The Facemask: An Overreaction or 2020’s Seatbelt?



Seatbelt use became law as early as 1984 in the United States. The state of Illinois adopted this as law in 1985. Shortly after adoption of this law in Illinois, four people challenged the constitutionality of this law in court after they had been penalized for failing to comply. Ultimately, the Supreme Court would uphold that the law did not infringe on any constitutional rights. During this early resistance to the legislation of seatbelt use, the public’s dominant thought was that the new rules infringed on individual rights, and also intruded into private life (see Hayden’s article in the list of resources). As of today, all but one US state (New Hampshire) have seatbelt laws (primary or secondary). And almost without question, we meet these expectations, and accept the risk of penalty when we fail to comply.


During this early resistance to the legislation of seatbelt use, the public’s dominant thought was that the new rules infringed on individual rights, and also intruded into private life.

Public health concerns fueled the movement to enact seatbelt laws. As a result of seatbelt use in 2007, the U.S. Department of Transportation estimated 15,147 lives were saved. In 2016, 23,714 deaths occurred in passenger vehicles, with over half of the deaths involving unbuckled teens and adults. This is the scale of the “seatbelt problem.” We’ve accepted a law because it prevents a range of 11,857 to 15,147 deaths annually. In less than half the time, the coronavirus has resulted in roughly ten times more deaths (143,190) in the United States. Clearly, the “coronavirus problem” carries greater death risk than the “seatbelt problem.” Yet, the resistance to the coronavirus’ “seatbelt” remains staunch. Why?

Set aside real medical concerns and issues with having to wear a mask, such as post-traumatic stress disorder, claustrophobia, and a few other conditions, a few reasons come to mind:

  1. Human beings are just hard-wired to resist change

  2. People believe it is an infringement on their freedom and liberty

  3. The virus is blown out of proportion by the media – “it’s all propaganda”

  4. People have strange unscientific beliefs about the dangers of wearing a mask

  5. People just find it annoying to have to wear a mask

  6. “There’s no point hiding from the virus, we’re all gonna get it anyways”

  7. “We don’t even know if the mask actually protects us”

  8. “I can’t live my life in fear. I choose freedom”

As your “favorite opinionated doc,” allow me to help you re-frame your thinking on some of these ideas. I’ll be as short as possible.

The infringement on freedom and liberty argument falls to the wayside when you consider the history of the seatbelt laws as stated above. This “rights and freedoms” view exists mainly because we all weren’t born into a “masked-up” world. In contrast, because you were born into a world of mandatory seatbelts, you don’t see it as an encroachment on your rights and freedoms – you see it as common sense. The experience of the transition in real-time (from a “mask-less” to a masked-up world) is what gives rise to this “rights and freedoms” position.


We’ve accepted a law because it prevents a range of 11,857 to 15,147 deaths annually. In less than half the time, the coronavirus has resulted in roughly ten times more deaths (143,190) in the United States.

The virus would be “being blown out of proportion” if it wasn’t ten times as fatal as the seasonal flu, or significantly different from the seasonal flu in many ways. The seasonal flu does not lead to blood clots in multiple blood vessels all over the body (leading to strokes, lung blood clots, and “heart attacks”). The seasonal flu does not trigger your body into eating up its nervous system (Guillain-Barré Syndrome). It does not typically lead to injury of your heart muscles. It does not typically kill healthy adults who have no pre-existing medical conditions. All these things are the work of this new COVID-19 virus. Many of these, I’ve read in medical reports; others, I’ve learned from my medical colleagues on the frontlines of the coronavirus pandemic. In addition to these real-time effects of the virus, one can only imagine what the long-term impact of the virus will be on survivors’ future health – some viruses lead to blood and immune cell cancers multiple years after the original infection. Remember that thirty percent of COVID-19 infections will require hospitalization, while ten percent will require intensive care, and one to three percent will die – so it’s not quite the smooth ride that many believe it will be if they get infected. Take it from a medical professional – the coronavirus is not blown out of proportion.

Is the media weaponizing the pandemic to oust Donald Trump? Absolutely. Donald Trump made some reckless statements that significantly hurt the public health response to curtailing the pandemic in the United States. He called it a “hoax” at first, suggested using bleach – which, given my medical experience, patients will try out of desperation because they “heard it from the president” – and he continued to blow it off, saying it will “disappear.” As a president, every word you utter matters significantly in responding to a public health crisis – in fact any type of national crisis. And this is where Donald Trump made some major mistakes. In typical media fashion, they will capitalize on these errors, just to further their agenda. But this single fact/realization does not make the virus a “made-up” propaganda.


The seasonal flu does not lead to blood clots in multiple blood vessels all over the body (leading to strokes, lung blood clots, and “heart attacks”). The seasonal flu does not trigger your body into eating up its nervous system (Guillain-Barré Syndrome). It does not typically lead to injury of your heart muscles. It does not typically kill healthy adults who have no pre-existing medical conditions.

Now comes the idea that completely blows my mind – the idea that masks “activate” certain viruses or bacteria in your body, or can make you develop certain “illnesses” or pass out from “low oxygen levels.” These are outrageous, unscientific ideas – although the idea that a mask will be a bacterial petri-dish is not false, these bacteria were already in your mouth and nose, and are not expected to cause any new illnesses that you won’t have developed otherwise. You must be a non-believer in science to believe these things. I’ve been to the gym in a cloth mask, and I completed a vigorous workout without having any breathing issues. By the way, the gym is one of the most important places to wear a mask since you breathe heavier and expel more aerosols during intense exercise.


How about “I can’t live in fear” as the reason to resist mask-wearing. In fact, wearing a non-medical grade (N95) mask is not meant to protect you. The virus is so small that it can pass through your non-medical grade mask if there are enough viral particles suspended in the air. The reason that you wear a mask is to decrease the number of viral particles suspended in the air, so that the people around you have a lower chance of picking up the virus. So, someone else's wearing of a mask protects you more than your wearing of a mask.


In summary, the resistance to wear a mask comes down to one simple truth – humans are hard-wired to resist change. When you can accept this about your feelings towards wearing a mask, it may become a little easier for you to call yourself on your own b.s., and just be a leader and wear a mask!


#yourfavoriteopinionateddoc #publichealth #coronavirus #COVID19 #wearingamask #maskup #rightsandfreedoms #choice #mandatorymask #publichealthpolicy

Resources:


Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Napoli RD. Features, evaluation and treatment Coronavirus (COVID-19). StatPearls [Internet]. 2020. StatPearls Publishing: Treasure Island, FL. USA. Accessed March 20, 2020 at: https://www.ncbi.nlm.nih.gov/books/NBK554776/?report=classic

Centers for Disease Control and Prevention. Motor Vehicle Safety: Primary Enforcement of Seatbelt Laws [Online Publication]. 2015. Accessed on July 22, 2020 at: https://www.cdc.gov/motorvehiclesafety/calculator/factsheet/seatbelt.html

Centers for Disease Control and Prevention. Motor Vehicle Safety: Seatbelts: Get the Facts [Online Publication]. 2018. Accessed on July 22, 2020 at: https://www.cdc.gov/motorvehiclesafety/seatbelts/facts.html

Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Inf Dis. 20(5):533-534. doi: 10.1016/S1473-3099(20)30120-1. Accessed on July 22, 2020 at: https://coronavirus.jhu.edu/map.html

García-España JF, Winston FK, Durbin DR. Safety Belt Laws and Disparities in Safety Belt Use Among US High-School Drivers. Am J Pub Health, 2012;102(6):1128-1134. doi:10.2105/AJPH.2011. 300493. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483950/pdf/AJPH.2011.300493.pdf

Hayden RM. Cultural Context and Impact of Traffic Safety Legislation: The Reception of Mandatory Seatbelt Laws in Yugoslavia and Illinois. Law & Soc Rev., 1989;23(2):283-294. https://www.jstor.org/stable/3053718

Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017 [Online Publication]. National Vital Statistics Reports. 2019 (Vol. 68, No. 9). National Center for Health Statistics: Hyattsville, MD, USA. https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf

Studdert DM, Hall MA. Disease Control, Civil Liberties, and Mass Testing – Calibrating Restrictions During the Covid-19 Pandemic. N Eng J Med., 2020;383(2): 102-104. doi: 10.1056/NEJMp2007637. https://www.nejm.org/doi/full/10.1056/NEJMp2007637?query=featured_coronavirus#.XxgzuL_Xrw8.twitter

U.S. Department of Transportation. National Highway Traffic Safety Administration. Lives Saved Calculations for Seatbelts and Frontal Airbags [Online Publication]. 2009. Accessed on July 22, 2020 at: https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/811206.

U.S. Department of Transportation. Seat Belt Laws [Website]. 2015. Accessed on July 22, 2020 at: https://www.transportation.gov/mission/health/seat-belt-laws

van Doremalan N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared to SARS-CoV-1. N Eng J Med., 2020;382: 1564-1567. doi: 10.1056/NEJMc2004973. https://www.nejm.org/doi/full/10.1056/nejmc2004973