Early in the pandemic, some public health officials and experts downplayed the importance of wearing masks among members of the public. There were two main reasons for this. The first is related to SARS-CoV-2 being thought of as a "respiratory pathogen." Most such viruses and bacteria do not typically spread in asymptomatic people. This means that until symptoms occur, the risk of spread is slim-to-none for most diseases such as influenza and a variety of pathogens that cause flu-like illnesses. The thought was that if people were not having symptoms, they could go about their business and not spread it to others. Once the extent of symptom-free contagion became clear, the idea of covering the mouths and noses of people who may not know they are infected began to make more sense.
The second is that early in the United States outbreak, there was a national run on N95 masks. Unlike cloth coverings and even surgical masks, N95 masks (known as respirators) were known both to decrease the spreading of disease from a contagious person as well as intercepting droplets headed towards the noses and mouths of uninfected persons. So when the public started buying these masks in droves, the fear was the healthcare professionals, those who were most likely to be exposed to people with the virus, would not have enough. Amazon had to crack down on price gouging of the masks (and also prioritized hand sanitizer orders to medical facilities) early in the pandemic. Many experts, myself included, worried that public hoarding of personal protective equipment would leave us in the medical profession unable to perform our duties safely.
While there are still semantic debates as to the extent that SARS-CoV-2 is "airborne," most experts now agree that the largest fraction of spread is not from surfaces as we once believed, but through droplets in the air, whether from people very close by or—in the right circumstances—those recently in the room.
There seems to be a mythology among some that somehow masks might be dangerous. As we have covered in Brief19, even among persons with existing lung disease such notions are ludicrous. Meanwhile, masks decrease spread of coronaviruses from a small (6 percent) to a great extent (80 percent), especially combined with practices such as physical distancing and hygiene. This implies that many lives would be saved if mask use rates were higher.
Perhaps it all comes back to an observation made early in the pandemic; men are less likely to wear masks. More recently, President Trump insulted Vice President Biden for wearing masks too often. Could it be that the male ego among some of our leaders is so fragile that it can be derailed by a piece of cloth? Ironically, nothing could project weakness any more effectively than cowering in fear over something as benign—not to mention as helpful—as PPE.