Are Mask Mandates a Waste of Time?

I suspect that Geoff Shullenberger’s post at UnHerd will raise some hackles. Its title, “Were masks a waste of time?”, seems intended to produce that reaction but the post is actually a bit different. There are actually three distinct questions:

• Has the health system guidance on wearing masks been unambiguous and effective?
• Do masks work?
• Do mask mandates work

and much of his article is devoted to the first and last questions. For example, this observation:

A document published by the World Health Organisation in 2019 framed the results of these studies in no uncertain terms: “there was no evidence that face masks are effective in reducing transmission of laboratory-confirmed influenza”. It’s unsurprising, then, that when the CDC briefed reporters on the pandemic in February of 2020, masking was not even mentioned among the NPIs that might be deployed. The UK government, too, stated early in 2020 that there was no evidence to support masking.

doesn’t actually tell us whether masks (or what sort of masks) work or not. It tells us that the guidance we’ve been receiving from healthcare professionals has been confusing which I should think we should all be able to agree. And this statement:

In light of the earlier consensus, Miller’s findings in Unmasked should not be surprising. As we might have predicted based on a plethora of trials and meta-analyses published prior to the pandemic, mask mandates have had little to no demonstrable impact on curbing the spread of the virus. Miller reaches this conclusion by comparing areas with mask mandates of longer and shorter duration with each other and with areas that never imposed mandates at all. The results, he shows, simply do not support the standard adage that “masks save lives”.

For example, Los Angeles County, the most populous county in the US, imposed one of the earliest mask mandates in the United States, just after the CDC released its new guidance in early April 2020. By May, the county was requiring masks outdoors as well as indoors and enjoying 96-97% compliance. (It also imposed an array of other strict mitigation measures.) But it had case and mortality rates well above the national average throughout 2020 and 2021. LA currently ranks 3rd among California counties in its Covid death rate, faring worse than numerous counties with mask mandates of shorter duration and lower levels of compliance.

doesn’t tell us whether masks (or what sort of masks) work or not. It’s not even dispositive that mask mandates do not work although it does call them into question.

Bearing in mind the economist Paul Samuelson’s jibe (“When the facts change I change my opinion—what do you do?”), my view is that there is some marginal benefit in a non-healthcare setting in preventing me from spreading COVID-19 to others by wearing a mask, with the greatest increment in effect being simply by wearing a cloth mask with surgical and then N95/KN95 masks providing additional marginal benefits. By far the best way to encourage people to use masks is for the relevant authorities to provide unambiguous guidance and systematic utilization of them themselves. I think that unenforced and in all likelihood unenforceable mask mandates are, indeed, a waste of time, at least in the U. S. If wearing them is seen as providing benefits, people will do it without mandates but there won’t be 100% compliance. In the U. S. it’s darned hard to get overwhelming compliance with anything.