Coronavirus DK: Why aren’t face masks necessary?

(This is the first part of a two-part post.)

During the COVID-19 pandemic, face masks have become a flashpoint of contention in America between those who favor precautions and lockdown and those who rebel against them in the name of personal freedom or because of skepticism about the disease. Masks have become the new symbol of the culture wars in the United States between the Right and Left. The CDC recommends them, and many states and cities require people to wear them on public transport, in stores and elsewhere. According to a new Wall Street Journal/NBC News poll, “Roughly two-thirds of Americans said they always wear a mask when they leave the house.” Yet the country has the highest number of deaths from COVID-19 in the world, and although the epidemic might be plateauing, it is not yet under control.

Worse than nothing?

In contrast, Denmark, where coronavirus infections continue to subside during the reopening of the economy, has never required masks. The government has followed the precautionary principle with a stricter lockdown than the Danish Health Authority recommended even while it drew criticism from the private sector and the right-wing opposition. Danes are much more acculturated to acting in the collective interest than Americans, yet masks have been considered unnecessary. In fact, the government and the Health Authority have always advised healthy people not to wear them because they can do more harm than good. None of the other Scandinavian countries has required masks either, and except for Sweden, which has followed a laissez faire policy, they have had an even lower infection rate than Denmark. 

So what is the reality? Do masks work at all in nonmedical settings, and if so, do the benefits outweigh the costs? Is it possible that the masks and all the strife they have occasioned in the United States have been unnecessary and even counterproductive?

False security

Masks clearly have value a protective value when health professionals wear them while treating infected patients, and there appears to be strong evidence that they reduce the spread of the virus from infected persons. Whether they have much protective value for the wearers is not as well established. What is the downside the Danish Health Authority alludes to? This is the government’s position, explained on the English FAQ page of its coronavirus website, under the heading “Other questions”: “The Danish Health Authority does not encourage healthy individuals who go about their daily business to wear mouth or face masks as is [sic] uncertain that they have any effect on virus transmission.”

The Health Authority does not deny that masks might be beneficial or reject their use altogether. They are recommended in certain situations, “such as prolonged or frequent close face-to-face contacts with customers/clients.” They are also advisable for persons in high-risk groups in “situations where you get very close to others, for example if you have to take public transport during rush hour.” 

But these are the reasons against general use: First, the infection rate in Denmark is low; people are generally conscientious about following advice on hygiene and social distancing; and in ordinary situations they are not at much risk of infection. Masks can be a liability if you don’t use them correctly, so that they cover the mouth and nose fully, and do not dispose of them correctly. If you adjust them often, your hands can become contaminated. If you wear a paper mask for too long, it may become wet and ineffective. You should not try to make your own fabric mask because it protects less well than a surgical mask. Masks can lull people into a false sense of security and make them less careful in following the guidelines on hand-washing and social distancing. They may also make people with symptoms believe they need not isolate themselves.

Practical disadvantages

The Authority argues rather that, in situations where people observe hygienic guidelines, the additional value of masks is slight and does not outweigh the risks that masks themselves entail and the disadvantages of using them. You must find them, buy them in a large supply, and replace them or wash them regularly. If everyone is wearing masks, you cannot see people’s faces and might not be able to understand their speech as easily. Some people might experience difficulty breathing. This is aside from another negative effect that is more relevant to America: the advantage it gives thieves by turning their disguise into ordinary apparel. They don’t look suspicious when they enter a store to rob it, and on the way out they don’t need to remove their masks at just the right moment between the security camera and the street.

(To be continued.)