Cynthia M. Allen: To mask, or not? How public health officials created cognitive dissonance, culture war

Cynthia M. Allen: To mask, or not? How public health officials created cognitive dissonance, culture war

  • 0
Cynthia M. Allen mug

Cynthia M. Allen

In March, when fears about the dearth of medical grade masks for health care professionals were dominating social media discussions, I asked my friend — a physician’s assistant in a big East Coast hospital emergency department — if I should put my paltry sewing skills to work making cloth face coverings.

“I appreciate your enthusiasm,” she replied, “but we’ll all end up with COVID-19 if we wear cloth masks.”

She directed me to a study from 2015 in which researchers tested surgical and cloth masks in clinical settings involving high-risk exposure to respiratory infections in Vietnam.

Cloth masks, they found, not only resulted in higher rates of infection than surgical masks but also showed higher rates of infection than the control group (which followed standard hospital procedures, including use of surgical, cloth or no masks at all).

It would have made sense if this type of finding was what motivated the surgeon general in February, to tweet, that masks “are NOT effective in preventing general public from catching #Coronavirus”; Health and Human Services Secretary Alex Azar to suggest that improper mask use could actually spread the virus; and Dr. Anthony Fauci to confidently declare on 60 Minutes, that a mask is not “the perfect protection that people think that it is,” and that unless you are sick, “right now, there is no reason to be walking around with a mask.”

But it wasn’t.

Public health officials later conceded that their initial guidance to the public regarding masks was not motivated by cutting-edge research so much as the need to dissuade the public from siphoning them away from health-care workers, which, of course, was a legitimate need.

So when those officials abruptly did an about-face just weeks later and began encouraging the public to wear homemade cloth face coverings, even those made from a variety of common household items — T-shirts, bandannas, rubber bands — for their safety and that of others, they had to assume the public would suffer from cognitive dissonance or even begin to question their credibility.

In fairness, understanding of the virus is quickly evolving.

Because doctors and scientists now suspect that people infected but not exhibiting symptoms may be responsible for as much as half of new cases, there is reason to believe that increased mask usage might reduce the spread.

Researchers and academics are pointing to countries such as South Korea and Japan, where mask use is nearly universal and the outbreaks have been more controlled, as evidence that mask culture could have similar quantifiable value in the U.S.

A study from Yale University estimates each additional cloth mask worn by the public has an economic value of at least $3,000-$6,000.

Another very aspirational model argues that “just 60% of people wearing masks that are 60% effective could, by itself, stop the epidemic.” That would be something.

Of course, nearly every study that promotes masks acknowledges that they must be used properly to be effective (fit correctly, washed frequently, removed the right way), and emphasizes that mask-wearing is only one strategy, not a solution in and of itself.

Unfortunately, failure to clearly and honestly communicate the benefits and limitations of masks early on — to instead use mask guidance as an opportunity to manipulate people’s behavior — has had the outcome one might expect: Masks have become a cultural flashpoint. They are a symbol of either independence from or obsequiousness to the government. And it’s getting harder to stake out a position beyond those extremes.

There’s compelling evidence on both sides of the debate: models that suggest masking at 80-90% of the population could eventually help eliminate the disease; and research that indicates how COVID-19 breaks through to the external surface of masks when infected patients cough into them. Both deserve consideration and sound assessment from a reliable arbiter.

But when it comes to discussions of mask policies and behavior in the U.S., the opportunity to have reasonable debate seems to have eluded us. People are dug in. And frankly, we have our trusted public officials and their muddled messages on masks, to thank for that.

As they say on Twitter, great job everyone.

Cynthia M. Allen is a columnist for the Fort Worth Star-Telegram. Readers may send her email at


Catch the latest in Opinion

* I understand and agree that registration on or use of this site constitutes agreement to its user agreement and privacy policy.

Related to this story

Most Popular

President Donald Trump has finally goaded Twitter into starting the fight that Trump has been itching to have. Unfortunately for the social media giant, it's a fight Twitter cannot win anymore - and one that Trump and his allies do not want to end. Over the course of his term, the president has flouted Twitter's terms of service countless times with impunity as he's used the platform to launch ...

As a child, I grew up in abject poverty with our family being evicted often. A number of times I found myself in a poor African American neighborhoods or public housing. During those times, I was often the only white child in my class. I can say in total honesty, I was never happier as a child than when I was in those neighborhoods, housing projects or those classrooms. Ever. During the rare ...

You have to hand it to Twitter CEO Jack Dorsey: He may have been lured into an unwinnable election-year fight with President Donald Trump, but at least he's still throwing punches. Shortly before 1 a.m. EDT Friday, Trump verbally barreled into the hot flaming mess on the ground in Minneapolis, where protests over the death of George Floyd had turned violent. A bystander's video shows an ...

Will your neighborhood school open on schedule in the fall? The answer should vary by location, but some headline-grabbing declarations are prolonging the uncertainty for families and students. And uncertainty leads to fear - an infectious state of mind best treated with a dose of common sense. Special-interest groups encouraged educators to "scream bloody murder" if collective bargaining and ...

It has often occurred to me that the appropriate response to some of the ridiculous things President Donald Trump utters is: "He's an idiot." Don't get me wrong (as op-ed writers like to say). I'm not impugning Trump's IQ. By "idiot" I mean something a bit different: that Trump often doesn't know what he's talking about. (That doesn't exclude the possibility that some of his misrepresentations ...

In July 2001, a 28-year-old woman named Lori Klausutis fell and hit her head on a desk at work in Fort Walton Beach, Fla. She was found dead the next morning. The medical examiner concluded that there was no foul play, and it later turned out that Klausutis had an undiagnosed heart condition. There would be no reason today to publicly discuss this tragic accident, but for the fact that ...

He isn't trending right now, but he should be. Still, it didn't take long for savvy social media mavens to make the connection between banished NFL quarterback Colin Kaepernick, who was blacklisted after taking a knee against police brutality, and Derek Chauvin, the Minneapolis cop who was fired after taking a knee on a black man's neck. The two images side by side say everything that needs to ...

Get up-to-the-minute news sent straight to your device.


News Alerts

Breaking News