Masks are not effective every bit helps

Preface

I hope you are not tired of more COVID19 content? I actually never wanted to put much about it on this blog. This was supposed to be about images and thoughts. But seeing mostly hysteria and numbers porn on mainstream media and politicians whose only solution is to restrict our freedoms I feel that we sorely lack rational voices. I want to do my admittedly small part in providing some calm deliberation.

But I do not want to be another site that argues for or against any measure. Instead I would like to take a step back, have a look at the kinds of arguments and thoughts that are being used in public and analyze them with you. Let’s go.

Introduction: Even if masks are not effective every bit helps against COVID19

It is my conviction that the widespread wearing of non-medical masks by the public especially in situations like stores, markets or even outdoors is barely effective in containing the spread of SARS-COV2. I also think that prolonged wearing of masks can lead to adverse effects like skin and respiratory infections with other pathogens (by wearing the masks under your chin, on your arm or touching it with your hands), build-up of bacterial and mold colonies, difficulty breathing and lack of oxygenation especially in children.

This post is not supposed to argue for or against masks nor am I trying to convince you of my position. I can offer you three links to start doing your own research [1, 2, 3, 4]*. I want to analyze a common argument that goes like this:

Even if masks are not very effective every bit helps to contain the spread of the virus. So it is better to wear a mask than to not wear one. Even if you prevent just a few new infections it will be worth it.**

I am sure you heard this argument before. It is essentially a variation on “better safe than sorry”. In what follows I want to show how this argument might be correct in one setting but can also be wrong or even dangerous in another setting. Both pros and cons of masks can be argued but this post is about making a decision where the pros and cons are not clear.

How better safe and sorry can become neither safe nor sorry

The argument essentially says that it is better to wear a mask if even they are barely effective than to not wear a mask at all. The argument concedes that masks are either ineffective or their effectiveness has not been proven yet by science but “better safe than sorry”. The huge problem with such an argument is that it completely ignores that wearing a mask has a tradeoff. I remarked a few times on this blog that everything in life has a tradeoff.

I want to be better safe than sorry

If you alone decide to wear a mask not knowing if it is effective but using this argument to justify mask use than you are implicitly making a tradeoff. You accept (even without consciously doing so) the negative and positive effects of masks without knowing for sure. Your caution makes you think that the positives probably outweigh the negatives.

This is a not a good decision because you are in effect guessing or going “with your gut”. But as individual humans we are limited in how much data we can gather and process so oftentimes guessing or feeling is the best we can do. I can suggest a book by Danny Kahnemann (Thinking, Fast and Slow) on why this is so. But as you are making this decision for yourself you are of course free to use this argument. YOU are making this tradeoff for yourself.

You might say no I am making this tradeoff for others as well because I protect them from me by wearing a mask. But then I like to remind you that the “better safe than sorry” argument already concedes that we at least do not if masks protect others or even know that they offer only small protection.

When we have to be better safe than sorry we are anything but

The problematic part comes when this argument is used to force people to wear masks. Now someone else in power makes this tradeoff for you. Now in itself this how government works. It has to make rules that are usually the same for everyone and all rules have tradeoffs.

Here is the crucial difference. If you make a decision for everyone you better make sure it is the right one. Without going into too much detail but as soon as you make a decision for someone else you are ethically bound to do the utmost in making sure your decision is right. In a democratic society this very much applies to the people in power. Most legal traditions have codified this in one form or another. In Germany such a decision needs to pass the trifecta of a) being a suitable measure b) being reasonable or proportional to what is going to be achieved and c) being necessary.

Conclusion: Better be sure about being safe before you are going to be sorry.

And this is where our argument fails. “Better safe than sorry” mandated by government forces this tradeoff on everyone. No matter what the costs of mask wearing are (from inconvenience to mental and physical health risks) they are imposed for a goal that has not yet been proven with a high enough certainty. The bigger the potential downsides are the more unethical such a forced decision becomes.

So what to do? Maybe make it a suggestion or an advice. Tell people honestly that masks might help, that they might have adverse effects and urge people to make their own informed decision. Only mandate something when one can be certain that it is effective, suitable and necessary. Essentially I am arguing that the more people are being affected by a decision the better the justification has to be. This is in fact a basic principle of free and democratic societies than can and should not be dispensed with because of a virus. Then we would not need principles at all.

*Be aware that the information from the WHO is very sparse on actual sources and only very recently did they change their advice on masks for the general public while the Wikipedia only lists recent preliminary research. Jim Mehaan’s blog has the most sources but he is actively trying to persuade you. Sebastian Rushworth’s blog entry seems quite balanced. As always evaluate for yourself.

**This argument is being made by the national infectious disease authority in Germany (the Robert Koch Institut). “Eine teilweise Reduktion der unbemerkten Übertragung von infektiösen Tröpfchen durch das Tragen von MNB könnte auf Populationsebene zu einer weiteren Verlangsamung der Ausbreitung beitragen.” Translated (emphasis by me): A partial reduction in the unnoticed transmission of infectious droplets (so no aerosols) by wearing a community mask can lead to a slowing of the disease spread on a population level [4].

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