The Ethics of Masking in an Unending Pandemic

After a brief summer of freedom, the United States is reeling under a fresh assault of coronavirus, the India-bred Delta variant having proved more than infectious enough to overtop our half-built barriers of herd immunity. In some ways, this latest wave is the most dangerous yet, at least in its capacity to stoke social hatreds and political unrest. There’s nothing more disconcerting than a fresh wave of adversity just when you thought you were totally through, and few communities, I suspect, have the political will to face a renewed round of restrictions.

The likely absence of such restrictions, and the stark divides between vaccinated and unvaccinated America, pose a very interesting test case for Christian ethics, which I’d like to explore in this post. Regardless of where you come down on the myriad questions surrounding Covid, I hope you may find this a useful exercise in moral reasoning.

Over the past year, I’ve written quite a bit about Christian ethics and coronavirus, but the discussion has often come down to the comparatively narrow (albeit not necessarily easy) terrain of the Fifth Commandment, “Honor your father and mother,” which has been traditionally read as including the duty to (except in extraordinary circumstances) obey lawful civil authorities. For many Americans during the pandemic, the ethics of mask-wearing and social distancing were superseded by the ethics of civil obedience, in communities where magistrates (not to mention most private businesses) mandated masks and gathering limits.

This spring, with the virus and restrictions easing, I wrote a piece reflecting on how to live virtuously in the twilight of the pandemic, guided by justice, prudence, fortitude, and temperance rather than the stern voice of law. Now that we find ourselves having passed from the twilight into the twilight zone, or perhaps rather, the zombie Deltapocalypse phase of the pandemic, in which an undead mutant virus returns to torment us, what does wisdom look like? Must we continue to make sacrifices for love of neighbor, or can we at last, with the advent of vaccines, allow every man to do what is right in his own eyes?

Well, let’s start by reviewing the basic arguments for and against mask-wearing, and then look at how the new phase of the pandemic might change our reasoning.

The argument in favor focuses on three main goods to be protected: (1) personal health; (2) neighbor’s health; (3) community health. To elaborate:

  1. Mask-wearing seems to reduce the risk that I personally will become infected. If I am older or more unhealthy, this is hardly a trivial point, since the virus could be quite dangerous; if I am young and reasonably-healthy, severe disease is unlikely, but there’s still a good chance I could be sick enough to knock me out of commission for awhile, and as a husband, father, and breadwinner, it’s only proper to take reasonable precautions to reduce that risk.
  2. Mask-wearing seems to reduce even more the risk that I will inadvertently infect others around me—even if I’m an asymptomatic carrier. Given that these others might well be more vulnerable to the virus, or might themselves come in contact with those who are, I should absolutely want to avoid putting them at risk (a risk of debilitating illness or death) where reasonably possible.  
  3. Although healthcare workers are paid to take care of the sick, that doesn’t mean we don’t owe them basic neighbor-love. If mask-wearing slows transmission, it reduces the number of sick people hospitalized at any given time, keeping doctors’ and nurses’ workload and stress within reasonable bounds and enabling them to give the best care possible. In many places throughout the pandemic, we here in the US have failed in this core public health goal, resulting in severely overstrained hospitals, traumatized healthcare workers, and numerous preventable deaths.

An analogy at this point might be helpful. For younger healthier folks like myself, mask-wearing would be like making sure you have working brakes on your F350 pickup truck. If you drive around a big pick-up truck without brakes, there’s a good chance you’ll be in an accident. Although you yourself are likely to come out of it with just a few scratches, that’s still something wise to avoid, and more importantly, you have a pretty good chance of inadvertently killing the poor Prius driver in a collision. Plus, if you’re in an accident, you’re liable to snag up traffic for miles, or even cause a multi-car pileup, with harmful ripple effects far beyond yourself. The analogy is imperfect, especially in the third element, but you get the basic idea.

There’s one other looser and more indirect, but potentially significant, argument for masking:

4. It’s a highly visible symbol reminding people “Crap we’re in a pandemic.” As such, it can encourage others to mask up, and indeed to generally conduct themselves cautiously, avoiding unnecessary opportunities for transmission. I suspect that the most significant factors in mitigating transmission and reversing waves of virus over the past year were not formal legal restrictions, which differed widely from place to place, but the informal tendency of people to alter their behaviors in areas where they knew transmission was widespread.

Now, why not mask then?

Well, the most obvious retort is, “Masks don’t work.” If so, that cuts the feet out from under arguments (1)-(3) above, and leaves only a relatively weak argument (4) standing. This is obviously quite an important retort, but let’s just bracket it for the moment, and assume masks do work. What are the other arguments one hears?

  • I. Masks are inconvenient and unpleasant. Obvious enough, and although a fairly trivial point, this is a good enough reason why we don’t wear masks all the time to reduce the risk of catching mild colds and flus. But of course, in the face of genuinely severe disease, not much of an argument.
  • II. Masks are psychologically harmful/undermine communication. Masks obviously make communication more difficult, both because speech is harder to decipher, and, more importantly, many emotional cues from the face are lost. Humans are very adaptable and it’s remarkable how much you can pick up from a person’s eyes, once you’re used to masked faces, but there’s no question that a great deal of intimacy and meaning can be lost in masked communication. Over the long haul, I wouldn’t be at all surprised to find that people surrounded with mask-wearers are much more likely to suffer from depression or other mental health issues.
  • III. Masks symbolize servility. This claim is often linked to the “Masks don’t work” objection—certainly if we’re being asked to wear something for no good reason, then wearing it becomes a gesture of obsequiousness in the face of arbitrary power. But, even setting that aside, a masked populace is a depersonalized populace; masking reduces us to mere huddled, shuffling masses, with at least an apparent loss of agency. Masking is a self-hiding, and thus cannot but tend to convey a certain cowardice, however unfair this may be.

Now, if we are indeed dealing with a severe disease, and if masks indeed work reasonably well in limiting transmission, then arguments (1)-(4) are obviously more powerful than arguments (I)-(III). But what if we’re not dealing with a severe disease, or what if masks don’t work?

The first can be dealt with readily enough. In the early days of the pandemic it might’ve been plausible to question how serious this Covid thing really was after all, but not, I’d submit, after all we’ve seen in the last 18 months, particularly in places where the rate of transmission has overwhelmed the capacity of the healthcare system to cope.

So then, what if masks don’t work? To be sure, there seem to be plenty of studies and data points that show that they do help, at least to a non-trivial extent, and they have been strongly recommended, if not required, by health authorities in nearly every nation on earth, with medical professionals from national epidemiologists down to ordinary nurses overwhelmingly supporting their use. On the other hand, there are also studies and data points that call their usefulness into question, and there’ve been a fair number of dissenting voices from contrarian medical experts. How is the ordinary Christian to judge?

Normally, if you’re not an expert, the best thing to do is simply to defer to the majority consensus of expert opinion. In this case, that is clearly in favor of masking. But there are obviously areas where the Christian should not simply defer to the majority consensus of expert opinion, if the experts in question are caught up in a mass delusion driven by perverse motives—as is increasingly the case with what the “experts” will tell us about gender and reproductive health. Is there reason to think that there’s a global delusion stretching from Australia to Argentina to Azerbaijan to America when it comes to Covid? Many of my fellow citizens seem to think so, though I can’t say I fully understand their reasoning.

Let’s suppose, though, that there are very good reasons to doubt the consensus, and that most of us ordinary Christians are thus left with no clue as to whether masks are useful or not. At this point, we’d have to do a sort of “Pascal’s wager”: Scenario A: “If masks don’t work, and I still wear them, how much harm will it do?”; Scenario B: “If masks do work, and I don’t wear them, how much harm will it do?” This is perhaps a challenging comparison, because in the first case, the harms are pretty intangible and psychological—(II) and (III) above—whereas in the second case, the harms are quite concrete. For myself, it seems clear to me that the harm of Scenario B would be much greater, and thus mask-wearing when Covid is on the rampage is the most responsible course of action.

But, what about now? What about when 50% of the population is vaccinated? What about when you yourself are vaccinated? Let’s look at our three main arguments above in order.

Self-protection. This is now much less of a factor. The vaccines work almost completely in preventing severe disease, even for the Delta variant. There are exceptions, and Delta can still make you unpleasantly sick for a few days even if you’ve been vaccinated, but if you don’t mask for the seasonal flu, you shouldn’t mask to protect yourself from Covid if vaccinated. (NB: Similar reasoning would go for children, who even when unvaccinated are extremely unlikely to have severe disease)

Protection of neighbor. This is very murky. Do the vaccinated still transmit the virus? Not the original version, usually, but quite possibly yes for the Delta variant. At least, that’s the disturbing tale the scientists are now telling us. If so, then it sounds like we should mask up again to protect the unvaccinated. Or should we? There’s an interesting wrinkle here, the most interesting question of all: Do we still have moral responsibility for those who remain at risk? There’s a very good case to be made that we don’t. At this point, every adult in America has had ample opportunity to receive the vaccine; and although there are a tiny handful that perhaps cannot for particular health reasons, most who have declined the vaccine have freely chosen to accept the risk. So why should a vaccinated person worry about them?

Our answer here must be nuanced. Clearly we do, up to a point, have a responsibility to protect those who have chosen not to protect themselves. If someone rashly decides to walk on the rail of a bridge to show off, and then falls off, we should still try to save them from drowning. If someone is intoxicated, we should try to get them safely home. If someone has squandered all their money, we shouldn’t let them starve. But only up to a point. If someone is determined to be a daredevil, no matter how many times we save them from drowning, or refuses to deal with their drinking problem, or keeps gambling their money away, at some point, you have to leave them to deal with the consequences of their own choices.

So really, the question here is, “Are the people who haven’t gotten vaccinated yet likely to change their minds if given a bit more time?” If so, then by all means, we should act to protect their health. However, if they have firmly decided that they do not want the vaccine, and aren’t likely to reconsider that decision, then it would be absurd for the vaccinated to go around forever wearing masks to try to reduce risks for the unvaccinated.

Community health. It might seem, then, that there’s no reason for the vaccinated to mask up, if everyone who’s going to get vaxxed already has. (Which isn’t quite the case, clearly—new vaccination rates are actually climbing in the US right now.) But, if indeed the vaccinated can still transmit the virus, there is still the question of community health, still the question of loving our brothers and sisters condemned to continue dealing with the consequences of our choices in ICU units after 18 horrible months. Their stories are harrowing, even now. Even if the virus is going to eventually burn its way through all of the unvaccinated, we still want to slow its pace; we must still, one last time, “flatten the curve.” There are many places where this doesn’t apply; many places where cases are so low, and vaccination rates so high, that there’s little risk of out-of-control spikes. But of course, there are unfortunately many places in the US right now where this tragically does apply, and hospitals are under extreme pressure from careless behavior.

So, to mask or not to mask? Well, I won’t answer that question for you. But hopefully, if you’ve read all the way to the end, you feel a bit more equipped either to answer this question yourself—or to live together in charity with those who answer it differently.

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