Wednesday, January 12, 2022

The Pandemic Rages In January 2022 -- Are You Wearing a Mask? Why Not?

 

Because masks, along with other non-pharmaceutical interventions, are still among the easiest and most effective ways of limiting the spread of infection, the question of how Americans relate to and attribute meaning to masks remains relevant. Indeed, the hope that the insight gained about human behavior during the COVID-19 pandemic will help prepare the world for the next pandemic–whenever it may occur.”

(Markus Kemmelmeier and Waleed A. Jami. “Mask Wearing as Cultural Behavior: An Investigation Across 45 U.S. States During the COVID-19 Pandemic.” Front. Psychol. July 2021.)

We, unfortunately, aren't even finished with this pandemic yet.

Here we are in the middle of January 2022 and suffering through an unprecedented surge in COVID-19 cases believed to be largely due to the Omicron variant. We were warned that after Christmas and New Years the numbers would rise. Still, huge numbers of people, righteously sick of restrictions and longing for a return to normal, gathered together to celebrate the holidays. And, here we are again, still held captive by this unrelenting virus. One fact baffles experts – so many people now refuse to do the most basic thing to stop the spread – wear a mask.

Do people even care about how serious the current outbreak is? Consider that, as of today – January 12, 2020 – Covid-19 hospitalizations in the United States have reached a new record high, surpassing the previous peak from January 2021, according to data from the US Department of Health and Human Services.

The Ohio Department of Health reports that two years into the COVID-19 pandemic, Ohio surpassed 100,000 total coronavirus hospitalizations. Compared to 60 days ago, Ohio COVID hospitalizations are up 168% and ICU admissions have increased 73%, according to OHA.

One in three hospital patients and one in three people admitted to the ICU in Ohio have COVID-19, according to the Ohio Hospital Association.

Since January 1, 2021, 50,828 people hospitalized in the state for COVID were not fully vaccinated and 2,991 people admitted to the hospital were fully-vaccinated. COVID-related deaths during that same time period included 729 people who were fully vaccinated and 15,324 people who were not fully vaccinated, according to the state health department.

And, you might want to know …

An Ohio State University doctor believes the number of COVID-19 cases people are developing daily is vastly higher than what is being reported.

The number of actual cases reported is a huge undercount,” said Dr. Carlos Malvestutto, an associate professor of infectious diseases at Wexner Medical Center.

And yet if you must go to grocery store or the convenience mart, you encounter the vast majority of people that refuse to mask. Local health officials have had their hands tied when it comes to issuing mask mandates after the statewide mandate ended in June 2021 and a new law took effect prohibiting them from issuing such sweeping health orders. The law will let lawmakers reject or modify any state health order as soon as its given, and let the legislature extend or end states of emergencies. Supporters say these are necessary checks and balances to executive power. Opponents, however, think it the changes could cost lives in the pandemic.

No Mask? Why?

Why, why, why is there such reluctance to mask as a personal choice to help stop the spread?

Call it a “core principal of individualism” or “exercising freedom,” it really doesn't matter the label for such resistance to health protocols. The controversy over mask wearing is mapped onto existing patterns of cultural division and political polarization. These patterns now affect our everyday actions, influence our relationships, and create new and different directions for the future.

Research confirms that, specifically, “established frameworks in cultural and political psychology help elucidate the controversies over mask wearing.”

That same research says: “Believing the pandemic to be effectively over, many individuals are less likely to wear masks than only months ago. Many U.S. states, eager to reinvigorate their economies, have dropped their mask mandates.”

Let's look deeper into social aspects affecting masking. With respect to masks, social norms vary across and within nations. But in many times and places, those who wear masks produce reactions (1), (2), (3), or (4).

Suppose that you pass a neighbor on the street or in a grocery store and that he is wearing a mask. If so, what do you think?

Here are seven possibilities:

  1. He has coronavirus.

  2. He is far more frightened than he should be.

  3. He looks peculiar.

  4. He is an anti-social, selfish person who does not want to be infected by others, even though the probability is very remote.

  5. He is being prudent.

  6. He is simply following the government’s recent recommendations

  7. He is protecting other people from a risk that he might
    be imposing on them.

It seems clear that if people know that if they wear masks, they will produce such reactions, they will be less likely to wear masks, even if they also believe that wearing marks is a sensible thing to do. Their decision will be a product of a rough calculation of the benefits of wearing masks (to self and perhaps others) and the costs of the negative reactions that wearing masks will produce.

The “spotlight effect” might well intensify people’s sense that other people will react to what they do. If people exaggerate the likelihood that other people will notice their actions, and care about them, the expected judgments and reactions of others might loom quite large in their calculation.

(Cass R. Sunstein. “The Meaning of Masks.” Journal of Behavioral Economics for Policy, Vol. 4, COVID-19 Special Issue, 5-8, 2020.)

Sunstein argues that in the same vein, people might not decline to eat meat, even if that is what they would otherwise prefer to do, if declining to eat meat would produce a loud and unwanted social signal. As Red Auerbach, the great American basketball coach, frequently said, “It’s not what you say; it’s what they hear.” And if people know what “they” will hear, their statements and actions might shift dramatically.

The research finds …

“The larger point is that people’s actions have “social meanings,” which operate as the equivalent of subsidies or taxes on behavior/ Social meanings create incentives, sometimes small and sometimes large. Meanings are an artifact of social norms, which may serve a variety of functions, good or bad. We might not know where such norms come from; the act of historical excavation might be extremely challenging. But we might know what functions norms serve, and those functions might be highly desirable. They create meanings, positive or negative.”


(Cass R. Sunstein. “The Meaning of Masks.” Journal of Behavioral Economics for Policy, Vol. 4, COVID-19 Special Issue, 5-8, 2020.)

Sunstein's conclusion?

In 2020, many nations saw numerous shifts in social meanings, as the meaning of declining to shake hands, of working from home, and of washing your hands a lot were turned upside-down. Those shifts bear directly on the question of masks. Also in 2020, officials at the Center for Disease Control and Prevention advised “the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others” (CDC, 2020). On public health grounds, it seemed clear that people ought to be wearing masks in public settings.

Whether people follow advice of this kind will depend in significant part on the social meaning of doing that. If a nation’s leader says, “'Wearing a face mask . . . I just don’t see it,' many people will decline to wear a face mask, because they also 'just don’t see it.' But imagine, for example, if President Trump had announced the recommendation while wearing a mask – or at a minimum, by saying that he would personally follow the CDC’s recommendation whenever in proximity to groups of (say) more than ten people.

And whatever national leaders do, others can make a modest contribution to changing the meaning of wearing a mask, simply by doing as the CDC advised – and thus of increasing the likelihood that wearing a mask will be seen as what most people are doing, these days, in order to be good citizens, and in order to protect themselves and others.

“But the main point is broader. In the midst of a pandemic, it is critically important that precautionary measures are subsidized, and not taxed, by their social meanings.”

(Cass R. Sunstein. “The Meaning of Masks.” Journal of Behavioral Economics for Policy, Vol. 4, COVID-19 Special Issue, 5-8, 2020.)

Allow me to tie the messages together if you will.

  1. Although masks (face coverings) are a prime tool in fighting the COVID-19 pandemic, the use of masks encountered resistance based on existing patterns of cultural division.

  2. Mask wearing must be understood basis on existing cultural frames assessed at both the individual level and the state level – individualism (the self is defined independently of others), political orientation, act of altruism (paternalistic actions), ethics.

  3. Conservatism is linked to lower mask wearing and consistently unfavorable perceptions of mask wearing. Independent self-construal predicted a greater intent to wear masks, even though masks were also evaluated less favorably.

  4. To many, mask wearing is seen as a civic duty, whereas others see it as spoiling one's public image. Different people and even different communities in the U.S. respond to its symbolic and social meaning.

(Markus Kemmelmeier and Waleed A. Jami. “Mask Wearing as Cultural Behavior: An Investigation Across 45 U.S. States During the COVID-19 Pandemic.” Front. Psychol. July 2021.)

 

Conclusion

Masks, effective tools in fighting the pandemic, are symbols of social meanings. This is the way I see the dilemma to wear or not wear a mask based on research. Two people with differing approaches are in public …

  • Look at me. I am wearing a mask” = “I take the virus seriously. The inconvenience is the least I can do in the circumstances to help ease the crisis.”

  • Look at me. I am not wearing a mask” = I want to show that the virus is not that serious. You cannot make me wear a sign of weakness and interfere with my individual right.”

The widespread division created by those refusing to mask has become toxic. Fears about spreading the disease and exhaustion from isolation press us all, and threaten to make America a nation of permanent distrust – a country of people without hope for reconciliation. It is the lack of empathy that I do not understand. It is the choice of self-interest over public health that I abhor.

I can take being labeled “anti-social” or “fearful” or “peculiar” or “liberal” because I wear a mask in public. I'm not hiding behind this facial covering: I'm living responsibly. What I cannot take is the pride of the anti-masker who refuses to follow a simple intervention to save lives. If and when this pandemic ends, I fear I will never forget those who “just didn't see it.”



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