children and they’ve tried to reach out to the households by calling, ringing the doorbells, and leaving messages at the door. They wanted the Zoom-audience to help out if they suspect they know one of these kids, but they obviously can’t tell the public who they are because of privacy. Maybe they’re ok.
My daughter is well into her first semester of teaching. Its 100% zoom, and its a horror show.
Absentee kids, absentee parents. Distractions in the home. Quality of instruction diminished. Discipline problems. These are the so called underprivileged kids. We are doing them no favors.
On the subject of coronavirus. I just noticed this, but New Zealand, the most successful country in the “West” in dealing with coronavirus — actually implemented mandatory quarantine camps for people found infected.
https://www.bloomberg.com/news/articles/2020-08-13/new-zealand-reports-13-new-community-virus-cases-amid-outbreak
I know it won’t fly in the US; but still, decision makers need to look at how to improve isolation for people that are infectious. I’m guessing 5% more effective isolation policies would do more then boosting mask wearing in public from 80% to 90%.
Look at this story https://www.bloomberg.com/news/articles/2020-08-13/forced-isolation-may-be-the-only-way-to-stop-resurgence-of-virus .
Australia found 25% of people who were supposed to isolate at home were actually outside the house during spot checks.
Don’t tell them to wear masks in Chicago!
https://www.foxnews.com/us/chicago-security-guard-stabbed-27-mask-coronavirus