David Kirp

Skepticism about the value of wearing a mask to reduce the spread of coronavirus drives the current government policy. Widespread use of face masks has little, if any, effect on reducing the spread of upper respiratory infections, a working group led by the Ministry of Social Affairs and Health concluded. The government’s unwillingness to recommend their use, except in shoulder-to-shoulder places like trams, is predicated on that finding.

This decision is mistaken—and if, as predicted, coronavirus returns it could be dangerously mistaken.
For more than a century, public health officials have delivered the same message—to combat a pandemic, people should wash their hands frequently and maintain social distancing. Many scientists and public health officials are also urging that, to slow the spread of coronavirus, masks should be worn in public. Worldwide, more than fifty countries have heeded this message.
A brief history lesson--during the 1917-1918 influenza epidemic of 1917-1918, many American cities required that masks be worn. So strong was the belief that masks were effective that those who refused to comply were subject to fines and jail sentences. “Doctors wear them,” said the Red Cross. “Those who do not wear them get sick.” It was a smart move—a 2007 study found that in San Francisco, the first city to require masks, the practice reduced the number of fatalities by 25 percent.
There’s a straightforward explanation for why masks make a difference—they reduce the spread of fluid droplets emitted by sneezing, coughing and speaking, the main way that the virus spreads.
A study just published in Nature, the world's leading multidisciplinary science journal, determined that a single droplet from someone who is contagious contains 7 million viruses per milliliter. The research team used this number to estimate that one minute of loud speaking generates at least a thousand virus-containing droplets of fluid that can hang in the air for over eight minutes. Anyone who inhales these droplets is at acute risk of developing coronavirus.
Bottom line: the most effective way to prevent respiratory viruses like COVID-19 from spreading is to lessen the chance that a respiratory droplet from someone who is infected lands on someone else. Even though those with symptoms of coronavirus are told to stay at home, that’s insufficient protection, since close to half the transmissions occur when the person who is infected hasn’t yet experienced symptoms or will never develop them.
While medical-quality masks do the best job, a cloth mask masks a difference. Let’s be clear—in slowing the spread of the pandemic, masks aren’t a magic bullet. Social distancing and hand-washing are at least as important. But masks do help, and that’s a good reason to urge people to wear them in public.
The researchers offered several rationales for their no-masks conclusion. None of them are persuasive.
The researchers point out that there is no gold-standard study that proves, beyond a shadow of a doubt, that masks are effective. That’s true enough, but irrelevant—it would take years before such a study were completed, by which time coronavirus would continue to wreak havoc. They argue that masks aren’t a substitute for social distancing--that’s a straw man, since nobody has made that claim. They point out that, if worn improperly, masks are ineffective and may even harm the wearer. But learning how to put on a mask isn’t rocket science—place the straps over your ears first and don’t touch the inside of the mask. I have every confidence that Finns, like people worldwide, will figure that out for themselves.
The main reason not to wear masks, say the researchers, is that they do not protect the wearer. This assertion is not entirely true, since any face covering offers some protection. What’s more important, it misses the crucial point. A face covering is not all about you. It is a selfless, contribute-to-society act, a duty that comes with being a card-carrying member of the nation. In the spirit of solidarity, you need to protect others from yourself.
With the number of new infections plummeting and death rates hovering near zero, Finland has dodged a bullet. That’s shout-from-the-rooftops news.
Would lives have been saved if Finland had required that masks be worn when it issued the emergency decree in March? Probably. While we cannot change the past we can do better in the coming months. Scientists predict that Covid-19 will return with a vengeance this autumn. Will lives be saved during the next wave of the pandemic if mask-wearing is required? Almost certainly. That’s more than enough reason to insist that they be worn.

David Kirp

David Kirp is a professor of public policy at the University of California at Berkeley and a contributing writer to the New York Times.

He is a permanent resident of Finland.



This is a "Viewpoint" opinion column. The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the views or position of The Helsinki Times.