WASHINGTON (Sinclair Broadcast Group) — Recent experience with the coronavirus has left little doubt that the use of face masks can significantly slow the spread of the coronavirus, yet with coronavirus cases topping 2.5 million in the U.S., only 17 states and Washington, D.C. have required their use in public places amid partisan controversy.
Rather than being a matter of science, wearing a mask has become interwoven in partisan politics. President Donald Trump has rarely been seen wearing a face mask and has made it a point to not appear on camera with his face covered.
According to a recent Pew Research poll, only 49% of conservative Republicans reported wearing a mask regularly, compared to 60% of moderate Republicans and 88% of Democrats.
Another poll by Axios-Ipsos found that between May 8 and June 22, two-thirds of Democrats reported wearing a mask, whereas slightly more than one-third of Republicans reported consistent mask-wearing during that same period.
President Trump's critics have faulted him for failing to show leadership by refusing to wear a mask in public and not issuing an executive order mandating the nationwide use of face coverings.
In a Sunday appearance on ABC's "This Week," House Speaker Nancy Pelosi, D-Calif., insisted that a national mandate on the use of masks is "long overdue." She criticized the president for flouting Centers for Disease Control and Prevention guidelines, which recommend cloth face coverings for everyone in situations where social distancing is not possible.
"Real men wear masks," Pelosi said. "Be an example to the country and wear the mask."
Retiring Democratic Rep. Denny Heck of Washington told Sinclair Broadcast Group that President Trump "is contributing materially to the problem of people not wearing a mask by his refusal to do so."
Ahead of an indoor campaign rally in Tulsa, Oklahoma last week, Trump signaled that his supporters could "do what they want" and that face-coverings would be optional. In the past, he has mocked mask-wearing as "politically correct" and ridiculed his political opponents for covering their faces in public.
"It's unfortunate this has become a controversial topic and I don't believe it should be controversial," said George Wehby, a researcher at the University of Iowa Department of Health Management and Policy who recently published a study documenting outcomes from states that mandated mask use during COVID-19.
The University of Iowa study offered the first real-world evidence of the effects of the masking policy. The researchers found the states that had mask requirements saw a significant decline in daily COVID-19 growth after the mandates took effect. According to the study, potentially 230,000 to 250,000 cases may have been averted by the end of May as a result of state mandates.
"The effects are not necessarily small," Wehby noted. "We believe the estimates are directly relevant for policymaking in terms of providing a sense of the effect of the policies."
As more states and local governments grapple with a surge in coronavirus cases, many are beginning to reconsider mask requirements. They have a growing body of research supporting the conclusion that the near-universal use of face coverings can suppress the growth of infections dramatically and can also help the country reopen faster.
Another study by a group of international researchers determined that, over the long term, locking down the economy was less effective in combating new coronavirus cases than having 80% of the population use masks. Moreover, researchers found near-universal use of masks was linked to the elimination of the disease over time.
Despite reluctance among some groups to wear cloth face coverings, Pew Research found that up top 65% of U.S. adults regularly wear masks when they go out.
In recent weeks, more political leaders on the left and right have been seen embracing mask use. This past week, several members of the Trump administration donned face masks in public and urged Americans to do the same.
Vice President Mike Pence was seen wearing a cloth mask at a meeting in Dallas, Texas this weekend, an area hard-hit by the pandemic. Housing and Urban Development Secretary Ben Carson was also wearing a mask, as was White House coronavirus task force coordinator Dr. Deborah Birx.
During a press conference, Pence told Americans, "Wearing a mask is just a good idea and it will—we know from experience—will slow the spread of the coronavirus,"
The president's attitude flies in the face of the recommendations of the Centers for Disease Control and Prevention, members of his coronavirus task force and recent studies that demonstrate the effectiveness of masks.
"The president, we know, is a very unique circumstance as leader of the free world," Secretary of Health and Human Services Alex Azar. In an interview Sunday on NBC's "Meet the Press," Azar defended the president's decision not to wear a mask in public, saying Trump is "in a bubble" where he and those around him are tested constantly.
The HHS secretary went on to encourage people to practice social distancing. "If you can't, wear face coverings. Practice appropriate personal hygiene. And always please consider your individual circumstances and those of your household members."
Recommendations appear to carry only so much weight when it comes to encouraging people to put on a mask, explained Jeremy Howard, co-founder of the volunteer organization #Masks4All and a research scientist at the University of San Francisco.
"If you don't have that mask mandate in your state, your transmission rate will be from three to ten times higher than it would be otherwise," Howard noted.
Partly, that can be explained by surveys that found people in states that don't have mask mandates wear them at a lower rate than states that have the requirement. "It seems to us the way to get most people to wear masks is to tell them they have to," Howard added.
New York Gov. Andrew Cuomo mandated mask usage in public in April, amid the state's surge in coronavirus cases and deaths and later allowed businesses to deny entry to anyone refusing to wear a mask. The state's ability to contain COVID-19 has been credited, partly, to the mask mandate.
At a Monday press conference, Cuomo urged President Trump to prove he was "New York tough" and issue a similar mandate requiring masks nationwide.
"Let the president have the same sense and do that as an executive order. Let the president lead by example and let the president put a mask on it," Cuomo said. "Because we know it works. We’ve proven that it works in the state of New York."
The overall benefits of masking tend to far outweigh the perceived disadvantages. Outside of the United States, countries and territories with near-universal masking have seen fewer coronavirus cases and fatalities as well as relatively less damage to their economies, including South Korea, Vietnam, Taiwan and Hong Kong.
While there is some reluctance to mask-wearing in the United States for cultural reasons, many people are doing it for political reasons or because they distrust the information they are receiving about the virus.
A lot of people have also reported not wearing a mask for ideological reasons, or because they believe it's a sign of weakness, Howard noted. "That's a terrible reason to kill people and to destroy the economy, to protect the vanity of a small group of people."
Rather than requiring masks, states including Arizona, Florida and Texas have reinstated some restrictions and paused the reopening of their economies. California has also slowed its reopening and the governor issued a statewide masking mandate June 19.
"Why is it a higher priority to not wear a mask than to close down the economy?" Howard asked.
At a time when the country is already divided, some states have questioned whether requiring masks is worth fanning the flames.
"We are probably as under pressure as a country as we've been for a very long time," said Clay Marsh, coronavirus czar for the state of West Virginia and vice president of Health Sciences at WVU. While noting that wearing a mask was a simple public health measure, Marsh supported the West Virginia governor's decision not to mandate mask-wearing. The state has had a low rate of infections and deaths and widespread testing.
"I do believe there is a great benefit in holding people together," he added, noting the mask issue has become a "flashpoint" for controversy and division.
While many people have seen the evidence in favor of wearing a face mask as overwhelmingly beneficial, others are skeptical. "A lot of people see things differently than others and I think there's a general distrust of science today, maybe more than we've seen before," Clay said.
Disagreements over whether to mandate mask use are "at the basis of what we perceive as our liberties and freedoms" Clay continued. "The question is at what level do you need to adjust your own sense of personal freedom for the greater good?"
In four states, Iowa, Montana, South Dakota and Wisconsin, there is no mask requirement. Another 29 states have local mandates or require that certain types of workers, like food servers or retailers, cover their faces when interacting with the public.