COVID has caused two pandemics. The first infects our bodies. The second corrupts our minds. A respiratory virus caused the first; a mental virus the second.
We can beat the first pandemic with reason, science, and experimentation.
People will need comfort with ambiguity, uncertainty, and changing information. But it is not impossible to beat. We must embrace the exploratory nature of trial, error, and experiment.
The second pandemic cannot be beaten in the same way. It must be abandoned. We can inoculate against the nonsense caused by fear, but it will require hard work to learn things long ignored. Although fear caused the second pandemic, the disease itself manifests as political nonsense.
Mask Intolerance
What can we do about COVID19? We swab, social distance, and hand wash. But we have no treatment. Our entire plan rests on preventing transmission while we wait for a vaccine.
Masks seem a reasonable way to block a respiratory virus. But not everyone agrees. Despite public recommendations, some simply refuse to wear a mask.
This exasperates politicians and those working on the front lines of care. Even if we do not have perfect evidence, masks seem the neighbourly thing to do. Maybe we have no choice but to force people to wear them?
Mask Laws: Necessary or Nonsense?
Mask laws are not the same as masks. While obvious to most, some find this nuance strange, almost mischievous. They attack anyone who doubts the wisdom of mask laws, by flinging out evidence in support of masks. Even if we knew that masks worked perfectly (which we do not), we would still need to debate whether we should pass a law about them.
Some insist masks are the same as seatbelts. Seatbelt laws save lives. But aside from both being things that people wear, seatbelts and mask are entirely different.
Seatbelts protect drivers and passengers, not the pedestrians they run over. The causal connection between exposure and outcome for seatbelts is clear for those riding in the car.
The level of evidence supporting seatbelts cannot compare with that for non-medical face coverings. Whether or not, and to what degree, non-medical face coverings decrease the burden of disease in the community remains unknown.
This ecological relationship offers a place to start scientific study. It is not a point to start writing laws. True, some populations have high mask use and low transmission rates. But we do not know whether masks cause the benefit or something else entirely.
Someday we might have enough evidence to prove that wearing masks decreases disease. But even if we had proof, could we implement a mask law?
How would we define and oversee proper mask use?
How far down one’s nose must a mask fall before we consider it illegal?
Can we tell if masks are in good working order?
Are they new, clean, not soiled, and so on?
Do people need letters for mask exclusions?
Notwithstanding these difficulties, some argue mask enforcement is the same as enforcing drunk driving laws. Here again, they are entirely different.
A weaving car with a staggering drunk driver used to demand expert sleuthing by police. Today, breathalyzers remove the guess work; a number on a machine determines guilt, not an opinion about the smell of booze on a driver’s breath.
We have had many pandemics, such as HIV, with clear connections between cause and effect. After extensive debate, we have never passed barrier laws.
Constitutionally Clueless?
Our society has run for decades on fumes from a different age. Although voters support slogans such as “tell your own truth,” the state machinery still attempts to function on old ideas about reason and logic, where truth is not an opinion and never ‘your own’.
Regardless of how we fail in trying, parliament still rests on debate and division of power (see Monstesquieu). Our British form of government combines the best of monarchy, aristocracy, and democracy. It grew from the fact that men find ways to corrupt any political system. We insure against corruption by using the best of each approach to limit the worst of all the others.
Students no longer learn about the Westminster Parliamentary system, let alone what it tries to achieve or avoid.
Why is our system better than others which came before? Hint: It is not because capitalism creates cool stuff to buy.
Do we even know what our system tries to avoid?
We seem to have lost a collective sense of the fragility upon which our balanced system of freedom and order rests. We need a firm grip on why we have our system of government and the dangers we are trying to avoid. Without it, we remain ignorant of how to manage the danger of a pandemic, while avoiding the even greater danger of bad government.
Pandemic Resistance
We need to immunize against fear and the nonsense it inspires. Inoculation against nonsense already exists, but it requires hard work and serious study.
When it comes to mask laws, we might start by learning about legal instrumentalism—passing laws to solve social problems—and how this differs from the Rule of Law.
Then, we might explore why the Founders of Confederation designed parliament the way they did. They knew about threats to national security. But what did the founders fear most? What were they trying to achieve?
Modern narratives aside, the founders were not trying to cheat, steal, and colonize the world. They were trying to build a peaceful nation, free of government tyranny. We should understand the options they considered.
For most people under 65, COVID19 is about as lethal as influenza, depending on the year (see CDC). The Lancet notes (Sept 2020) that for COVID19 “fatal outcomes are almost exclusively seen in people older than 50 years.”
Even though we have had flu vaccines for years, most younger patients refused them and did not suffer for it. We will survive COVID19, whether or not we get a vaccine.
Vaccine Against Fear
A vaccine for the second pandemic presents a bigger challenge. Fear infects a naive host that has been taught to reject the treatment that could save it. The second pandemic infects society and causes vital organs to fail, starting with parliamentary process and the Rule of Law.
We are long past worrying about civil liberties, in pandemic planning. We must now focus on the fabric that holds together government, law, and civilization itself.
We can beat both pandemics, respiratory and mental. But we must first acknowledge they both exist.
Photo credit: Forbes – “…Why we aren’t beating this virus.”
” True, some populations have high mask use and low transmission rates. But we do not know whether masks cause the benefit or something else entirely.”
Some populations have high mask use and ongoing/substantial transmissions rates – Italy comes to mind – what might that tell us?
As you said, it’s the ‘neighbourly thing to do’ therefore I will continue to don a mask in closer public confines – however not in my car, not in the parking lot, not in my house, not on my way downtown to the subway, not on my walk with Fido.
Great point, Rick.
On top of this, we now hear that all the non-medical masks we’ve worn all summer are not good enough. We need three layer masks. So all the righteous indignation in defence of masks up until this point was for naught. They were never good enough.
This whole thing has moved so far away from anything resembling reason.
Thanks so much for posting!
Cheers
Thought provoking commentary as always Shawn on the difference between a “neighbourly act” and a legally mandated requirement. Our society is permissive towards many actions which have a net-negative outcome in the aggregate.
Examples include tobacco/alcohol/cannabis consumption, processed food consumption, trampoline usage, contact sport participation, hazardous recreation like skydiving/paintballing and countless more.
Should we also outlaw those because they are more damaging than beneficial?
And as you said, we never mandated barrier laws before for any communicable disease, even ones which were as potent as HIV or influenza- rather we relied on innovation, science and calm leadership to drive us forward. I must admit I do support the mask requirements in high-risk places (crowded indoor spaces) and acknowledge the role of masks in reducing transmission of respiratory viruses but your article highlights some important boundaries which are crossed when such laws are made. Although masks are a simple thing with minimal harm, one wonders how this situation could be extrapolated in future circumstances? (forcing people to wear full-body suits as an example).
Great additions to the conversation, Shankar. Brilliant!
I agree with you: masks make sense, especially in the most crowded areas.
We’d better buy our full body suits before they go on back order. 😀
Great to hear from you! Thanks so much for reading and taking time to post.
Cheers
Nothing wrong about the wearing of a mask, one ply, two ply, three ply if it brings in a sense of security even if it is only as effective as the curved beak masks with herbs designed to shield the wearer from the miasma of the Great Plague.
If I can reduce fear in those around me by wearing a mask then I’ll wear a mask, I will wear a mask also as an act of courtesy.
Fear is the oldest and strongest human emotion , this particular fear ,magnified, could grind our society to a halt leading to a collapse.
Courage is not the absence of fear, it is the rising above it we will have to.
I like the seat belt analogy…I recall working as a surgical intern and in the ER at Victoria Hospital in the late ‘60’ in the pre seat belt era with its terrible accidents, assisting the legendary surgeon Mc Laughlin as he skillfully managed the unbelievable up MVA injuries…then came the seat belt laws and, seemingly overnight, the volume dropped precipitously…laws can work.
One recalls the tremendous fears in the pre immunization era, as a child I was forbidden to go into the village with the outbreaks of diphtheria , polio, scarlet fever/ rheumatic fever and pertussis…affected homes were marked and those within placed in quarantine with the whole village in a state of tension.
When immunization came along fearful parents rushed to have their children inoculated …that fear has diminished over the decades and now there is a casualness regarding these diseases with a skepticism that did not exist 60 years ago….that sense of “ fragility” was lost…until now.
A little fear/ respect is good…overwhelming fear is paralyzing….no fear / respect is foolish.
I like Will Durrant’s quote” Civilzation exists by geological consent, subject to change without notice”…paraphrasing him, by nature’s consent , subject to change without notice…one year ago we were in a state of fools happiness in complete ignorance of bats in a Wuhan cave.
Chaos theory had a butterfly flapping its wings in China leading to a Hurricane hitting Mexico…it turned out to be bat saliva in China hitting the whole world.
Oh Andris,
This is your Best. Comment. Ever! (Sorry, I didn’t know how best to emphasize it.)
The Plague beaked mask. The seatbelt observations. Immunizations 60 years ago. Will Durrant. This stuff is golden. Thank you!
Favourite line: “A little fear/ respect is good…overwhelming fear is paralyzing….no fear / respect is foolish.” Wise and well-said.
Thanks so much for taking time to read and post. Readers love the comments most.
Cheers
Excellent article Shawn. I must say that you really hit the nail on the head with this one. Balancing the potential for harm with the potential for benefit has been the basis for almost every decision that I have made as a physician in the past two decades. Rare circumstances in the practice of medicine occur where this balancing act becomes palpably uncomfortable. These rare circumstances always occur in instances where a lack of evidence leads to the making of assumptions…
I wear the mask… But I am very uncomfortable with the prospect that my behaviour is propagating fear while doing very little to reduce the spread of this virus.
Moments before reading your article, I experienced the horror of a family member who was having difficulty hearing me, take two steps back as I removed my mask to help her understand what I was saying.
How much harm is this behaviour causing?
How much damage can be caused by physicians who act without truly weighing the risk of harm with the potential for benefit?
How much more damage could be caused by law-makers who enshrine potentially harmful behaviours into all our human interactions?
This is a huge experiment that is impacting of all. Eventually, we will all find out if the outcome was worth the cost.
Brilliant comments, Paul! Loved this.
You make an excellent point about modelling. It reminds me of other MDs who’ve commented on their ability to influence public perception by simply wearing a mask at all times. While social pressure can be helpful, social pressure unbalanced by thoughtful discourse becomes propaganda.
Where can we go to find calm, rational discourse on this?
Thanks again. Really appreciate these comments!
I think we should spell out the questions more clearly:
• What is the primary function of the mask? Protecting me from others or others from me?
If the mask protects me, why should I expect anybody else to wear one?
• Does the mask work at all? Is there any evidence that it does? Can there be any? If it does, how much of a difference does it make in infections rates?
• Is there a possibility that wearing a mask can be harmful? I believe there is. Is there any way to determine that the possible benefit is higher than the potential harm?
And theses are just the questions we have to ask before asking what kind of society we want to live in. Do I have a positive obligation to entertain the fears and delusions of others? (consider it as an analogy with transgenderism)
To what extent governments should be allowed to impose restrictions on us to protect us from ourselves and each other?
An argument could easily be made that mask laws have nothing to do with public safety.
They represent a giant experiment of social engineering, cowing us into compliance through irrational fear.
Really enjoyed these questions and comments, Zork. Excellent!
I tried to the avoid a discussion of mask efficacy (your second bullet). This is a crucial discussion, which I tried to separate from the equally (more?) important question of making laws.
You raise a great line of thought around our obligation to entertain what we see as the fears and delusions of others. Does politeness require us to tolerate what we think is nonsense, or must we publicly endorse what we think is nonsense in order to avoid attack? This is a whole other discussion, but an important one to have for sure.
The social engineering question is yet anther line of discussion.
Too much fun for one piece! As you point out, I’ve left out far more than the topic demands. That has always been my motive: How can I spark conversation with ~750 words? I’ve found it usually means I need to pick out one tiny corner of the topic. In this case, I was most exercised about the nonsense of trying to pass a mask law.
Thanks so much for taking time to read and respond!
Cheers
Beautiful Zorc,
Perhaps we both originated in dystopian societies that conducted a series of imposed utopian social experiments.
The escape of COVID19 from Hunan has generated a global human experiment, the largest human experiment in history and we are all guinea pigs.
Every global government may well have the well being of its citizenry in mind but unfortunately an element of compulsion with media indoctrination , high tech police surveillance , tracking Apps “ to protect the vulnerable”, informants and social influencers etc., has crept into the experimentations , more so in some countries than others…some in Communist China are quite frightening.
Billions follow the COVID 19 statistics as if they were football, cricket, baseball, hockey statistics….each individual, politician and bureaucrat interpreting them in their own way…excusing the imposition of more and more oppressive and restrictive policies with horrifying economic and social consequences….economic and social upheaval and collapse.
One day they will all be analyzed and compared with conclusions and policies made.
Agree.. It’s hard to do a RCT right now with masks but saw this vid a few months back that seem to confirm my bias for masks preventing droplet spread.. Yes, I know.. Not perfect but something to think about and somewhat logical at that…
https://youtu.be/sIpHCptKZUg
Having said that.. Laws are needed when sanity seems to leave the room. Your freedoms do not “trump” (sorry😜) my right to life.. And I think precedent exists on leveling charges when knowingly spreading infection. Superspreader events without precautions in high risk regions is tantamount to orgies in an STD outbreak!
So if we have to legislate a minimal precautionary measure, I’m ok with that.. I think the risks of harm are greater without…
Hey Rob,
Great to have you offer some push back. Love it! And great to hear from you also.
I’ll take the bait. No argument, coughing at someone with an open mouth seems to be a great way to transmit germs. Although this video looks at bacteria, it seems reasonable to assume the same thing would happen with viral spread if someone coughed in your face or “talked moistly.”
Having said that, bacteria are almost 4 times as large as COVID19 (0.4 vs 0.12 microns). Furthermore, growth in a petri dish does not mean bacteria or viruses would grow in another human. But beyond that, we just do not know how many layers our mask should have, whether we should have mask test fitting (one size definitely does not fit all), how long a mask lasts, what determines a soiled mask, positioning on one’s face, and so on.
But even beyond all this, we still need to establish the ecological argument. We haven’t even begun to build the research necessary to make this case strong enough to warrant a law.
We could make laws that allow businesses to refuse entry to anyone not wearing a face covering.
Implementation/enforcement of any mask law would spark an interesting discussion. How would we decide when punishment was warranted?
Finally, the whole discussion about legal instrumentalism vs the Rule of Law seems to apply here too. It’s a huge discussion also.
Given all the difficulties involved, many just shrug and say, “Let’s try a mask law.” I’m worried that it’s a rabbit hole we do not want to go down.
Thanks again! Really loved your comment.
Cheers
The Trump COVID vaccine initiative has borne fruit with Pfizer’s version supposedly having a 90% effectiveness ( Fauci stated that he would have been happy with 50%).
There is no way that President Trump will be given the credit for his drive and energy expended, his opponents and the media have already worked hard to discredit its safety and effectiveness which might have a vaccination immunization suppression effect.
As it is the Biden organization has indicated that they would introduce a “compulsory mask wearing out side the home law “ and economic lockdown on taking power, in the present climate, that could cause tremendous social upheaval.
Interesting. I didn’t know that. I’m trying not to anticipate the nonsense that might follow a coastal control of the economy.
A quote attributed to Thomas Jefferson is haunting.
“ The tree of liberty must be refreshed, from time to time, with the blood of patriots and tyrants”.
Haunting indeed.