Vlog
This post is available as a vlog. Why? Just trying to serve you better! Perhaps you just got back from the eye doctor and your pupils are dilated, so it’s really hard to read the screen text. In that case, just roll the video, kick back, gaze at the blurry talking head—or not!—and let the audio monologue wash over you, leaving you deeply edified, catatonic, or both! (For the regular text version just scroll down. Obviously.)
Introduction
This post is available as a vlog. Why? Just trying to serve you better! Perhaps you just got back from the eye doctor and your pupils are dilated, so it’s really hard to read the screen text. In that case, just roll the video, kick back, gaze at the blurry talking head—or not!—and let the audio monologue wash over you, leaving you deeply edified, catatonic, or both! (For the regular text version just scroll down. Obviously.)
Introduction
I was surprised to learn recently that the Dutch government
not only doesn’t require face masks to stop the spread of the coronavirus, but
formally opposes masks, telling people that they don’t help and might even
hurt. I decided to delve into this and learn more about it—not just by reading
up on the subject, but by sending a survey to both Dutch and American citizens,
to compare the results. In the process I have, surprisingly enough, hit upon a
novel way forward that could really help.
What the Dutch
government says about masks
According to this article in the British Daily Mail, Coen
Berends, spokesman for the Dutch National
Institute for Public Health and the Environment, stated, “Face masks in public
places are not necessary, based on all the current evidence. There is no
benefit and there may even be negative impact.”
(Based on all the
current evidence? Like, every study worldwide? Really? This post isn’t
primarily focused on the effectiveness of masks, but for more on this question
see the appendix.)
The article goes on to say, “Christian Hoebe, a professor of
infectious diseases in Maastricht … [and] head of infectious disease control in
Zuid-Limburg, the region hit hardest when the pandemic struck Holland, pointed
to a Norwegian study showing 200,000 people must wear surgical masks for one
week to stop a single Covid-19 case.”
Okay, I’m just going to stop right here and cry bullshit on
the Norwegian study. It fails the sanity test. Meanwhile, basing Dutch policy
on a Norwegian study seems a bit flimsy now, considering that the government of
Norway, two weeks ago, revised their own position on masks. According to this article, “the ministry recommends face masks as an extra precaution when it is
difficult to maintain a ‘social distance’ of one meter or more on public
transportation.” Granted, this is still a far cry from a nationwide mandate,
but if the Norwegian government really believed 200,000 people must mask up for
a week to stop one case, they wouldn’t have made this recommendation. The
researchers who came up with that 200K figure are, in strict epidemiological
terms, whacked out on coke and smack. (I
note that Holland already mandates masks on public transit.)
Setting aside the Norwegian article, let’s dig in to the
Dutch government’s assertion that there’s no benefit and there could be
possible negative impact. According to this Reuters article, “RIVM chief Jaap van Dissel … argued wearing masks incorrectly, together
with worse adherence to social distancing rules, could increase the risk of
transmitting the disease. ‘So we think that if you’re going to use masks (in a
public setting) ... then you must give good training for it,’ he said.”
Okay, so here’s a novel idea: how about simply providing
that training? How hard could it be? After all, the Dutch have done a great job
teaching contraception. As described here, they have the lowest abortion rate in Europe. I think van Dissel’s
lack of faith here seems
unreasonably defeatist.
And how about empirically investigating the relationship between
mask wearing and social distancing? Turns out, a study has done just this. As
detailed here, “A group of researchers observed people walking the streets of the Dutch
capital and found that wearing masks did not give anyone a false sense of
security … As part of the research, Lindegaard analysed video footage from June
1 of a shopping street in Amsterdam that was not particularly overcrowded. The
footage showed that people wearing a mask violated the 1,5 metre distance rule
just as frequently as people not wearing masks. Her research also found that 80
percent of those wearing masks wore them correctly.”
(Note that this fellow here is French, not Dutch.)
How do the Dutch
people feel about masks?
Masks are frankly a pain in the ass, so it’s not surprising
that crack investigative journalism turned up some decidedly anti-mask attitudes.
The Daily Mail article reported that the Dutch
government’s policy has brought about “the delight of all the citizens I spoke
with in Amsterdam. ‘I hate wearing them,’ said Aicha Meziati, 29, in the hip
fashion store Das Werk Haus. ‘They are horrible. People look like they have
nappies on their faces.’”
(Since most of my audience is American, I’ll point out here
that a) a “nappy” is a diaper, and b) both paper and cloth masks can resemble
diapers. Probably few Americans have ever seen a cloth diaper, but trust me,
they look a whole lot like white cloth face masks, like the ones my employer
mailed me.)
Notwithstanding the retail employee’s pithy statement
(which, by the way, showcases a rather naïve attitude toward the seriousness of
this pandemic), the Mail goes on to
say that “two recent polls claim a majority [of Dutch citizens] back use of
face masks for indoor public spaces.” The Mail
doesn’t cite either poll, but I found this article that states, “In a weekly poll conducted by political researcher Maurice de
Hond, 55 percent of the [Dutch] people surveyed revealed they think face masks
should be made compulsory in order to help battle a second wave of the
coronavirus.”
I wouldn’t put too much stock in any one survey, but I’ll
bet there are more Dutch citizens who support a mask mandate in the abstract
than there are Dutch citizens who actually wear masks. It’s human nature to go with the flow and not be that odd person taking
a precaution that nobody else is. If I somehow found myself in Holland right
now, I’d be more conflicted about going outside with a mask on than I am in the
U.S., because I wouldn’t want anyone construing my behavior as a silent
judgment against theirs.
Now let’s get to my survey results, and the thoughtful
comments from my Dutch respondents, whose direct personal experience can nicely
supplement the stuff I’ve read online.
The survey responses
I’ll have to start out by saying my survey was not very
broad … only three Dutch citizens responded. I’m only one guy and the research budget
for albertnet is zero. Still, I hope you’ll agree three bits of anecdotal
evidence are better than nothing. (If you don’t, click here.)
Of the three Dutch respondents to my poll, none wears a mask.
Two of these respondents, asked why not, chose the answer, “I’m not sure the
Dutch government is right about masks but I don’t wear one because if I did, I
would stand out.”
The third respondent chose the answer “I agree with the
Dutch government that masks aren’t helpful so I don’t wear one,” with this
added comment: “While I answered no, I do think masks would be useful if they:
- Are quality masks - Are switched regularly (never worn consecutively) - Are
actually worn over the mouth and nose. However as is the case, the quality
masks that make a difference are reserved for healthcare workers. This leaves
the rest to wear masks that don’t really work.” So this is a bit different than
saying masks couldn’t help.
Asked if the Dutch government should require masks, one
Dutch respondent answered yes, “Because it makes it more visible that Covid is
present. Makes people more aware that they have to keep distance.” The two
others could not decide. One of these
two says, “I think it’ll cause too much protest” and the other says “if it was
made easier (or cheaper) to get quality masks, and everyone does it correctly,
I would make it mandatory.”
Holland vs. U.S.
I’m not going to compare overall Covid rates between the US
and Holland, nor compare the efficacy of our governments, other than to say
when I mentioned the Dutch government’s position to my daughter, she replied, “I
love that we’re not the only idiots!”
What I want to explore is how consensus in a community can
be a very comforting thing, especially during such difficult times. I mentioned
already that in the absence of a mandate the Dutch people will tend to behave
the same—that is, not wear masks.
Happily, I don’t have to worry about offending anyone in my
community when I wear a mask. Of the 19 American respondents (all of whom are
on my bike club, and are thus local), 17 believe masks help, and two chose “I
really don’t know.” Regarding a nationwide mask mandate, 15 support it, three
can’t decide, and only one opposes it. My American respondents’ comments tended
to be about wide open spaces and the need to address regional differences but
with consistent, national thresholds applied.
Suffice to say we’re all on the same page in my neighborhood.
Contrast this to other parts of the U.S. where you can be hassled for wearing a mask, or for not wearing one,
depending on your neighborhood and/or whom you happen to encounter. At least in
California we have a statewide mandate, so wearing a mask doesn’t make much of
a statement (other than “I don’t want to get in trouble with the law”). Nobody can
differentiate between the “us” who only wear a mask because they’re required to,
and the “them” who really believe masks are helpful (or vice-versa if you’re on
the other side of the fence). So you have widespread adoption of a behavior
that reduces the spread of the coronavirus, without all the social friction. I would
love to see this be adopted nationwide, and I think this would help in the
Netherlands as well. Anywhere, really.
Can the Dutch
government change their tune?
Initially, the CDC in the U.S., along with the World Health
Organization, discouraged the use of masks, but as more data have become
available, both agencies have changed their position. Is it realistic to assume
the Netherlands may eventually fall in line?
It could be that this accusation is unfair, and/or the
supposed fear of political embarrassment is unfounded. My (albeit tiny) survey
suggests this. I asked how my Dutch respondents would feel if the government changed
their minds and started requiring masks in public. Two chose the reply “I would
be relieved because I think we’d be safer with a mask requirement” and the
third chose “None of the above” and commented, “I would be annoyed because
masks are annoying. However, if they made it mandatory they probably did it
based on scientific research. This would make me relieved because that means
there is a safer way to go out in public. If they did it without any reason I
would pick option 3 [less respect for Dutch government].” Fair enough.
I asked specifically if the Dutch respondents would lose
respect for their government simply for abandoning their initial position (i.e.,
for being wishy-washy). Two responded that “This wouldn’t affect my opinion of
the Dutch government” and one added, “I like that the government bases the
decisions on science and follows what the RIVM says about it. I realize new
studies can show new things and I trust the RIVM in evaluating what studies are
trustable.” The third respondent chose the response, “I would have more respect
for Dutch government because they can admit when they’re wrong.”
Is there a quick fix?
Unfortunately, to get the Dutch government to change their position would require that new evidence be put in front of them, or that they take another look at existing studies … both of which would take precious time, while the rate of infection is climbing. Is there another, faster way forward?
Unfortunately, to get the Dutch government to change their position would require that new evidence be put in front of them, or that they take another look at existing studies … both of which would take precious time, while the rate of infection is climbing. Is there another, faster way forward?
There is! We don’t actually need to persuade the Dutch
government that masks prevent airborne transmission of the coronavirus … we
just need to give them other reasons why masks should be worn. I have come up
with three very compelling ones.
First, if aligned with a powerful campaign of public service
announcements, a mask mandate could increase
social distancing behaviors. The key is to focus on a particular side effect of
prolonged mask wearing: maskne. This is the problem of mask-induced acne, and as
detailed here, it’s a real enough problem that “the Covid-19 task force of the American
Academy of Dermatology (A.A.D.) felt compelled to release advice on the
subject.” So, if a nation is required to wear masks in public, and masks cause
maskne, what is the natural human reaction? To stay home! And that’s exactly
what needs to happen. Too many people are going out there on stupid, needless errands
just because they’re bored of being housebound. Well, boo hoo hoo … people are dying! If you hired a bold filmmaker
like Lars von Trier to create an absolutely grotesque and graphic PSA video of mask-induced acne,
with a tagline like “Maskne is not worth it … please just stay home,” the good
people of Holland might do just that.
Next, we need to point out to the Dutch government a
simple fact that so often goes unappreciated: masks can be very, very sexy. Just
look at how beautiful and mysterious this woman looks:
The fact is, even if not all people are beautiful, almost
everybody has pretty eyes. Alas, so often the effect of nice eyes is ruined by
nose hair, unkempt beards, cigarette-stained teeth, or a weak chin. A mask easily
hides these shortcomings. The trick is to furnish the Dutch people with elegant
masks that actually enhance their appearance. It would be a pity if somebody
spoiled the effect with an ill-advised design like one of these:
Finally, we need to impress upon the Dutch government that
the pandemic is not the only global crisis right now: there’s also the economic
turmoil that Covid-19 has wrought. It’s time to get businesses back on their
feet, and masks can be a big part of that. How? One word: advertising. These
pro cycling teams have the right idea:
If the Dutch government suddenly mandated the wearing of
masks when in public, for these reasons alone and irrespective of masks’
efficacy in reducing airborne spread of the coronavirus, they could slow the
spread of COVID-19 and eventually look like heroes to the Dutch people.
Appendix – Should we
believe that masks help?
This study “provides evidence
from a natural experiment on the effects of state government mandates for face
mask use in public issued by fifteen states plus Washington, D.C., between
April 8 and May 15, 2020 … Mandating face mask use in public is associated with
a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0
percentage points in 1–5, 6–10, 11–15, 16–20, and 21 or more days after state
face mask orders were signed, respectively. Estimates suggest that as a result
of the implementation of these mandates, more than 200,000 COVID-19 cases were
averted by May 22, 2020.”
Meanwhile, this publication declares, “In countries with cultural norms or government policies supporting
public mask-wearing, per-capita coronavirus mortality increased on average by
just 8.0% each week, as compared with 54% each week in remaining countries.”
The University of California at San Francisco (UCSF) medical
school is very highly respected, and I have all too much firsthand experience
with their hospitals and medical centers, all of it positive. They published
this very compelling article explaining why masks are helpful, and how the CDC and WHO came to reverse
their earlier positions. Among other evidence, the article cites case studies
from UC San Francisco epidemiologist George Rutherford, MD and infectious
disease specialist Peter Chin-Hong, MD: “In one case, a man flew from China to Toronto and subsequently tested positive for COVID-19. He had a dry cough and wore a
mask on the flight, and all 25 people closest to him on the flight tested
negative for COVID-19. In another case, in late May, two hair stylists in Missouri had close contact with 140 clients while sick with COVID-19. Everyone wore a
mask and none of the clients tested positive.”
Of course, you don’t need to believe any of this to support
a worldwide mask mandate. The Netherlands should impose one for the indisputable
social value of masks: their sex
appeal, the advertising space, and the maskne-driven increase in improved
shelter-in-place behaviors.
More reading on the
pandemic
- Shelter-in-Place FAQ
- E-Book Options During COVID-19 Lockdown
- Is Cycling Safe During the COVID-19 Pandemic?
- The Toilet Paper Hoarding Conundrum
- More COVID Chronicles – Baking in Place
- When Will the Pandemic End?
- What Are Hospitals Like During the Pandemic?
- How to Talk to Your Cat About COVID-19
- Teleworking During the COVID-19 Pandemic
- Travel Tips During the COVID-19 Pandemic
- COVID Wristbands
