Recent studies have shown the presence of protective antibodies for approximately six to eight months , and epidemiological analyses have reported natural immunity protection from re-infection for at least six to 12 months .
• health agencies , public engagement with science , health literacy , messaging from various sectors , past experiences with masking , mask comfort , consumer appeal , degree of enforcement by public authorities , accessibility , and affordability . They emphasize that the psychological effects of masks are culturally framed and shape acceptance and adherence : “ Mask policies aimed at fostering uptake should reflect the complex and contested sociocultural meanings and implications of mask wearing . Studies examining sociocultural and psychological factors underlying public masking amid the COVID-19 pandemic are therefore vital to identifying motivators , barriers , and disparities , and formulating behavior change strategies that encourage and sustain appropriate mask wearing .”
As the pandemic wanes with an increased uptake in vaccination , no small portion of the American population currently considers mandatory masking an impingement on civil liberties upon which the United States was founded . As Escandón and colleagues note , the “ issuance of blanket laws and punitive enforcement involves a trade-off with personal freedom . This might be counterproductive by further politicizing mask wearing , deepening structural inequalities , triggering active resistance and violence , and eroding public trust , particularly in regions with zero or little SARS-CoV-2 transmission . For the same reasons , mandating masks in circumstances that provide marginal benefit such as outdoor spaces is inconvenient . Therefore , mask mandates — targeting specific settings and situations — should only be issued upon careful analysis of the legal challenges and local implications .”
Instead of universal masking , Escandón and colleagues advocate for what they call “ smart masking ” which acknowledges nuances regarding viral transmission dynamics , risk communication , and sustainability . So ubiquitous and accepted have face coverings become now that they are often no longer questioned in terms of their usefulness relating to the evolving science . As the authors affirm , “ Masks have become normalized during the COVID-19 pandemic , and therefore the quandary of yes / no has been replaced with a debate about who , where , when , how , and what type of mask should be worn . Aligned with the WHO risk-based guidance on masks , a smart masking approach seems more appropriate than universal masking in community settings . The term ‘ universal ’ entails all persons , places , and times , but some exemptions for masking are legitimate and reasonable because of particular benefit-risk assessments . Mask exceptions should not be seen as symbolic rejections of the pandemic .”
It is common sense that not all settings and activities allow mask wearing or present the same risk of SARS-CoV-2 infection . Aligning with what we already know , Escandón , et al . ( 2020 ) say , “ The case for mask wearing is strongest in higher-risk scenarios such as crowded spaces , indoor venues , and unventilated places . The case for mask wearing is weakest in marginal-risk scenarios such as outdoor and uncrowded environments where physical distancing and ventilation may be ensured ( e . g ., people engaging in outdoor activities , people driving alone ). Additional exemptions from mask wearing include those scenarios where the mask would interfere with a particular activity or occupation ( e . g ., people eating , performers who require clear enunciation or being recorded , high-intensity or professional athletes ). Since households may represent scenarios where routine appropriate masking is impractical for members , the case for mask wearing in households is strongest when non-household members are visiting or when a household member ( who lives with other people ) is infected or has been potentially exposed to SARS- CoV-2 because of a recent potential exposure ( e . g ., occupational exposure , crowded settings , travel ). Mask policies directed toward high-risk settings , and not toward low-risk activities , are expected to foster mask adherence and acceptance and decrease mask-related discomfort and fatigue .”
As long as the pandemic is politicized and the science held for ransom to benefit a socio-political agenda , there will be misstatements made and selective guidance issued . Direct and intentional obfuscation aside , genuine uncertainty on the part of scientists should not be demonized .
As Escandón , et al . ( 2021 ) observe , “ Some uncertainties still exist regarding the wearing of face masks and coverings as a measure to prevent or mitigate SARS-CoV-2 transmission . There are COVID-19 research opportunities to obtain direct and actionable evidence on the effectiveness of specific cloth face covering designs in community scenarios , extended use and reuse of cloth face coverings , the impact of diverse approaches to mask adoption , alternatives that are more comfortable and more environmentally friendly , downsides of masking , additive effectiveness of cloth face coverings and face shields in the community , and attitudes , beliefs , and behaviors toward masking in the long term . The evidence around the relationship between mask wearing , SARS-CoV-2 inoculum , COVID-19 severity , and immunity has been poorly addressed and misrepresented in several viewpoint articles and scientific opinions … Overstating the effectiveness of masks or the existence of benefits additional to curbing viral transmission may lead to false expectations and increased exposure to high-risk places , social gatherings , and leisure activities ( in the absence of full vaccination ), which in turn may end up undermining trust in pandemic response efforts when people , exhausted from the pandemic and the response , realize masks are not infallible , severe cases still occur , and the pandemic has not fizzled out .”
Until the fear of communicating scientific uncertainty is addressed and overcome , there may be no meaningful way to break the cycle of distrust .