Question for Surgeon General: Do you regret telling the public early on not to wear masks?

If Trump loses this fall, a what-if for historians will be “What if his administration had strongly endorsed mask-wearing in February, at the first sign of community spread in the U.S.?”

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For all the ink spilled about his tweeting and impeachment and dubious moves like pardoning Roger Stone, it’s conceivable that an emphatic pro-mask message from the feds on day one would have produced a much less severe epidemic in the United States. And the epidemic is the thing that’s blocking his reelection right now. Change that one variable and he’s probably a slight underdog against Biden at worst, possibly even a slight favorite depending on how well the economy weathered the first, much smaller wave of COVID in the “universal masks” scenario.

The failure of the president’s experts — starting with Jerome Adams but including Fauci (who was also bearish on masks early) and of course the CDC — may have doomed Trump to defeat in November more so than anything the president himself has said or done.

But that hypothetical may be too charitable to him. Even if Adams, Fauci, etc, had gone all-in on masks early, it’s hard to imagine Trump himself going along. All of the now familiar objections to mask-wearing would have remained: They’re unmanly, they’re a politically correct form of “social control,” they’re a tacit admission that the virus is a serious threat rather than “just the flu.” It took until July 11, with his polling in the toilet and a second wave of the disease raging through battleground states, for POTUS to finally agree to be photographed wearing one and only then during a visit to a hospital.

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In fact, at Trump campaign headquarters, they’re basically anathema even now.

Facing no threat of enforcement, the Trump campaign has continued to make its own rules on coronavirus protections, said the individuals, who requested anonymity to speak freely. For instance, staff have been told to wear masks outside the office, in case they’re spotted by reporters, but they’ve been instructed that it’s acceptable to remove them in the office, the individuals said, adding that staff also publicly joke about the risk of coronavirus and play down the pandemic’s threat.

“You get made fun of, if you wear a mask,” said one person. “There’s social pressure not to do it.”

The individuals described an environment where campaign staff have been discouraged from telling colleagues whether they were exposed to the virus, particularly after a series of negative headlines about multiple campaign staff testing positive ahead of last month’s campaign rally in Tulsa, Okla. Instead, campaign staff have been encouraged by officials to quietly self-quarantine when they are thought to have come in contact with the virus.

Maybe that’ll change now. Some of Trump’s fans and deputies, including Brad Parscale, hooted last night on Twitter after the photo of a masked Trump began circulating that Joe Biden’s chances of winning this election had just gotten a lot smaller. That was their way of trying to influence the president, knowing that he follows social-media chatter from MAGA Nation. If they can make him feel more comfortable wearing masks by convincing him that he looks bad-ass in them, he’ll wear them more often, then maybe his fans will wear them more often, then maybe the pandemic will slow down a bit. It’s the sort of psychology you’d use on a kid, but if it works, it works. Besides, they’re not wrong that Biden’s chances will be hurt at least a little by Trump wearing masks more frequently. Slowing the spread is an absolute prerequisite to him winning a second term. His cultural influence will make mask-wearing more common and that should help slow the spread.

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My guess is that a pro-mask consensus early on by the administration would have improved things somewhat but wouldn’t have delivered a durably good outcome for the U.S. like we’ve seen in South Korea and Taiwan. Even in a best-case hypothetical in which Adams and Fauci shout “MASK UP NOW!” on February 15, the public follows their advice, and case counts in March and April turned out to be a fraction of what they were in reality, we would have ended up victims of our own success. The economy would have slowed down even absent any stay-at-home orders as frightened consumers began avoiding businesses for awhile, and mask skeptics would have looked at that and at the low case counts and howled: “We told you this virus was massively overhyped! Look at the economic damage we’ve suffered, and for what? There are barely any cases anywhere!”

Then many people would have taken the masks off and we’d be back on the track we’re on now. We were never going to avoid a bad outcome. Adams and Fauci — and Trump, if he’s now willing — can only do so much to correct for the dumber impulses of American culture.

But we shouldn’t let fatalism lead us to let Adams off the hook. He defends his terrible early advice in the clip below by noting that we didn’t know nearly as much about the virus in February: We thought it spread mainly through contact with surfaces instead of via the air and we had no hard evidence yet that masks prevented transmission or that asymptomatics were contagious. Right, but precisely because the virus was novel and our knowledge of it was so thin, why didn’t he, Fauci, and others encourage the public to err on the side of caution and take maximum precautions, starting with mask-wearing? Adams’s analogy to other badly outdated medical advice (e.g., prescribing cigarettes for asthmatics) doesn’t wash considering that Asian countries like South Korea which have had recent experience with deadly viruses like SARS went all-in on masks early on. It would have been simple to say, “We should follow the example of nations that struggled with SARS until we know more about what we’re up against.” Why didn’t they?

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