This week, shortly after southwestern Missouri’s growth rate of new COVID-19 cases grew to the highest in the country, local leaders there voted against requiring masks, saying that it should be a matter of personal responsibility.
Many Missouri leaders have cited the importance of individuals accepting personal responsibility as an alternative approach to requiring masks and other mandates, but health experts say this strategy runs counter to basic principles of public health.
When Joplin, Missouri, city council debated and then rejected a mask requirement on Wednesday evening by a vote of 5 to 4, the city’s former mayor, Gary Shaw, who is a councilmember, explained his vote against the measure.
“I believe the citizens of Joplin are responsible to take care of themselves,” Shaw said. “Do we need to figure out a way to cut back on the potential increase? Yeah. But in my opinion, it’s not maintaining a mask.”
Research suggests that masks may be the single most effective way of reducing transmission of the coronavirus, and a new analysis conducted by the Philadelphia Inquirer shows that the eleven states that require masks in public have seen COVID-19 drop by 25% in the last two weeks, while the sixteen states that merely recommend masks in public saw an 84% increase.
While many communities are actively debating whether it’s necessary to mandate them, crisis communications expert Sarah Bass says that requiring masks sends a very different — and more effective message — than simply asking people to wear them.
“That kind of puts out the message that maybe it’s not that important,” Bass says. “If they are not telling us we have to do it, then maybe it’s not that important.”
Bass, an associate professor at the Temple University College of Public Health in Philadelphia, studies how to communicate to the public effectively in times of mass crisis and stress.
She explains that, throughout the pandemic, federal, state and local leaders have failed to follow many of the basic tenets of crisis communication that say leaders should communicate a single, consistent message guided by science.
“Unfortunately, that’s not what we’ve seen at all,” Bass says. “And it’s been very different in different parts of the country, and because of that, it’s been very difficult for the public to kind of grasp or take these messages to heart.”
The abundance of voices weighing in on COVID-19 — including President Trump, Dr. Anthony Fauci, health researchers, and state and local leaders — who have often conveyed conflicting information, has led to mixed signals about how to handle the virus.
“In this case, because you are getting all of these mixed messages, it’s much easier to find somebody who says what you want them to say,” Bass says.
Bass says that much of the fear and stress that led people to follow stay-at-home orders during the early months of the pandemic has been replaced by fatigue and increasing numbers of people reevaluating how they need to behave to stay safe.
The importance of wearing masks, however, has been muddled by changing messages from health experts, especially the Center For Disease Control and Prevention.
“In a very short time, like in about three months, we went from, ‘Oh, you know, we don’t need to wear masks,’ to ‘we absolutely need to wear masks,’” Bass says. “And I think that has been problematic, just from the messaging standpoint.”
Political leaders have also sent mixed messages by opting to not wear masks in public, according to Bass.
In Missouri, Governor Mike Parson did not wear a mask when visiting a thrift store in Joplin and a Bass Pro shop in Springfield in May.
“There was a lot of information on both sides,” Parson said when asked about the safety of masks.
Claire Standley, an infectious disease researcher at Georgetown University, agrees that mandating masks can send a strong message about the severity of an outbreak and the urgency of taking action to mitigate it.
But she adds that the effectiveness of these mandates can depend on a community’s relationship with its government, and mask requirements should be made with cultural differences in mind.
“I think it is important, in some way to have local control over the types of measures that are put in,” Standley says. “Because different populations have a different relationship with public authorities or different concepts of social responsibility as well.”
Standley says that, in some cases, a mask requirement could be interpreted by community members as a government not trusting them. And some people may have also difficulty wearing masks due to health issues or other reasons.
Standley says mandates must be implemented carefully.
“Particularly if there are fines or other types of penalties that comes from not complying with something like a mask order, I think it’s important to make sure that isn’t going to exacerbate any inequalities or discriminate against certain groups of people,” Standley says.
Adherence to calls for masks or social distancing can also depend on individual's assessment of their own risks.
In recent weeks, as Missouri and other states have loosened stay-at-home orders but requested that people maintain social distance, the sight of people partying in pools and doing other close-up socializing has baffled many observers, but Bass says it’s not unexpected.
Many people assess their risks with an “optimism bias,” that may make them feel protected from harm that’s affecting other people.
“It’s much easier to say, ‘I live in X, and that’s never going to happen here,” Bass says. “Because that makes us feel a lot better. It makes us feel we can function on a normal basis and be out in the world.”
However, as the coronavirus increasingly spreads in areas that have, so far, managed to avoid the worst of it, Bass thinks it’s likely that many people will see the effects of the virus more closely and reconsider their resistance to masks.
“I think the more people see this as a risk,” Bass says, “The more likely they are to comply.”