Lifting the Outdoor Mask Mandate

I remember making plans when we shut down the office last March - I figured that we needed to be closed for two weeks, and I was working out how we were going to deal with that. How do you make God laugh? Tell him your plans.

It’s hard to gauge where we are as a city, as a nation and as a planet in the battle against COVID-19. The US is doing really well with vaccine distribution, and the real world outcomes have been fantastic, both in terms keeping people alive and of stopping the spread of new cases. On the other hand, variants are still evolving and people are still dying. Every day there is a flood of misinformation on social media and elsewhere - some out of ignorance, some out of bad faith.

What the country could really use right now is something to make it clear that we are winning, that our policies are being driving by science and data, and that there is a light at the end of the tunnel. What do I think would help? Lifting outdoor mask mandates.

All of the recent research on COVID transmission seems to show that outdoor transmission is very rare, a tiny fraction of the problem. When it does occur, it’s often people in large, dense groups, shouting or singing, without masks. The social pressure to mask up in public seems to have worked well here in Manhattan - you rarely see someone without one outside. Where do you see happy, smiling faces in public? Indoor dining! Derek Thompson has an excellent article on this in The Atlantic; he points out that this is like wearing your seat belt in the parking lot, and then taking it off as soon as you start driving.

While indoor spaces can be made somewhat safer through ventilation and spacing, outdoor spaces already are much more COVID friendly. And as we continue to vaccinate our population, the risk of outdoor transmission outside of huge packed crowds continues to drop towards insignificance. Israel - nearing the end of an incredible vaccination effort - lifted their outdoor mask mandatethis week.

I wear my mask outside, crossing the park and walking on the street. I have been fully vaccinated since January, and I’m probably never within 6 feet of another person for more than a few seconds. So the mask really isn't keeping me or anyone else safe. I wear it for the messaging, to say “COVID isn’t gone”. But I’m also looking forward to taking it off during that commute, once there is clear guidance that it’s safe for EVERYBODY to do that.

One of the biggest problems that the medical community has had during the pandemic is inconsistent messaging, so it's important to get this right. Two doctors, three opinions. The truth is a moving target, we learn more and more about the virus every day. Even the best insights age rapidly. And social media amplifies voices in ways that are not always proportional to expertise.

Lifting mandates will depend on local conditions, so it’s unlikely that the CDC will just tell the whole country all at once “masks off when you are outside”. It’s a complex decision with a lot of stakeholders and variables. There are a patchwork of federal guidance and local ordinances that overlap and may be contradictory. Nevertheless, it seems that the consensus is definitely moving in that direction.

Seeing faces in the park on a beautiful spring day will go a long way towards getting us to put up with all of the other things that we have to do in the end game - monitoring variants, getting vaccinated (possibly again!), watching for regional outbreaks and staying safe indoors. Clinging to outdoor mask mandates through inertia - especially as cases drop and vaccination rates rise - give people the idea that ALL mask rules are arbitrary and unnecessary, and it builds resistance to indoor masking. On the other hand, if the message is that outdoor spread is rarely an issue and you generally don’t need a mask, but indoor spread is a problem, people may be more receptive to wearing one indoors (at least until most of us are vaccinated). People respond surprisingly well when you speak to them clearly and honestly. Harvard epidemiologist Julia Marcus wrote about this early in the pandemic with insight gained from her work with HIV mitigation.

Masking is not the only area where policy has gotten away from epidemiology. Closing outdoor recreational spaces, or shaming people going to the beach, also may have worsened transmission. Again, from Derek Thompson’s article:

“…mandating outdoor masks and closing public areas makes a show of ‘taking the virus seriously’ while doing nothing to reduce indoor spread, in a way that often hurts the less fortunate… the Canadian province of Ontario instituted a stay-at-home order and closed many parks and playgrounds. ‘These policies are made by people who have yards’ [Julia Marcus] said. ‘If you live in an apartment building and have no yard, and are required to wear masks at all times outdoors, you never get to be maskless outside. And then, where do people gather maskless to socialize? Inside their homes’—where the risk of transmission is higher.”

I understand, it's hard to endlessly make these calculations of relative risk, deciding what's safe to do when you are vaccinated and your kids are not. Whether you should eat indoors or outside. Whether and how to travel. And even though I take the pandemic very seriously, I also recognize that we are migrating out of crisis mode, and the vaccines are really making that happen. David Leonhardt has a great piece in the New York Times about this:

"... major media outlets trumpeted new government data last week showing that 5,800 fully vaccinated Americans had contracted Covid. That may sound like a big number, but it indicates that a vaccinated person’s chances of getting Covid are about one in 11,000. The chances of getting a version any worse than a common cold are even more remote.

But they are not zero. And they will not be zero anytime in the foreseeable future. Victory over Covid will not involve its elimination. Victory will instead mean turning it into the sort of danger that plane crashes or shark attacks present — too small to be worth reordering our lives.

That is what vaccines do. If you’re vaccinated, Covid presents a minuscule risk to you, and you present a minuscule Covid risk to anyone else. A car trip is a bigger threat, to you and others. About 100 Americans are likely to die in car crashes today. The new federal data suggests that either zero or one vaccinated person will die today from Covid."

Lifting the outdoor mask mandate would LITERALLY be a breath of fresh air, and soon we can do it safely.

Here’s to seeing all of your wonderful smiles.

#stopthespread