This morning brings an important @Health_Affairs blogpost from a group of writers including #medtwitter allstars @FutureDocs and @meganranney, calling for a national mask mandate. Because their voices are so important, it's important to point out the gaps.
https://www.healthaffairs.org/do/10.1377/hblog20200804.515241/full/?fbclid=IwA
https://www.healthaffairs.org/do/10.1377/hblog20200804.515241/full/?fbclid=IwA
First: only a sentence or two is devoted to enforcement and implementation. Public health mandates are borne heaviest by the most disadvantaged. When a mask isn't worn, what happens to whom when and how, under what legal mandate (and with what recourse for appeal?)/1
Second: the mask-wearing is described here as mandated, but the mask *supply* is only suggested. It is unfair, not to mention contradictory, to demand masks be worn while (for example) they aren't universally available even to health workers. /2
Third: we don't know enough re *why* people don't mask. Our health system mistreats people, we mandate behaviors without realizing what lies at their root. We should give people reason to trust us (cf @JuliaLMarcus on harm reduction). We should ask them why masks are hard./3
Fourth: masks are important, but not a panacea. Mandating masks without mandating employer protections; food for the hungry; homes for the homeless; freedom for the jailed; and medicine for those lacking access is not an ethically or public-health-responsible approach./fin