Some Utahns see wearing a mask during the COVID-19 pandemic as a social responsibility. “I wear a mask because it helps protect people around me,” said Kris Irvin, 33, of Bluffdale. “I think it’s a respect thing.”
Others aren’t convinced that face masks protect them from contracting the coronavirus, or insist mask mandates violate their constitutional rights.
“Masks CAN be effective, but the benefits are so minimal that they should not be required,” said Andrew Jensen, 21, of Millcreek. “Cloth masks do almost nothing to stop someone from contracting COVID-19.”
It’s true that the biggest benefit of wearing a cloth mask is protecting others, said Dr. Mark A. Lewis, an oncologist and director of gastrointestinal oncology at Intermountain Healthcare. The coronavirus is most often transmitted by respiratory droplets; if you cough while wearing a mask, he said, it “will catch on average about 90% of the particles that are coming out of your mouth into the air.”
And that safeguard is crucial to controlling COVID-19, Gov. Gary Herbert said last week, asking Utahns to heed the guidance of doctors and of a new study from Brigham Young University that confirmed the effectiveness of masks against the spread of the coronavirus.
The Salt Lake Tribune spoke with six Utahns about their views on masks and talked to physicians about common myths.
Why some Utahns wear a mask
Bettie and Greg Turman of Bountiful lived for 18 months in Malaysia, where it is common, she said, to see masks worn in public by families, the elderly, businesspeople and schoolchildren.
“What was enlightening to me was seeing so many people comfortable in wearing their masks,” said Bettie Turman, 69. There “was no [stigma] associated with it, no political statements were being made, it was just a thoughtful thing to do.”
Now, with the coronavirus outbreak, she said, they are inspired by that example to wear masks themselves.
And they have a new motto — mask it or casket — adopted from a post they saw on social media. They thought that mentality would help them, as senior citizens, to stay out of dangerous situations, she explained.
Bettie Turman said she’s “perplexed” that many Utahns are against mask wearing, saying that she finds the state’s residents to be kind, giving and thoughtful on other issues.
Shannah Baker, 48, from St. George, said she didn’t wear a mask before she tested positive for COVID-19. Now she always wears one in public spaces, except for during workouts in her gym.
Baker was exposed to the virus by a family member who was asymptomatic, she said. She exposed at least two people to the virus herself, she said, before she showed any symptoms and realized she was ill. One person Baker passed the virus to became seriously ill, but the other had minor symptoms.
She said having the coronavirus was “the sickest [she’s] ever been.” She missed 18 days of work, and six weeks later, she still suffers from blood pressure spikes, heart palpitations, extreme fatigue and loss of taste and smell.
“I feel so horrible that I was responsible for spreading this virus,” Baker said. “I hate wearing a mask. It is miserable, but I also feel like it is such a small sacrifice that most of us can make for our friends, families and communities.”
Irvin agrees, calling it “the easiest way to help prevent the spread of COVID-19.”
Because, like in Baker’s experience, it’s unclear who has the coronavirus without symptoms, “people should act as if they could be infectious to others, despite how well they feel,” said Dr. Hannah Imlay, an assistant professor of infectious diseases at the University of Utah. Masks also help Utahns protect others with suppressed immune systems, Lewis said.
Masks “are by no means convenient … but they are safe,” Imlay said, “and this is one of the single biggest steps you can take to protect your community.”
Why some Utahns aren’t wearing a mask
Jensen said he doesn’t wear a mask because he believes politicians are pushing mask use “for political purposes and not for the safety of the public.” Pam Fredericks, 43, of Heber City, also is skeptical; she believes there has been a lot of contradictory information about the coronavirus. And Allison Howes, 48, from Clearfield, agrees, pointing out some physicians disagree about when or whether the general public needs to wear masks.
Lewis acknowledged there have been “mixed messages from major public health authorities about mask wearing,” in part because of concerns earlier in the pandemic that medical professionals would run low on personal protective equipment.
Now, Imlay said, “there is a pretty large body of evidence coming from many different places that mask wearing is effective.” She added: “The highest effectiveness is probably [for] people around the person wearing the mask, not the mask wearers themselves.”
Jensen also said he’s concerned that as long as people are required to wear masks, the public will be afraid to reopen the economy.
“It is predominately the Democrats that are pushing that the economy stays closed, because a bad economy will destroy the success that [President Donald] Trump has had over the past four years,” Jensen wrote in an email. “Including creating jobs and stimulating growth in small businesses.”
But Herbert, a Republican who has said he supports Trump, has repeatedly said that masks are key to slowing the spread of the virus, which allows businesses and communities to reopen.
Imlay said preliminary studies suggest that — when worn by a majority of the population — face masks can “decrease spread significantly enough that case counts start to decrease instead of increase.” She referred to the most recent Centers for Disease Control and Prevention guidelines, which encourage Americans to wear cloth face coverings in public or when around people who don’t live in their household.
“The goal,” Implay said, “is really to get the majority of people wearing these masks in any kind of public place where they’re outside of the people that they see in their home.”
A recent analysis from Goldman Sachs showed that a national face mask mandate could potentially replace statewide lockdowns that would “otherwise subtract nearly 5% from GDP,” helping the economy.
Fredericks said she also doesn’t wear a mask because it is uncomfortable. Howes agrees, explaining that in her case, wearing a mask resurfaces trauma from her childhood. Minutes after reluctantly agreeing to wear one for work, she said, she had one of the worst panic attacks of her life.
Howes also said Utahns have a constitutional freedom to choose what medical steps they want to take — a stand Fredericks also takes. Fredericks said the virus has been blown out of proportion, and “you can’t live your life in fear.”
“I don’t think it’s the government’s place to tell me I should or shouldn’t wear a mask,” she said. “And if I want to take that risk or if I choose to put people at risk, that should be up to me.”
Myths about masks
Many Americans have raised concerns that face masks might decrease their oxygen level, but Lewis said this is rare. For some people with severe chronic obstructive pulmonary disease (COPD) and end stage kidney disease, he acknowledged, putting on a medical grade N95 mask could impair their intake of oxygen and release of carbon dioxide.
“But for simple cloth masks, there’s almost no chance of decreasing gas exchange for the average person or the average patient,” Lewis said. He posted a video on his Twitter account that shows him wearing 30 face masks and maintaining his normal oxygen level.
He also said the concern that face masks can lead to harmful carbon dioxide exposure is debunked by looking at the experiences of health care professionals.
“Surgeons at my own center who perform very complicated cancer operations will routinely wear a mask for six, seven, 10-plus hours with absolutely no decrease in their mental acuity and no increase in their carbon dioxide level,” Lewis said.
Face masks, Lewis added, do have one potential drawback: They can give people a false sense of security that makes them less likely to social distance or wash their hands properly. He also said it may not be wise to put masks on the youngest children, because they can become exposed to the virus by touching particles that accumulate on the outside of the mask.
But “aside from the very, very young,” he added, “it seems like masks worn properly and taken on and off properly are almost certainly much more good than they are harm.”
In an emotional video he recorded last week, Lewis said that two of his patients had died that day. He read an excerpt from an essay in the New England Journal of Medicine by Connecticut physician Anna DeForest, describing how COVID-19 patients die, “near no one who ever loved you.”
“Please, please, please, again, I am begging you, put this on, OK?” he said, holding up the mask he had removed as he began speaking. “It’s not going away.”
WEARING A MASK
Cloth masks chiefly decrease the spread of the virus, said Dr. Hannah Imlay, an assistant professor of infectious diseases at the University of Utah. Utahns should use a mask that covers their entire mouth and nose, she said. The fabric should be dense, like cotton. (She suggested holding a mask up to light, saying the fewer holes you can see, the better.) And ideally, cloth masks should be washed after each use.
Surgical and N95 masks are intended to be used and thrown away, she said. The benefit of those masks, she added, is that they protect the wearer along with the people around them.