How researchers get heard
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I Advance Masked

Science has spoken. So I walk Maxie, my beautiful, one-year-old golden retriever, nearly every day — long hikes in the mornings, even longer ones on weekends. Exercise, science shows, has benefits — especially exercise with dogs.

I wear a mask when I walk Maxie, even though it fogs up my glasses, especially in the heat and humidity of a DC summer. (No, I can’t take my glasses off; I’m functionally blind without them.)

I wear the mask because the CDC says so (and is reportedly about to say so more forcefully, as do all those epidemiologists and virologists and medical types and even some economists who’re wearing masks in their Twitter avatars. Although the WHO says we shouldn’t exercise with masks because it will reduce our ability to breathe comfortably and a sweaty mask can promote the growth of microorganisms, so that’s interesting. Maxie walks fast — we’re at least always on the brink of exercising, especially if he sees a squirrel.

I wear the mask for my health. The trails we walk and bridges we cross can be narrow, and people (invariably without masks) often walk too close to me for my comfort and maybe my health (a medication I take regularly makes me immunocompromised).

And, of course, masks work, don’t they? Although that link goes to an observational study with a high degree of uncertainty about just how well they do work. OK: But what about this new PNAS study about how face mask usage prevented more than 66,000 coronavirus infections in New York in three weeks and tens of thousands more in Wuhan? Unfortunately, some scientists think it should be retracted. And this one claiming mask mandates in 15 states have prevented up to 450,000 new infections — even though those states also instituted other measures? When did correlation vs. causation become so dismissible?

I wear the mask for others’ health. I’ve had a very mild sore throat for about six weeks and, while my doctors tell me I have no cause for getting tested, there’s a minuscule chance I’m infected. Of course, the only review of randomized controlled trials of mask wearing extant showed a “very slightly protective” effect “against primary infection from casual community contact” — but “the RCTs often suffered from poor compliance and controls using facemasks.” Hmmm.

I wear the mask because (like almost everyone else) I saw that animation of a typical exhalation cloud that trails runners and others who are exercising outdoors and, even though the science behind it has been debunked, the image has proven sticky. And there still have been very few studies on outdoor transmission of the virus. And just talking can launch thousands of aerosolized droplets that last for up to 14 minutes, at least in stagnant indoor environments.

I wear the mask because I’m seeing fewer and fewer people wearing masks outdoors and I see that as a sign we’re not taking the pandemic as seriously as we should or did before, especially as a WHO official warns that the coronavirus is “definitely accelerating” in the US. I do this even though the non-mask-wearers could be reading the same reporting I’m reading and drawing different conclusions — reporting such as this New York Times story that quotes aerosol scientist Linsey Marr on how outdoors is “so much better than indoors in almost all cases….There’s so much dilution that happens outdoors. As long as you’re staying at least six feet apart, I think the risk is very low.”

I wear the mask because wearing masks are now political statements — in my case, that I am a person who cares about all of us, unlike you and so many others who are unmasked, and so many of our leaders, who don’t understand that we are all in this together, even if I as a well-compensated knowledge worker can’t see the pain of economic shutdowns. (Something like that; a bit righteous, but not too terribly grand.) After all, the mask gets really sweaty and uncomfortable — so if I am suffering, it must be for a virtuous reason. It certainly can’t be to shame others, because that doesn’t work (it didn’t work for wearing condoms or abstinence during the AIDS crisis, as Julia Marcus points out).

I wear the mask because Japan’s transmission rate is so far low. They did everything wrong in responding to COVID-19, but the Japanese wear masks routinely in public, so that’s very suggestive.

I wear the mask because I paid a lot for it and waited a long time before my shipment of KN95 masks arrived, and was disappointed by their quality, especially for the price I paid, but damn it, I’m wearing it anyway.

That’s eight reasons I wear a mask while walking Maxie.

None of those eight is science-based — not in the way we conventionally understand “science-based” to mean “based on the preponderance of evidence and the literature.”

Yet I’m loathe to not wear a mask — out of reluctance to contradict the perceived scientific consensus; because it’s a symbol of my social/political tribe (although less and less so); because it’s a bit of self-congratulation and virtue signaling; because I’m afraid of infection; because I’m making a bet.

All those factors are mutually reinforcing. But perceived consensus came first — well before the correlative studies that are now tumbling out on masks and COVID-19. And perceived scientific consensus is a powerful force in swaying one’s own perception of the truth as well as one’s own subsequent behavior. And because I spend a lot of time reading high-end opinion content and on Twitter, I perceive consensus on this issue, if not precisely trusting it.

I am, of course, not unusual at all in how I’ve arrived at my stance on masks. And one could also easily make arguments for an opposing stance — that there is no scientific consensus in the literature and, in the absence of facts, we should feel free to choose our own behavior or cling to our own unfalsifiable world views.

I wonder what science gains by pushing a perceived consensus until it becomes an actual consensus, even if the behavior that consensus yields turns out to be useful.

Science has spoken. Sometimes, though, I forget to take my mask on our hikes. There’s so much to remember to carry — treats, poop bags, a ball, my phone, my keys.

Maxie enjoys our time together, regardless.