Masks forever?

There are arguments over the effectiveness of some covid measures. Similarly there is some room for disagreement on how bad the negative side effects of measures are. But the most stark disagreement seems to be over whether covid remains unpleasant or dangerous enough to warrant a “new normal”, where we continue to make transmission suppression efforts that we never made before (such as masking, or avoiding crowds or busy indoor places). Some see these interventions as now belonging in the same category as seat belts, treatment of water to make it safe to drink, sunscreen, and toothbrushing. I found this surprising, and have tried to understand how different people can think so differently about this.

Pandemics have always come and gone; I never envisaged that the old normal wouldn’t come back. Especially if there was an effective vaccine. I guess I believed early on that this virus would become endemic, and that immunity was going to be the way out of the crisis, however painful a process it entailed. My hopes are pinned on our ability to adapt to its presence, to the effect that more frequent exposure may even be better for most people – making covid less unpleasant and dangerous (more often asymptomatic or mild). It certainly seems ordinary colds are hitting people harder now with the immunity debt caused by lockdowns.

If this is true then, in the long run (and post vaccination), on average, harms are paradoxically mitigated by opening up. More covid = better health! But like all hormesis phenomena it isn’t black and white. There is risk involved with exposure to covid. It will happen to virtually everyone sooner or later, but for some individuals, maybe less frequent exposure – i.e. delaying the inevitable, and fewer lifetime infections – is worth the cost of somewhat restricted social lives and indefinite N95 usage.

Even the sunscreen example has an element of that – using high-factor sunscreen makes you stay pale and therefore more vulnerable to burning; it also inhibits vitamin D production. But adaptation to sun exposure does carry the risk of skin cancer. Similarly, adaptation of young children’s immune systems to a milieu of viruses sets them up for good health, but the exposure also brings some risk of severe illness and even death – even with the more major threats removed by immunisations.

But I think a lot of the “masks forever” people do not see the virus as something humans can adapt to at all, and they express anxiety about nasty, as-yet-unknown harms that will emerge over the longer term. This is arguably no different from the people fearing the exact same thing about the vaccines. It seems like for those who are inclined to be afraid, what you fear is dictated by your political tribe, which is interesting as well.