29 Comments

Wearing a mask could be the perfect compromise when you wake up feeling "meh" and don't know whether you should waste a sick day on it.

Expand full comment

The selfishness you're observing _is the point_. What's mere "social responsibility" to you is "socialism" to the far right, and is completely anathema. Performatively demonstrating that they don't care if something they're doing inconveniences or hurts other people around them is a sport. See: people in pickup trucks parking in electric vehicle spots, or rolling coal. Because "f*** your feelings."

Expand full comment

Countries with customary masking have very high rates of respiratory deaths (https://www.worldlifeexpectancy.com/cause-of-death/influenza-pneumonia/by-country/), including Japan.

As a crazy alternative, how about normalizing that sick people stay home?

Expand full comment

But sick people staying home would require offering paid sick leave, which would also be socialism. (The crazy thing is that if employers were capable of doing a little math, they'd realize that paying one employee to stay home a couple days would actually save them money, relative to having their whole work force trying to work sick, and as a result being less focused and productive.)

Expand full comment

Mandatory sick leave isn't important for this, and wouldn't even matter, as workers in the US would feel a stigma from using it. It's a cultural shift that might be something public health agencies can encourage.

Expand full comment

Eh, I think management could make a difference in workplace culture if they wanted to. If you came in with the sniffles and your supervisor said, "WTF?! Go home before you make the rest of us sick!" and that was the consistent expectation, people would shift behavior.

Expand full comment

I would wonder if this is correlation vs causation, assuming Asia is mostly the customary masking area, they have a very high density of individuals, so I'd assume spread is naturally higher. Masks as a flat reduction on spread should unequivocally be a thing we do.

Expand full comment

There are number of confounding variables, obviously, and I doubt a lot of the data is reliable. Still, this data does not suggest those countries have some hygienic practice worth exporting.

Expand full comment

What I was intending to convey with the above was the thought that masks can and are probably an item that decreases the spread of disease. The fact that there is more disease in those regions has more to do with the population density and climate imo. Masks I assume just help lower the numbers, as we've seen from testing, so we should adopt them.

I don't think that throwing the baby out with the bathwater is a good move here.

Expand full comment

A lab experiment is not a test of a large-scale public health measure. We would need some sort of large-scale trials to figure out if this actually reduced harm in the population. By contrast, just normalizing staying home while ill at this specific moment (where even the most resistant workplaces had no choice but to go remote) is clearly a good thing.

Expand full comment

I'm of the opinion we should do both.

Also, healthcare professionals have been wearing masks for a long time lol, lower spread is lower spread.

To be honest, even when I'm sick, sometimes I have stuff I have to do, so I go out and sneeze once or twice.

mask helps that case

Expand full comment

You have absolutely not made your case at all. You lazily linked to a list that doesn't control for age of population, quality of healthcare system...or anything. It doesn't even have a control for "customary masking" or not.

Vietnam has customary masking and is #129 on that list.

Did you really think you get made a good point?

Expand full comment

The link does say it's age-controlled data, but if you're aware of a better worldwide mortality study you can go ahead and share.

If the masked countries were clearly better than comparable Western countries, it would tell us something. Otherwise, we have no proof and this isn't worth doing.

Expand full comment

According to anime, the Japanese cold is extremely fatal. Maybe they're right about that.

(Anime also suggests a risk factor is having that hairstyle where you have one braid over your shoulder.)

Expand full comment

Don't forget the surprising number of places around the world where wearing a mask was actually illegal before the pandemic. Did those laws ever actually get fixed? If not, that might be an impediment to normalisation of mask wearing for sick people.

Expand full comment

Sometimes I don't know if it's illness or allergies?

Expand full comment

One thing:

Circa the 1980s, Fran Lebowitz has a good bit on wearing masks in Japan: https://www.youtube.com/watch?v=2mszuV0Pa18&t=2145s

Expand full comment

'Masks work' is simplistic. They are not the universal good that you suggest.

The question to ask is: what long-term effect does mask wearing have on populations?

Expand full comment

Lmao. Ok I’ll bite. What is an example a long term effect of mask wearing that you’re more worried about than curbing the spread of disease?

Asking questions like yours shows how little you understand about the topic. People like you attempt to move the goalposts because you mistakenly think there’s no way we can predict the future with any degree of certainty. It’s simply a way to disregard facts and weigh your baseless opinion as equal to reality. You’re not smart and smart people don’t fall for that. Anyone who tolerates your BS is dumb or feels bad for you and doesn’t want to hurt your feelings.

Expand full comment

What would be rather hilarious, given the latest CDC recommendations, is if the anti-vax started wearing masks to "prove" they didn't get a vaccine.

Expand full comment

Indeed it is even more hilarious than that: https://news.yahoo.com/anti-vax-conspiracy-theory-apparently-071507094.html

Expand full comment

I very happily shed vaccine residues at work today. 😏

Expand full comment

Muahaha, I will spread my vaccine residues to them, if they fail to wear masks!

Expand full comment

Very supportive of this for UK too! I have advocated this idea among my medic friends a dozen or so years ago after visiting Japan on placement in medical school. Could never get much interest in it. It's hard to imagine the pre-pandemic (and early pandemic) disinterest and dismissal of masks within mainstreatm medicine.

That said, there is one better than copying what seem like good ideas from other countries and that is testing them first. For this kind of public intervention that means an RCT. The case for masks being effective is not as much of a slam dunk as you might think. And there are important questions like cloth vs surgical vs N95, only when you are sick or after meeting sick contacts etc. The value of information from large well constructed masking trials would be enormous.

Expand full comment

Great post, but a big impediment to the mask-when-sick proposal is that people don't want to draw attention to themselves when they're sick, which is exactly what that will do. If someone is sick on the subway, they sure as heck don't want to broadcast that to the world. I agree that it would be the right thing to do, but it just ain't going to happen for many.

Expand full comment

This is true in the US. No one wants to appear weak- except of course when playing the victim and quivering over a shot

Expand full comment

A selfish society needs selfish arguments. Yes, wearing a mask helps others, but it also helps the healthy wearer of a mask. Why so many bend over backwards to scant this benefit is beyond me.

I'd love for the government to provide guidelines on how we could best slow the spread of the flu and common cold with the minimum of mask wearing. If, for example, we'd all wear masks while taking public transportation during the flu season, we might significantly reduce transmission while also taking the first step in a new societal norm. Baby steps. Low hanging fruit. Bang for the buck.

And I'd be interested in hearing how Japan came to wear masks. It must have strange in the beginning.

Expand full comment

And here's a recent study by the Oxford Vaccine Group: COVID-19 vaccine messaging that focuses on personal benefits is most effective with those who are hesitant

https://www.ovg.ox.ac.uk/news/covid-19-vaccine-messaging-that-focuses-on-personal-benefits-is-most-effective-with-those-who-are-hesitant

While I'm not claiming that the selfish overlap 100% with the hesitant, what works for one group might well work for the other.

Expand full comment

I've often said that in America that individual rights matter more than what is good for the community as a whole and masks are a great example of that. my comfort trumps keeping the community healthy.

Expand full comment