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The advice to wear face masks to help stop the spread of the coronavirus ranks among the most contested public health recommendations of all time.
People who say it’s their right to not mask engage in often heated debate with those who point to the weight of scientific evidence. From stink-eye stares in the grocery store to vitriolic Twitter exchanges, emotions run high.
Public health officials have touted the importance of mask-wearing again and again and again. And yet …
“We have messaged this in every way we can,” Indiana State Health Commissioner Dr. Kris Box said. “There’s some people you’re not going to change their mind no matter how much you talk to them.”
Whether considered a symbol of government intrusion, an encumbrance to good breathing or an annoying habit that is difficult to make, mask-wearing has its detractors.
Government leaders find themselves in a bind. Some states or municipalities, including at least two counties in Indiana, have mandated wearing face masks in public indoor spaces. Thursday California became the latest state to adopt a similar policy, joining New York and New Jersey among others in requiring face masks in public when social distancing is not possible.
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But a number of other states and large cities, Indiana and Indianapolis among them, have not. Instead, public officials strongly recommend people wear a mask because otherwise they might unknowingly infect someone else.
Count former Major League Baseball player Aubrey Huff among the anti-maskers. He said in a Tweet that went viral that he would rather die from coronavirus than live the rest of his life in fear, wearing a mask. Although he acknowledged that the coronavirus is real, he said he was trying to “free” Americans so they can breathe freely.
The decision not to wear a mask, even where it is not mandated, can come with consequences.
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A self-described “small government person,” Fishers resident Megan Stoner said she does not appreciate officials telling her what to do. The 22-year-old says she suffers from post-traumatic stress disorder and has yet to wear a mask. Although she has a letter from her therapist, some stores prohibit her from entering without a mask.
“It does unfortunately dictate where I can go,” she said.
Because she does not feel comfortable in a mask, Stoner said she is careful to social distance wherever she goes, from the grocery store to church.
Centers for Disease Control and Prevention experts argue that social distancing, hand-washing and mask-wearing work as a three-pronged attack against coronavirus. Numerous studies have found wearing face masks can lower the risk of spreading the disease, particularly if both the infected person and the people with whom the person comes into contact wears one.
Two infected hairstylists in Missouri recently came into contact with more than 100 clients and coworkers. Everyone wore masks. No additional people developed the illness.
Requiring, but not enforcing, mask-wearing
Early in May, St. Joseph County enacted an order requiring people to don face coverings in public indoor spaces if they could not maintain a 6-foot distance between themselves and others.
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But the county has no interest in punishing offenders, said Dr. Robert Einterz, St. Joseph County’s health officer.
“Really what we’re doing is trying to do what is right,” he said. “We would try to reinforce good behavior, to try to educate the public about the spread of the disease. But we felt that any sort of punitive method would not be effective.”
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In neighboring Elkhart County, mask-wearing is not required. Elkhart has had a much higher rate of disease per 10,000 residents than St Joseph has had, 116.3 compared to 59.3. Earlier this month Elkhart saw more new cases of coronavirus on some days than far more populous Marion County.
Elkhart County health officials considered requiring the wearing of masks but so far have decided against taking that step, said Dr. Lydia Mertz, the county’s health officer. She said the county did not want to send the wrong message that mask-wearing is more important than social distancing or hand-washing.
In Tippecanoe County, Dr. Jeremy Adler, the county’s health officer, said the health department was still trying to get businesses to install mask policies and to get residents to act as if masks were mandatory in public settings where they can’t guarantee social distancing. But Adler came up short of saying Tippecanoe County planned on mandatory mask orders, even as he pointed to a recent climb in the number of cases in Florida, Texas and Arizona.
“What’s happening in those states is an unfortunate reminder of just how easily this virus can spread and how things can easily take a turn for the worse with COVID-19,” Adler said last week.
Public health authorities should put their energies into promoting mask-wearing rather than requiring it, said Seema Mohapatra, an associate professor at the IU McKinney School of Law. Mohapatra recently co-authored an article in the Washington and Lee Law Review Online that argues against mandating mask use.
Some people can’t wear masks because of disabilities, she said. Others may fear that wearing a mask may make them look like a criminal. In addition, requiring masks opens the door to punishing those who don’t do so.
Now that the issue has been politicized, it would help to have people on both sides of the aisle wear masks and to invest in public service campaigns to teach people about why wearing masks benefits everyone, Mohapatra said.
“I really do think that will work better and do less harm than having a requirement where it is subject to both actual policing and citizen policing,” Mohapatra said.
Creating a new habit is difficult
Mertz said she believes some of the negative reaction in Elkhart County to wearing masks stems from the unfamiliarity of doing so. With time, she said, she hopes that more people would adopt the practice.
“As with anything different and new, it takes some getting used to,” she said. “I think that once people have been around masks a little more, it will be easier for them to slip it on when they’re going into a public place. … When they realize how important wearing a mask is for the lives of their loved ones and family, we will see a lot more mask-wearing around here.”
Persuading people to adopt a new behavior can be challenging, said Katie Boucher, an assistant psychology professor at the University of Indianapolis. People may decide whether to take up a new habit based on what they see others doing, she said.
People who know others who have been sick with the coronavirus or died from it may be more likely to wear a mask. For others, all the controversy makes the decision that much harder.
“Wearing a mask is a new habit, and that in and of itself is tiring,” Boucher said. “It seems like an easy decision. … It takes a long time to come up with a new habit, and then when we see other people not doing it, it gives us another reason not to do it.”
Making people wear face masks can be a difficult sell
The issue has become so controversial that a manager at a north side retail store refused to comment on its mask policy, saying there’s no way to win in the argument. The store has heard from irate customers both for and against masks.
Georgetown Market on the west side asks that employees keep a mask on hand should a customer come near, but they do not have to wear the facial covering for their entire shift, manager Ashley Williams said. Customers are not required to wear masks, though most of them do.
The natural foods grocer arrived at this plan to accommodate some employees who said health conditions precluded them from wearing a mask for their whole shift.
“It does have to be visibly on them, close to hand, where they can pull it up if they do have a customer that doesn’t feel comfortable if they’re not wearing their mask and then they can take it back down,” Williams said. “As a general rule of thumb, if you see a customer with a mask on, you should probably put yours on.”
As difficult as it may be to persuade some adults to wear masks, public health officials have an even greater challenge ahead: the reopening of schools. Students will be asked to wear masks when they are in the hallways, on school buses, or in other places where they can’t social distance.
If masks are required, Box has said, some parents may decide not to send their children to school.
Attitudes and behavior may change over time. At first LaGrange County health officer Dr. T. Anthony Pechin did not think requiring masks was necessary. But after the state reopened, coronavirus cases in the county started to climb while other counties saw stable or declining numbers. In LaGrange County, fewer than a quarter of the people Pechin saw were wearing masks.
Last week the Health Department issued an order that masks must be worn indoors and outdoors in public and private places if people can’t maintain a 6-foot distance from those outside their family.
Contributing: Dave Bangert/Journal & Courier. Contact IndyStar reporter Shari Rudavsky at [email protected]. Follow her on Facebook and on Twitter: @srudavsky.
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