My Alderman and i were having a heated online debate about a new mask mandate the city had put in place until March 1st. This is my last reply that got a little long..
Continuing our debate on whether mask mandates are helpful or not I am going to switch from masks to an analogise discussion of cars/bikes, seatbelts and bike helmets to see if we can clarify where I stand on this issue in a less heated discussion.
Helmet analogy
My sister has brain damage. My father was the head of the Wisconsin Brain Trauma Association for a while in the 80’s. I know that bike helmets can save lives and brains. I believe they can work. I also know and believe that seat belts can save lives. Now that said I wear a seatbelt almost all the time. It can be a minor hassle, like maybe in the summer it might rub my neck, but really it is nothing. I appreciated the propaganda campaign back in the day to buckle up. I don’t wear a bike helmet all the time. I wear one when I go on longer rides and through downtown etc. I don’t wear one when I am going short distances in my neighborhood of Riverwest or along the bike path. A bike helmet is not detrimental to me at all but it does decrease my enjoyment and quality of life a little bit when I wear one. I love letting my head breath and feeling the wind and sun.
To clarify, even though helmets can save lives, different places with different circumstances make different choices. Some countries in Europe have way more people on bikes and way less people use bike helmets and it is still safer to ride a bike there because the road and bike path infrastructures are designed better, so bike helmets are not needed. Citizens and lawmakers in those countries are not being thoughtless and uncaring. They know that although bike helmets can save lives and brains they are not needed because the risk is so low because riding is relatively safe because of how the built environment has been designed. Accidents can still happen, and do, but they are rare enough that the loss of quality of life is not worth it. Like people do die falling down stairs but we do not outlaw or stop building stairs because the quality of life of being able to build two story homes is worth more than the risk.
Creative journey into the future
Now let’s go on a creative journey into the future. Let's say the reckless driving incidents in Milwaukee keep increasing and a number of bikers are killed. So you, the Alder persons, decide to pass a law that people have to wear them all the time on bikes. I would be angry because I think I have the wisdom to know when I should wear one. I would understand your logic but would rather you focus on the reasons behind the reckless driving itself, not making me choose between wearing a helmet or breaking the law.
Now lets keep going with this train of thought. Let's say a company like the one that was putting scouters on the street moved into town and they started putting super fast and cheap little green cars on the road that anyone could access with their phone and drive off in. The rash of reckless driving increases dramatically. Kids that don’t even know how to drive are jumping in them. The company is advertising on TV. The government is giving them tax breaks because they are contributing to political campaigns etc. We have a huge increase of fatalities in crashes including ones where bikers and pedestrians get killed. So our Alder persons are super concerned and decide to pass a new law that all pedestrians and people near cars, bikes and roads need to wear a bike helmet. Now even though I know/believe that bike helmets can save lives and brains I am beyond astounded. I am angry and offended. I don’t think that bike helmets pose any danger nor any deep emotional and physical drawbacks, but I am angered by the laws that once again make me have to choose to break the law or not and that do not address the real problem. The root problem of the issue is not being addressed and the number of lives saved by helmets being worn all the time is now very indirect. What we really need to do then is address a number of issues. We need to stop the advertising of dangerous cars. We need to regulate their use. We need a long term plan to design safer roads and a better mass transit system. We can go deeper and address poverty, meaninglessness, lack of education and depression that lead to reckless behavior by providing even better infrastructure and social support and laws that deal with corporate predation of the poor. Quality schools and afterschool programs, vibrant community centers with thriving business etc. All this takes lots of time and investment that our country and city have not been doing well for decades so it would be a slow road but more than worth it. But even though slow, it is possible. We can witness that other countries have been doing much better on implementing these investments than us. Just legalizing drugs, putting an end to the industrialization of our prison system and focusing on supporting the emotional health of our citizens like Portugal would be a great start. Now drug laws may feel like they are a long way from car bike safety but this is false. They are deeply related. Kids that are part of a healthy community; with healthy families, fathers that are present and meaningful employed etc, are less likely to jump into cheap cars and drive in careless or even suicidal rages.
Investment in Soil
Here I will briefly switch analogies within the analogy to that of soil. In a garden you can invest in cheap fertilizer and pesticides for short term gain or you can invest in building great soil. In the long run great soil will be the easiest to work and yield the best returns and is better for the long term health of the environment. Investing in healthy social structures is a long term investment like soil health. If your plants are yellow or there are aphids attacking your plant you might use a short term solution but you should also be addressing long term solutions.
Two Terms and my personal experience with them
Before I go on I would like to differentiate two terms I use and my experiences of them. “Covid-19” which I am calling “covid” is a virus that is new to humans and causes sickness, disease and even death, especially in those with other weaknesses and illnesses already. We live in the country with the highest rate of the comorbidities for covid on the planet. Within that country we live in a city that is also on the high end of comorbidities. “The war on Covid” which was/is our reaction as a culture to the dangers of “covid.” “The War on Covid” includes: A fear of covid campaign in our media and social media, socially distancing people, mandating that we wear masks in public and sometimes closing businesses and schools, shaming “anti-vaxxers' and vaccine passports that affect how people move and live. This “war on covid” affected our social and political world in huge ways. It has torn families apart and ended friendships. Now these two things happened somewhat simultaneously, although for many like me, the “war on covid” started much earlier than the actual wide spread of “covid” itself in my community. So way before I knew anyone that was sick my business was closed, my income shriveled up, I was no longer taking part in many of the healthy activities that I normally would like yoga classes with others, dancing, singing, and hugging. I was not seeing my friends or parents. I was feeling almost constant stress and not sleeping well. My health declined and I would guess it was at least in part because of the stress and change in lifestyle. Within months, still before I knew anyone who got sick I was witnessing my tenant, previously an at risk but active and engaged 22 year old become an active alcoholic. In an effort to protect his elderly roommate he almost never left his house and started drinking large amounts of wine that he had delivered to our house. My 13 year old son lost all of his social life except on screens. He moved less, gained weight, and had little to no reason to go outside without his mother prodding him. My older son dropped out of school at UWM for a year and became addicted to videogames. He now is struggling with that addiction and very challenging sleep cycles. A year after covid came to the US both my boys and their father got covid and were fine. The elderly tenant, I and the other young man did not. My younger son still has to wear a mask at school and has had school canceled a number of times. He has been sent home because of “risk” of exposure and has had to be tested over and over just to go to school. So me and my family were slightly affected by “covid” and but highly affected by the social changes or as I call them the “war on covid” measures. The effect of the “war on covid” and how it has affected my life and how I have witnessed it affect others is something I could write a small book.. They are not up for debate because they are my truth. You can do research about each one of the negative impacts I witnessed and you will find they are wide spread. Many of these problems were already on the rise but rose even more dramatically from 2019-2021. Obesity in children and adults is way up,.. Reports of loneliness are up, Alcoholism is up, deaths by drunk driving are up. Many of these issues affect not only our social health but also our abilities to fight disease.
Mask debate
Let's bring this all back to the masks (and I will add social distancing) debate. To see if we can be on the same page here. As I acknowledge that masks can save lives in the right circumstances I would like to see if you can acknowledge that unlike bike helmets and seatbelts, masks have more social, emotional and physical drawbacks.
Stress and autonomic and parasympathetic nervous systems
Now the next thing I would like us to acknowledge is that social connections and emotional health affect physical health. As I acknowledge masks can help slow (or even stop) the spread of disease when used in the right way, I think it is imperative to acknowledge that humans are social animals and when we feel safe, loved and connected we have better immune system fonctions. Our autonomic and parasympathetic nervous systems are activated by what we see and take part in in our environment and social world. They act as a seesaw. When one goes up the other goes down. They both release hormones that affect not only our emotions but how our bodies function.
The sympathetic nervous system prepares our bodies for the “fight or flight” response during any potential danger. Chronic stress also activates our sympathetic nervous system. So when people don’t feel safe, when they are told they are in danger they heal slower and can even have suppressed immune systems. This is because when there is danger our bodies put our energy into immediate fight or flight. A person's body does not worry about fighting a cold when they are being chased by a lion. When we feel safe and relaxed the opposite is true.
Our autonomic nervous system is activated when we feel safe and relaxed. When it is active we get less sick, we heal faster and live longer. It has been long acknowledged that all the “Blue zones” where people live the longest in the world have very strong communities. People know their neighbors. They see people smiling at them and saying their names. They feel safe. They have reasons to live. This long life expectancy is widely thought to probably be partly because their autonomic nervous systems are activated by positive social connections and relatively relaxed social environments which fosters strong immune systems.
Nocebo effect
Also to be acknowledged is that the placebo and nocebo effects are real. We may not fully understand why this is and how the nervous systems and our beliefs play a part in health outcomes but it is well documented and part of why control groups and placebo groups in medical studies are so important.
Stress
The “covid” and “the War on Covid” connected to the increase of stress:
Here is just one of thousands of articles we can find linking “covid” and “the war on covid” to an increase in stress and anxiety.
Here is another from the CDC “During August 2020–February 2021, the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased from 36.4% to 41.5%, and the percentage of those reporting an unmet mental health care need increased from 9.2% to 11.7%. Increases were largest among adults aged 18–29 years and those with less than a high school education.” (Note here the group with the largest gain 18-29 year olds are at incredibly low personal risk for adverse reactions to “covid” itself)
Is the ‘War on covid' part of the problem?
Now we can go deeper into this debate if these increases in stress and anxiety are correlated or causal, but first we need to admit they are happening. If you can admit, by reading studies such as above, that an increase in anxiety and stress is happening, then we can debate the cause. I would argue that the ‘war on covid' is a large part of the problem because of my personal experiences and what I have witnessed and what I have read and researched. I would argue that when we do not have the opportunity to see people smile at us, that when we see a mask on another person's face it activeats our sympathetic nervous system because we are reminded, or told through the sight of the mask, that there is a dangerous disease out there. With nocebo in mind, we can ask if there is a nocebo effect in place when we see them on others and are told to wear one. That is, do they send a message to people that they are likely to have negative outcomes if they get covid? I would argue that they do have a nocebo effect. This may actually be the opposite for you. Masks in public may help you feel safe. But I would point to the above studies on stress and anxiety to suggest that you are likely in the minority. If Americans are more stressed than ever than there could easily be muntipl factors causing that up-turn in stress. Perhaps it can all be blamed on just “covid” but that seems unlikely as for most people in the US the virus itself was not even in full swing at all until long after the increase in reported stress happened and the vast majority of people have actually come through their encounter with the disease unscathed. (As for “Long covid” we could engage in a whole new discussion and investigation, as I realize it is worrisome to many, but I will just leave this link here.) We could also likely put partial blame on the “war on covid” and things like mask wearing. This will be hard to prove but is certainly up for debate. With the nocebo effect in mind, the continued heaping of fear in our people can be considered not only sad, but dangerous and irresponsible, as it increases the risk that when people are exposed ot covid they are at far greater risk of adverse effects. (Here is Dr.Vinay Prasads take on trying to begin to tease out the differences of how “covid” and our “reactions to covid” affected us)
So when I go to the grocery store and there is a sign that danger to covid is in the “red zone” and masks are required, I see a sign that is actually perhaps putting people in more danger as it is lowering their immune system and helping them believe when they get sick that they are in more danger of dying. As you can guess this triggers me to feel protective of my people and angry about this irresponsible behavior the same way I imagine you may feel when you see someone unmasked because you have been adhering to a different train of thought, that that is risky behavior.
Masks possibly be a detriment to health
So it is up for debate if masks can be a detriment to our health, but there is strong evidence that they might be and for sure evidence that they are part of a systemic reaction to covid that has been unhelpful and even dangerous. So I would then argue that unlike seatbelts and bike helmets, the implementation (and mandating) of masks in public places such as stores, yoga studios and schools is not clearly benign but actually risky and so must be done when there is only strong proof of a benefit or increase of safety in another area.
NOW we get to now.
Now there is still some proof that masks will slow the spread of a virus. There is also proof that covid is not going away. It has been around for 2 years. The vast majority of our population has been exposed to it at least once and there is a vaccine that decreases the risk of severe illness. Our hospitals have had two years to prepare and the peak of covid spread is past. Given all these variables and the downside of masks we must do a risk/benefit analysis. I have personally done mine and decided that the continued use of masks is like the use of bike helmets in our above metaphorical story of wearing bike helmets on the sidewalk. But worse in that there is a risk that it is detrimental to our health. Like helmets, it is just nicer to not wear a mask. Like bike helmets when walking on the sidewalk, wearing a mask in public is currently not saving any worthy number of lives. It is distracting us from focusing on longer term solutions, and more than bike helmets it can be argued to be unsafe and unhealthy.
NOW we can understand it is no longer time to mandate masks but to time to invest in long term health. Like investing in bike paths instead of mandating helmets. Because obesity, diabetes and sleep disorders play such huge roles in negative outcomes to covid, we can work to educate Dr’s on how to educate their patients about diets and healthy lifestyles choices. We can have a health propaganda campaign instead of a fear of covide campaign. Perhaps we can mandate longer times for Dr’s to spend with patients. Perhaps we can regulate ads for junk food. We can work on better food in our school lunches… Most of the solutions I imagined for the reckless driving problem above would also apply. This also could be a book of ways we could be creatively proactive in healing our communities and there are books out there already. So I will refrain from listing them further but I assume any reader who got to this point can imagine ways to be proactive and build the “soil of health” in our city and country.
We both have the same goal. We want healthy, relatively safe communities. We may see the paths to doing that differently, but by listening to others, researching, and thinking creatively and proactively, perhaps we can find ways to agree on what health and safety look like and how to implement programs and policies that increase them.
