COVID, Quickly, Episode 14: Best Masks, Explaining Mask Anger, Biden’s New Plan

Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series.

Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.

Lewis: I’m Tanya Lewis.

Fischman: I’m Josh Fischman.

Lewis: And we’re Scientific American’s senior health editors. Today we’re going to talk about masks: first, why people resist wearing them despite all the evidence that they work.

Fischman: Then we’ll explain why the kind of mask you wear matters and how to find a good one …

Lewis: And President Biden’s latest update.

It’s been baffling to watch how angry some people get about wearing masks. They refuse, and some politicians back them up. It’s a simple piece of fabric or material that stops the spread of COVID. So where does the pushback come from? Josh, you’ve spoken to an expert on mask attitudes. Any explanation?

Fischman: Like many strong reactions, mask backlash combines a bunch of different causes and personal values. Emily Mendenhall, a medical anthropologist at Georgetown University, has spent many months talking with antimask people in an Iowa town called Okoboji for her book called Unmasked, which is coming out next year. I talked with her this week about what she’s found out.

Okoboji is a small town on a lake in northwestern Iowa. It’s also where Emily grew up, so she knows a lot of people there. She knows steel workers and grocery story managers, and her father is on the city council. The town sits in Dickinson County, which has about 17,000 residents. But it balloons up to 100,000 during the summer because the lake is a big local vacation spot, and the local economy depends on summer people going to restaurants and amusement parks and marinas.

The need to make money was partly why people resisted activity restrictions, Emily says. And mask wearing got caught up in that. People pushed back when local health agencies wanted to limit occupancy at businesses. That was expressed as “we don’t want government telling us what to do.” The attitude extended to mask mandates. To many people, it was another example of pushy government overreach.

Emily says this view is very much a part of a Midwestern value of rugged individualism. You are tough enough to make it on your own, and you pull yourself up by your own bootstraps. It’s a fiction, she says, and ignores the history of agricultural subsidies and other government help that dominates the region. Yet it’s a very powerful fiction that people really believe.

All of that made for very fertile ground in 2020 when Donald Trump repeatedly said the virus was no big deal. His message was echoed by the Iowa governor. And at the time, there were not many COVID cases in this area. So Trump’s falsehoods really wormed their way into the thinking of many people in Dickinson County, who felt that since the virus wasn’t a threat, there was little benefit to wearing a mask. They were tough enough to deal with the disease, and government safety measures simply took away their freedoms for no good reason.

Finally, mask rejection is a very public act. In Dickinson County and Okoboji, it gives people legitimacy among their community, Emily says. It shows your neighbors that you are knowledgeable. You are smart enough not to buy into the line that liberals and scientists and the government are pushing. That public stance increases your standing in the eyes of many people around you.

Privately, some people told Emily they worried about a child getting sick or their father. But publicly, so many of these different antimask cultural values came together that they became an overwhelming force.

Tanya, we often talk about face masks or coverings as if they’re all the same. But you’ve been looking into it, I know, and you’ve found some masks are better than others. Can the public get their hands on—and faces into—the better ones?

Lewis: Yes. The masks that work the best are those that fit well and filter the air you breathe adequately. A type of mask known as a respirator, such as an N95, provides some of the best protection. Early in the COVID pandemic, health agencies, including the CDC and WHO, told the general public not to wear N95s or other medical-grade masks because they were in short supply, and health care workers needed them. But now these masks, as well as similar masks made in China or Korea, are much more widely available. We also know that the virus that causes COVID is spread through aerosols, tiny droplets that float in the air and can get around a loose-fitting cloth or surgical mask.

I spoke to several experts in aerosol science, including Linsey Marr of Virginia Tech and Kimberly Prather of U.C. San Diego, who say that it’s high time experts start recommending that people wear these high-filtration, better-fitting masks, especially with the extremely transmissible Delta variant circulating and kids going back to school. These masks include N95s, Chinese-made KN95s and Korean-made KF94s. They’re pretty easy to find nowadays online, and many of them are affordable—less than $1 per mask.

I talked to a guy named Aaron Collins, who calls himself the Mask Nerd. He’s a mechanical engineer with a background in aerosol science, and he has converted his home bathroom into a facility where he tests different masks and reviews them on YouTube. He measures three parameters: filtration, fit and comfort—which is especially important. Filtration refers to the amount of particles that get through the mask (or through gaps around the edges). Fit is how well it fits on your face. And he measures comfort in part based on the pressure drop of air entering the mask—basically, how hard it is to breathe.

On the Mask Nerd’s YouTube channel, you can find videos of his top mask picks, including masks for kids. For N95s, he recommends ones made by well-known brands such as 3M, Moldex, or Honeywell. He also recommends several types of KF94s and KN95s, many of which filter upwards of 98 to 99 percent of particles and are often more comfortable to wear. These fit a lot better than most cloth or surgical masks and are more likely to protect both you and others.

Counterfeit masks are a concern. But you can find reputable brands through sites like ProjectN95.org. If you can’t access these types of masks, you can still get pretty good protection if you wear a surgical mask with a well-fitting cloth mask over it. But it’s time to ditch those loose bandanas and gaping masks that hang off your nose.

[CLIP: President Joe Biden: “Good evening, my fellow Americans. Tonight I want to talk to you about where we are in the battle against COVID-19—the progress we’ve made, and the work we have left to do.”]

Fischman: President Joe Biden made tens of millions of jobs contingent on vaccinations this week. In a speech, Biden said he’ll require millions of federal workers to get vaccinated. He also said companies with 100 or more employees will have to give workers the shots or test them weekly. One trick will be enforcement: it’s not clear whether the Labor Department, which is in charge of workplace safety, has a way to make sure companies are really doing this.

Lewis: He’s also requiring that health care workers at hospitals and other providers that receive federal funding be vaccinated. And that’s not all: he aims to make rapid testing more widely available by enacting the Defense Production Act to make more tests and having Walmart, Amazon and Kroger sell them. And amid the anxiety over schools starting and some elected officials obstructing basic safety measures, he said that the government would compensate any educator who faced retaliation. Biden admitted these measures will take time, but it’s clear his approach is moving from carrots to sticks.

Now you’re up to speed. Thanks for joining us.

Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.

[The above text is a transcript of this podcast.]

Editor’s Note (9/11/21): This podcast incorrectly stated that the Iowa city of Okiboji was in Clay County. The city resides in Dickinson County. The podcast and the transcript of this article was edited after posting to reflect these corrections.

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