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By Rebecca Karb
COVID cases are falling and the worst of the Omicron wave seems to be behind us. As the dust settles, more and more states and school districts are lifting mandatory mask requirements [Rhode Island’s statewide mask mandate ends March 4]. This is a long-awaited and welcome move; no one could have predicted how long mandated masking would last, but certainly no one wanted it to last forever. An important question moving forward is: how will we reflect on the last two years and frame our experience of masking? History will not look back on nearly 6 million worldwide deaths (known to be significantly undercounted) and lament relatively benign restrictions such as masking. When we finally take off our masks, we should do so with a sense of pride in what our community has accomplished together and an open mind for the future.
What we have learned over the past two years is that masking is an important part of a multi-pronged approach to mitigating spread beyond our healthcare system’s capacity. Overwhelming evidence from the past two years has shown that masks work and are effective across a range of settings. If one approaches the data with objectivity (and not with a preconceived belief in search of confirmation), it is clear that masks are an indispensable tool in our public health toolbox – easy to implement and quick to take effect. Evidence also shows that the effectiveness of masks at mitigating surges is dependent on the percentage of the population that masks. In other words, masks work better at the population level when more people wear them. It’s a real life parable on how a whole can be greater than the sum of its parts.
Outside of their isolated benefit in the context of a deadly pandemic, it’s obvious to everyone that our kids are better off without masks. There are very real downsides that should not be ignored. However, many concerns have been distorted, overstated, and hyperbolized by radical disinformation campaigns. For example, despite pervasive myths, masks do not affect respiratory mechanics or oxygen and carbon dioxide levels. Nor do they seem to interfere with effectively reading facial expressions any more than a pair of dark sunglasses. Rates of depression and anxiety among kids are up since the pandemic, but isolating masking as the cause independent of the effect of living through a pandemic (including school closures as well as sickness and death among family and friends) is impossible and frankly disingenuous. In fact, for many kids and adults (especially those not on the frontlines) the pandemic brought about feelings of helplessness, and masks offered an opportunity to regain agency and connection by participating in the larger fight against COVID. My children continue to feel like they are contributing to the greater good when they mask up, and this pride and sense of responsibility has been an unexpected but important part of their development.
Understandably, many are eager to feel unburdened by the obligation to others that masks embody. But humans are social creatures and living together requires collaboration, responsibility, and sometimes sacrifice. From the oldest parables to the newest children’s books, human history is saturated with lessons on the responsibilities that come with communal living and the value of teamwork. Caring for our neighbors and working together to protect the vulnerable is a part of the human story, and one that we should be honored to pass on to our children. COVID has taken so much from us; we cannot let it steal our compassion. If we emerge from this experience with nihilistic individualism as our new mission statement, then we have lost a part of our collective soul to COVID.
There will inevitably be new variants and new surges as we settle into a new normal of endemic COVID. Armed with growing (and evolving) evidence, we can hopefully approach future surges with scientific nuance and a common goal of balancing freedoms with safety. I will be relieved to take my mask off when it’s time. My kids will too. But we are all prepared to mask-up again in the future for short, well-defined periods if and when a surge hits our community and we need to work together to curb the spread. We should do so with pride and with compassion, and the understanding that nothing lasts forever.
Rebecca Karb, MD, PhD, an emergency room doctor and researcher at Brown University, has three children in EG schools.