Fauci reverses: Maybe it's time for a national mask mandate

“A national mandate probably would not work,” he said as recently as six weeks ago. But last night he seemed to reconsider after being pressed by Erin Burnett, waving away the potential enforcement problem by saying, “if people are not wearing masks, then maybe we should be mandating it.”

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I don’t think he’s talking about a federal mandate. I can’t imagine that that would be constitutional or feasibly enforceable. Even Biden, as you’ll see in the clip, seems to grasp that a national mandate would have to come from all 50 governors agreeing to impose one at the state level, not via federal diktat.

But lay that aside. What’s got Fauci suddenly rethinking the merits of blunt-force legal compulsion to ensure mask compliance? It’s simple: Desperation.

We’re facing a hair-raising surge in cases and the near-term prospect of an explosive outbreak of the sort that’s already begun in Europe and we don’t have anything on the shelf to avert it. The vaccine and therapeutic treatments are close but not close enough to spare us from a terrible winter. We missed our window this summer to suppress the virus so that we wouldn’t be facing a high baseline of cases as fall began. We’re in the sh*t. All doctors can do right now is triple down on the non-pharmaceutical recommendations they’ve been making for the past six months. Keep your hands clean; avoid indoor spaces to the greatest extent possible; mask up.

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If you believe the models, the more diligent people are, the more lives will get saved.

If mask-wearing is 49% through February and states continue with removing social distancing mandates, the Covid-19 death toll across the United States could reach about 1 million deaths by February 28, according to the study, published in the journal Nature Medicine on Friday.

Yet under the assumption that states shut down when their daily death rate exceeds 8 deaths per 1 million people in the population but mask-wearing doesn’t change, the study’s model projections forecast the death toll could reach 511,373 deaths by February 28.

The scenario that 95% of people in each state wear masks — in addition to states reinstating social distancing mandates if their daily death rates exceed 8 deaths per 1 million people — resulted in the lowest death toll projection, with 381,798 deaths by February 28, according to the study.

Two obvious points there, assuming their assumptions are correct. One: Universal masking could mean a six-figure difference in deaths. Two: Even with universal masking, the outlook is sufficiently grim that we should expect an additional six-figure death toll over the next four months on top of the toll we’ve already amassed. Masking may help but it’s not a panacea. Look no further than Texas, which is now almost four months into a statewide mask mandate. Here’s the trendline:

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No state had a higher case count yesterday than the Lone Star state did, a day when the U.S. recorded the highest number of cases nationally since the start of the pandemic. On the other hand, daily deaths in Texas are — for the moment — far off their summer peak:

The death surge may be coming in November, as deaths always trail cases by a few weeks. But read last night’s post if you missed it for a reminder that some scientists believe masks could be helping to limit not just the number of infections but the number of *severe* infections by reducing the amount of viral particles inhaled by mask-wearers. Even if a mask doesn’t prevent infection, in some instances it might mean the difference between a mild case and a life-threatening one. We’ll see what Texas looks like at Thanksgiving.

Exit question: If we’re going to mandate masks, we should go all out, no?

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