Masking may seem like a thing of the past in the United States, even in cities like New York and Los Angeles that once embraced precaution. But as healthcare facilities grapple with a “triple epidemic” of respiratory viruses – with Covid, influenza and RSV rising simultaneously – experts are again urging the public to cover their faces.
“I wouldn’t go to a grocery store without a mask,” says John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at the University of California, Berkeley. “I wouldn’t go on rapid transit without a mask. I wouldn’t go on a plane or be in an airport without a mask,” nor would he attend a crowded outdoor event like a concert without a mask, Swartzberg says.
Yet after nearly three years of mixed messages from officials, with many Americans appearing to have moved on from Covid — and a president who has declared “the pandemic is over” even as hundreds die every day — someone will one listen?
As of December 2, the CDC reported a seven-day average of 4,201 Covid hospitalizations and 254 deaths. Meanwhile, flu and RSV seasons have arrived unusually early, with flu hospitalizations at their highest level in a decade. On Dec. 2, the agency reported 8.7 million flu cases, including 78,000 hospitalizations and 4,500 deaths, this season. And we haven’t seen the worst yet, given that it’s been less than two weeks since Thanksgiving, with many more holiday gatherings to come, says John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at the University. from California to Berkeley.
The good news: “Masks work against Covid, masks work against RSV, masks work against influenza, and masks work against other respiratory viruses,” says Swartzberg. “They really work to help prevent people from getting infected and the consequences of that infection.”
Abraar Karan, an infectious disease expert at Stanford University, agrees — as do a number of studies, including a recent “natural experiment” comparing masking and no-masking schools in Boston.
“Masks will help reduce the risk of virus acquisition,” Karan says. “The better the mask you use, the more effective it will be, depending on the fit and filtration of the mask” – with the N95, KN95 and KF94 offering good protection. His own experience testifies to their effectiveness: through years of treating Covid patients, he managed to avoid infection. “When I got infected, it was actually from someone who was sick at my house,” he says.
When it comes to Covid, he notes, vaccines work well against serious illnesses but are less effective against infections. Masks provide an important additional line of defense. As for other less transmissible viruses such as influenza and RSV, they “largely disappeared when we used mitigation measures,” such as masking at the start of the pandemic, he says. However, having withdrawn these measures, “we have now seen a recovery”.
But, as anyone who’s been to the grocery store or the subway in recent months knows, trying to find someone with a mask these days can feel like part of Where’s Waldo? And according to Sara Wallace Goodman, a political scientist at the University of California, Irvine and co-author of Pandemic Politics: The Deadly Toll of Partisanship in the Age of Covid, that isn’t likely to change any time soon.

“The pandemic has really eroded the trust of the public and health officials. And that stuff has long-term battery life,” Goodman says. The US has never “developed a flexible policy response narrative” – a “shared understanding” in which, for example, we treat “masking like a raincoat or like an umbrella: you take it out when you need it , and you put it away when you don’t”.
In the meantime, messages about masking have “shifted” from treating it as a matter of community response to one of personal choice. “It’s really hard to roll out that message and say it’s not an individual choice anymore. Especially in America – we’re very against those kinds of messages,” she says.
Benjamin Rosenberg, a social health psychologist at Dominican University in California, wishes we heard from more social scientists as the government’s messaging on the pandemic took shape. At this point, however, Rosenberg, who studies psychological reactance — “what happens when you tell people what to do” — argues that the language of mandates and compliance requirements won’t do much to change behavior.
Yet there are other ways to increase mask usage. “In general, people like to pick their stocks. We want to have the will, we want to have the choice of what we do and the decisions we make, so mandating something really takes that choice away from us,” he says. On the other hand, pushing for masking in a “more gentle and encouraging way” means “saying that you are actually going to have that freedom. We’re not going to take it away from you…but here are a few reasons why you might consider wearing one in this context.
When it comes to messaging, Karan says, public health officials need to be “more direct” with the message that “masks will reduce the risk of getting infected.” Governments could also help by increasing the availability of masks. Not everyone has access to it, and “there have been times when I forgot to take my mask, and I wish there was a way for me to get one quickly before I enter certain spaces”.
Goodman also sees benefits in “meaningful community interactions.” It would be great if Joe Biden continued to wear a mask, she says, but seeing neighbors wearing them will likely have a bigger impact: “If people you know and trust are wearing a mask, then maybe that you will think twice before not wearing one. .”
Ultimately, says Swartzberg, what we need is a cultural shift so that masks are “somewhat normalized, so people are more comfortable wearing a mask in certain settings.” . Such sweeping change is not without precedent: the 1918 influenza pandemic helped usher in societal changes such as an expansion of women’s rights, fueled in part by the growing role of women in the labor force in the era, he notes.
“History will look back and say, ‘Why were masks politicized in this country? How weird,’ and frankly, how weird,” Swartzberg says. ‘writing history right now.’
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