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An epidemiologist’s view on personal liberty and mask-wearing

I work in infectious disease epidemiology. I’m mostly a number-cruncher, far removed from the trauma being experienced by families and health care providers in hospitals around the world, but I still have an odd kind of front-row seat to COVID-19. Watching this scenario unfold has been surreal. It’s a tragedy epidemiologists knew was likely in our lifetimes, and for which the world was ill-prepared. The personal strain, public division and politicization has made it all the more difficult to fight and even to understand. Early denials and mistakes in combating COVID-19 outbreaks around the world made the problem worse. That is a fair point of discussion, but it is in many ways immaterial to the methods we need to fight the battle today.

Frankly, I’m exhausted. My guess is you are too. It’s tempting to want to let the beautiful weather lift the pandemic away like a bad dream. It can seem overblown and far away, especially if you haven’t seen suffering patients for yourself. I’ve certainly thought and felt that at different times. The burden and the burnout are real. The economic and emotional tragedies are real, and we all desperately want to be at liberty to move and interact freely.

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But that’s the problem with a pandemic. We can’t will it out of our individual lives — not directly, at least. We can’t pull ourselves up and out of the crisis by our bootstraps because we aren’t fighting something that works against just the individual. We are battling a force of nature that attacks by spreading through communities. We might as well try to individually force back an earthquake or a hurricane. All we can do is learn about the virus and do our best to overcome it in a united way. It takes a community to spread the virus, and so it takes a community to stop it. Even a vaccine will be a community-level tool.

I remain very hopeful about our ability to overcome COVID-19. I see the path back to our freedom to gather and move without fear becoming clearer.

A few months ago, we didn’t have the information, materials or resources to fight on even footing. That is changing. Now we know about how the virus is spread through respiratory droplets. I read this week about simulations suggesting the spread of the virus in classrooms could be kept near zero when at least 90% of students wear cloth masks and sit apart. In New Zealand, they designated personal “bubbles” of individuals who could interact freely with each other to counteract loneliness and the burden on people who could not care for themselves. As the disease was eliminated, those “bubbles” are expanding to include more people. We still have a lot to learn, but our efficacy in the battle is steadily growing.

The tricky part is that we can’t eliminate COVID-19 by focusing only on our individual liberty — we have to exercise a kind of generous, communal commitment to liberty as a principle. We have to believe in protecting the liberty of another as much as protecting the liberty of ourselves, and that belief has to drive us to make some necessary personal sacrifices.

As I move through my community, I see many people wearing masks and many people not. There is an element of discomfort to wearing a mask, and there can be a feeling of loss of personal control, or even of identity. It is a small change, but comes at a cost because we are not culturally accustomed to it. The question is, are we willing to pay that cost in order to protect the freedom of one another? If I use my freedom to wear a mask, it does little to protect me from COVID-19. It only protects the people around me. The freedom of vulnerable people to be healthy and move about in society depends on their community generously choosing to self-sacrifice. Scientists and government do not dictate that fact — the virus does.

The idea of generously using our liberty runs against the current tired political talking points, which keep us fighting in trenches against each other instead of together against COVID-19. I would love nothing more than to walk through a store and see someone sporting a mask that says “Don’t Tread on Me,” and walk past someone else wearing a mask that says “#TheResistance.” Life and liberty of our neighbor can be put ahead of the other lenses through which we see the world.

If we want liberty from the pandemic for ourselves, we can only truly get it by making sacrifices to liberate others. We have the tools and knowledge to do so in our communities, regardless of whether there is political will to match. I choose to wear a mask to protect and return your freedoms; please choose to protect and return mine.

Chantel Sloan is an associate professor in the Department of Public Health at Brigham Young University. She specializes in infectious disease epidemiology, air pollution and other aspects of respiratory health.

 

“As we have seen in the debate about opening the economy, many questions about the so-called end are determined not be medical and public health data, but by sociopolitical processes.  The challenge is that there will be no sudden victory. Trying to define the end of the pandemic will be a long and difficult process.” 

Allan Brandt, Harvard historian

 

“If we are not prepared to fight fear and ignorance as actively and as thoughtfully as we fight any other virus, it is possible that fear can do terrible harm to vulnerable people, even in places that never see a single case of infection during an outbreak. And a fear epidemic can have far worse consequences when complicated by issues of race, privilege, and language.”

                Susan Murray, Royal College of Surgeons, Dublin

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