Mask Mandates and Other Public Health Measures

Posted on 01 Feb 2021 by Steve Markham

I have some difficulty forming and maintaining friendships. It’s mostly laziness, I think, but a good chunk of it is that I spend most of my time with friends arguing/debating/disagreeing over less-than-maximally-important topics. I think I simply enjoy arguing. But also I am a little concerned about my own confirmation bias and tribalism, and so I want to hear the strongest arguments I disagree with. Internet strangers are useful, but if the argument isn’t especially based in objective fact, then I am more easily persuaded if the argument comes from someone I already trust. Hence, I’m constantly provoking my friends into debates.

Thus, it will come as no surprise that when I recently spoke by phone with my ~5th closest friend in the world:

1. It was the first time we’ve spoken in, let’s see now, May June July August September October November December January makes 8 or 9 months,
2. We spent about half the time discussing public health policy, despite the fact that neither of us influences public health policy, nor lives close enough to the other to be even remotely affected by how the other behaves.

The last time I went hiking with this particular friend he convinced me that the marginal benefit of child vaccination probably includes zero in the confidence interval. That is, given that measles is rare and most kids are vaccinated, my own kids are about as likely to have bad consequences with the vaccine as without. On the hike I outlined (largely in my head, but guided by the discussion with him) a metric that would be 1 if vaccines were net zero benefit, »1 if vaccines were good, and «1 if vaccines were bad. I was expecting MMR to be >10, and it was between 0.7 and 3. This was eye-opening.

So, when my friend mentioned that he might move (again) to avoid a mask mandate for his school-age children, I couldn’t resist dwelling on the topic for a half hour or so. Without putting words in his mouth (since the following summary is also formed by my own intuition, discussions with other people that are generally skeptical, and my reading of “conservative” news media), I think the basic arguments against mask mandates are as follows:

1. Mandates in general are bad. This is an all-purpose libertarian argument. For extremists, this is the end of the story. For more pragmatic/compromising people, this at least puts the burden of proof on people asking for the mandate.
2. Mandates haven’t prevented surges in COVID cases, hospitalizations, or deaths. That is, mandates don’t help because when necessary, people mask up without a mandate at about the same rate and to the same effect as with a mandate.
3. Masks have negative effects that outweigh positive effects, including social inhibition, bad hygiene, and general discomfort. This is possibly the most practical example of torture-vs-dust-specks that I have ever seen. Dying is bad, even just long-haul COVID is bad, but is it bad enough to justify mild discomfort in 300 million people? I believe that the torture-vs-dust-specks argument is meant to illustrate that torture is categorically bad, and a utility function that prefers 3^^^3 people each getting a single speck of dust in their eye is a prima facie bad utility function, but I actually think it’s a totally fair question to ask.

The point of this post is not to refute any of those three arguments–quite the opposite. I have my own reasons for not finding any of them compelling, but I at least want to steel-man them. If anyone is reading this, and you think I’m leaving out a significant theme, please let me know. Also, if you have specific papers or essays arguing for #2 or #3, please share them with me. If you Google #2, you get inundated with references to Kanses county-level data, or observational studies from October before the 3rd surge wrecked NY again despite its mandates. If you Google #3 you get a bunch of anecdotes that some people find masks intolerable, but even if thousands of people found masks intolerable to wear, that’s not nearly as bad as if 300 million people found them intolerable, so if we are maximizing utility I still end up in the mandates-are-good camp.

Relevant to the discussion, but not really related to mandates: Influenza rates absolutely plummetted starting the last week of March 2020. I’ve included a screencap of the main graph from this WSJ article below.

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