Medical Examiner

We’ll Never Stop Fighting About Masks

A shirtless man lays alone, far away from anyone else, on the grass in the meadow of Central Park.
A man enjoys the warm weather in Central Park on April 5. A perfectly safe maskless activity! Timothy A. Clary/Getty Images

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More than a year into the pandemic, some public health experts are starting to rethink the rules around wearing masks outdoors. Slate science editor Shannon Palus recently wrote an article titled “It’s About Time for Us to Stop Wearing Masks Outside.” She got a lot of blowback on social media, but plenty of public health experts—and even a writer at the stodgy New England Journal of Medicine—weighed in to say that she was right here. And on Sunday, Anthony Fauci told George Stephanopoulos that new guidelines should be coming soon from the CDC.

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But we fought over whether to wear masks in the first place, so it only makes sense that now we’re fighting over when and how to take them off. On Monday’s episode of What Next, I spoke with Palus about why she’s on the side of setting your face free—at least some of the time. Our conversation has been edited and condensed for clarity.

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Mary Harris: I want to be really clear about what your article was advocating for. You’re advocating for some states to potentially lift their mask requirements for people when they’re outdoors. So indoors, it’s still important to be masked.

When I looked into it, I was pretty surprised by how many places still have outdoor mask mandates. I think it was 26 states. That’s a lot of places. In New York, it means everywhere I go, because if I go running in the park, I’m pretty close to people all the time. The rule is if you can’t maintain social distancing, you have to have a mask. And in the city, social distancing is just kind of a little impossible. So I wonder if you could lay out exactly what your argument is.

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Shannon Palus: I’m going to talk about New York because that’s where I live too. In New York, in my opinion, you should be able to walk out your front door without a mask on—with a mask in your pocket but not affixed to your face. You should not feel obligated to pull it up when you’re walking past people. You should have it if you’re going to be in a crowd that’s stagnant or you’re going to stop and talk to a friend. But otherwise, if you’re just going to be within 6 feet of people from moment to moment, briefly, scientifically, it’s not necessary to be wearing one. And I think when you say it’s not possible to social distance in New York, we think if we get within six feet of someone that’s not social distancing—

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I think of it like an invisible hamster ball, like I’m rolling around the streets and I need 6 feet on either end.

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And I do think that’s a pretty good way to think about it, because you do want to try to keep your distance from other people. But it’s also really important to consider the time aspect of social distancing.

Like how long you’re exposed to someone else?

How long you’re exposed to someone else. And so in New York, unless you’re at the park during peak hours, you’re not going to be coming into the 6 feet hamster bubble of someone else for more than a second or two. You’re going to be coming into contact with them really, really, really briefly. And the CDC defines close contact as not just within 6 feet, but standing within 6 feet of someone for 15 minutes. And now that 15 minutes, that’s not a magic line either. And some experts say we should consider making it shorter in some situations. But the point is that that’s a really long amount of time. So when we think about social distancing, we shouldn’t just be thinking about the 6 feet. We should be thinking about the time that we’re close to someone. And then also the ventilation situation. And when you’re outdoors, it’s all ventilation. It’s nothing except ventilation. Outdoors, nothing that you breathe out is going to hang around in the air.

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So can you lay out some of the science about how you came to believe ditching a mask outdoors was largely safe? Like, I read that the risk of transmission is 19 times higher indoors than outdoors, which is massive.

That’s huge. So there have been a couple papers and reports. There was one in Ireland based on data from their health department saying that 1 percent of all of their cases occurred outdoors, which I think is on the lower end. But that’s exceedingly low. There’s data from China last year where the only recorded case of outdoor transmission during a certain period of time—and the caveat here is this was during pretty strict lockdown, so people weren’t going outside as much in general—was when two people were having a face-to-face conversation for an extended period of time. There was another paper recently where that 19 times figure comes from where they said at the very, very, very most 10 percent of cases occur outdoors, but it’s probably lower than that. And also those cases are happening in situations where you can point to a really clear risk. Say,  people were gathering around a fire and sharing cabins.

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So spending a lot of time together, not just passing each other on the street.

Yeah, where it’s clear that there’s potential for pretty close interaction here. The important caveat is that if you did get COVID from walking down the street and passing someone briefly, it would be very hard to report that on a form. I don’t even know how you would know that that’s how you got it. You could say the only thing I’ve been doing is going outside and very briefly passing people on the street.

So we wouldn’t know necessarily?

We wouldn’t necessarily know. It is impossible to say that you cannot get COVID that way. It is impossible to say that it does not happen. However, if it did happen often, we would expect all of those other numbers for outdoor transmission to be higher.

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There is this argument that masking outdoors makes it more likely that people will wear masks indoors. Why do you not buy that?

I think that that argument assumes that people are idiots. That might have made some sense last spring when we were all getting used to the concept of masking. But I think that we’re smart enough to know the difference. And I think that you can make it a really strong social norm that you need to wear them in grocery stores or you get thrown out. I would hope that giving people nuanced, science-based rules would make them more willing to mask when they should be masking instead of just saying you need to never take this off your face just in case you come into a situation when you need it. It’s kind of like saying we should always be wearing bike helmets, just in case we get on a bike.

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I’m wondering if you’re advocating for folks to consider ditching masks outdoors regardless of what’s happening in their communities. I’m thinking about places like Michigan and Colorado, where cases are rising. Do you think the rules should be different there?

I do not feel qualified to make the rules for places where cases are surging. I think that one of the infectious disease doctors I spoke to had a really good suggestion. Her suggestion was counties should look at two factors if they’re deciding to lift outdoor mask mandates. They should look at the vaccinations in the community and the level of hospitalizations.

I think that you could have a middle ground argument where you say, if hospitalizations get really high, we want people to be wearing masks all the time, in part just to signal that we’re going through this surge.

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Can we go in the Wayback Machine and talk about how these rules got put in place?

Let’s see, so the CDC first recommended masks on the faces of all Americans at the beginning of April. And that was a massive flip-flop from where we were in the beginning of March, where you had health officials screaming that masks on civilian faces were not worthwhile and should be saved for doctors. So my sense in hindsight is that a lot of it just came out of trying to pull this lever in the opposite direction. And also, a year ago, things were really confusing and they were changing rapidly and it sort of made sense to just go all in on one easy rule, which is, like, wear the fucking mask.

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It was a course correction.

It was a huge course correction. And yeah, it seems like that would have really been a difficult time to try to install this nuance. And maybe back in April of 2020, we did really need to see a lot of people wearing masks just to get used to the idea of it. I have a piece in Slate from last April saying, “Stop Yelling at Runners for Not Wearing Masks.” So I’ve been on the “outdoor masks are overkill” racket for a long time, but I can see in hindsight why the zealous outdoor masking would have made a lot of sense a year ago. And also we didn’t have as much data then. And remember that we went through this whole whiplash on surfaces—whether we need to wash our groceries. So I can see why a year ago you might say, “Well, yeah, but we just want to really batten down the hatches as much as possible because we’re learning new things about this virus all the time.” And it just made sense to go overkill for a little bit.

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You talk about people’s comfort level and how if it makes people feel comfortable to wear a mask, they absolutely should. And part of what makes that complicated when it comes to this decision is the fact that people have been told to feel comfortable if they see other people masked, that other people being masked is what protects them, them being masked is what protects other people. And so that’s where this gets tangled up a little bit.

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Yeah, I think that’s a really good point. And I think that if masking were just about my own personal comfort and safety, I would have stopped masking outdoors a really, really, really long time ago. The reason I wear a mask when outdoors still and the reason I’m pretty careful about pulling it up when I come close to other people is because it feels like it’s a choice that I’m not really making on behalf of myself. It’s a choice that I’m making on behalf of other people.

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I think we’ve thought about the rules around COVID primarily as protective and locking down. Now we’re in this position where maybe governments can be easing restrictions, and we haven’t really thought about that. We haven’t thought about what it means to take restrictions away and what it means to say this is what post-pandemic life looks like.

We’re in a really weird period where things are getting better and they’re also not getting better. And I don’t see easing outdoor masks restrictions just as an acknowledgment that some things are getting better. It’s also that we’ve been in this for a long time and we know how to make rules now that are really effective. And we maybe know how to peel back rules a little bit in ways where the data are really clearly showing us we don’t we don’t need to have them.

For me, it really feels like, especially with the masking thing, we’re all just really tethered together in this group project to keep each other safe. And it’s nice in a lot of ways, but we’re going to know this is over when every single little decision I make like this isn’t tethered to the rest of my neighborhood all the time.

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