Why Americans Are Tiring of Social Distancing and Hand-Washing – 2 Behavioral Scientists Explain

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Yves here. I have to confess to slipping on some of my Covid-19 discipline, such as cleaning the touched car surfaces with alcohol every time I drive (my mother’s aides use it every day and they don’t wear gloves) and wiping down handles and light switches 2x daily (but I rationalize that with more recent information showing that surfaces aren’t as big a transmission vector as thought earlier).

However, I find it nervous-making to relent on social distancing unless the other party is wearing a mask (and I always do when I venture out). Yet my youngest brother remarked casually last week that he’d just had his first face-to-face business lunch since the lockdown. I would not see that as worth the risk unless we were eating outdoors. But then again, I’m not in sales.

Particularly in Alabama, where Covid-19 case counts are rising even before most churches reopened (many were waiting till after June 1), I’m gobsmacked at the lackadaisical attitude. Last week, I wrote about failures to use masks in the ER of Grandview Medical Center. Today, I had to go to the drugstore (one of the few places I visit). On the one hand, it was gratifying to see a man in his early 20s wearing a blue face mask with white stars. On the other hand, employee handling checkouts (who had the self-imporant air of being a manager) had her mask pulled down under her chin. I told her from my position one back in the line that she needed to pull it up. She did, only to leave her nose uncovered. When I got in front of her, I explained the necessity of covering her nose and also told her this was important to me, since my getting the disease would mean my 92 year old mother would contract it and die.

She refused to adjust her mask to the correct position. And of course by wearing her mask in half-assed manner, she’s signaling to all the customers that masks don’t matter. It’s enough to make me want to stay indoors permanently.

My pet theory is most people are not anxious enough to be able to maintain strict personal discipline over long or even long-ish periods of time, unless they deem the stakes to be pretty high or are confident of a tangible payoff (like getting endorphins from a run).

By Gretchen Chapman, Professor of Psychology, Carnegie Mellon University and George Loewenstein, Professor of Economics and Psychology, Carnegie Mellon University. Originally published at The Conversation

States are beginning to open up their economies after successfully slowing the spread of the coronavirus. Much of the credit for that goes to Americans dutifully following prescribed behavior.

People have been washing their hands frequently, maintaining physical distance from others, wearing face masks, sanitizing door knobs and even disinfecting food and packages brought into the house.

But in order to continue to contain the spread of the virus, we’ll still need to sustain these behaviors for weeks and maybe months to come. Will people be able to maintain their vigilance over time?

As scholars who study health-related behavior change, we’re skeptical. While continuing to wash your hands and stay six feet away from others doesn’t seem so hard for an individual, the problem is that people are unable to “see” the benefits of their actions – and thus often don’t recognize just how important they are.

As a result, adherence to these protective behaviors could wane over time without policies designed to sustain them.

Intangible Benefits

It is, in fact, remarkable to us that efforts to promote hygiene measures have been as successful as they have been. That’s because they are almost the embodiment of the types of protective measures that people are especially bad at taking.

The most obvious reasons are that maintaining physical distances and constantly washing hands are inconvenient and require constant vigilance. The costs of these behaviors are immediate, but the benefits are delayed.

A more subtle and equally important reason, however, is that the benefits are intangible: You can’t touch, taste, feel or see the benefits of, for example, wiping off your door knob.

One reason the benefits are intangible is that people tend to be insensitive to even dramatic changes in probabilities – such as from one-in-a-thousand chance to one-in-a-million chance – when it comes to small probability events such as the chance of contracting coronavirus.

This is true unless the change in probability leads to certainty that the event will not occur, which is why people are not eager to engage in preventive behaviors unless they completely eliminate the risk, as research by psychologists has shown.

For example, one study found that people were willing to pay much more to reduce a pesticide risk from 5 in 10,000 to 0 in 10,000 than from 15 in 10,000 to 10 in 10,000, even though the actual reduction in risk was identical. A similar study concluded that people were more attracted to a vaccine said to entirely eliminate a 10% risk for a disease than to one that reduced the risk from 20% to 10%. And a third one found that a vaccine described as 100% effective in preventing 70% of known cases of a disease was more appealing than one that was 70% effective in preventing all cases even though both would have the same net effect.

Even if we follow all recommendations about sheltering in place, washing hands, wearing masks and disinfecting grocery deliveries, we can only reduce and not eliminate the chance of catching COVID-19.

Will people continue to feel that it’s really worth it to sanitize all those plastic bags from the supermarket if the only effect is to reduce the odds from, say, 1 in 2,000 to 1 in 3,000?

Invisible Impact

Another reason the benefits of prevention seem intangible is that we don’t get useful feedback about the effects of our actions.

The microbes are invisible, so we have no idea whether we had them before we washed our hands or have gotten rid of them after we have done so.

In addition, we get no feedback about how a particular protective action has changed our probability of getting infected. If all of our actions work, the outcome is that we don’t get sick. But not being sick was the state we were in before we took those actions. Thus, it seems as if the preventive actions caused nothing to happen because we can’t see the negative outcome that might have happened if we hadn’t been so vigilant.

Documenting such a pattern, studies of treatment for depressionhave found that many patients skip or discontinue taking antidepressants as soon as their symptoms improve, leading to relapse.

The same is likely true at a societal level. If all the sacrifices people are making pay off in the form of lower infection rates, people will point to those low rates as evidence that the sacrifices weren’t actually necessary. Such a pattern has been documented among anti-vaxxers, who claim that low rates of diseases that are vaccinated against are evidence that the vaccine wasn’t needed in the first place.

When one is healthy, it is very difficult to imagine being sick – even when one has been sick in the past. This probably has something to do with low rates of adherence to lifesaving medications.

For example, one year after hospitalization for a heart attack, nearly half of patients prescribed statins stop taking them. And rates of medication adherence for acute diabetics are similarly dismal.

In both cases, people who are healthy – or even those who are sick but not experiencing immediate symptoms – don’t appear to appreciate the risks of failing to protect themselves.

Constant Vigilance

So how can we sustain vigilance in the face of pervasive intangibility?

We could remind ourselves that life rarely offers certainty, and behaviors that reduce risk significantly are worth continuing even if they don’t eliminate it altogether. Or we could try to keep in mind those who have been hospitalized or even killed by COVID-19 – a fate that could befall any of us.

Realistically, however, neither of these approaches is likely to have much traction due to the intangibility of the effects of preventive behaviors. And so the best policies are those that eliminate the need for individual decision-making altogether, such as when stores ensure grocery carts and public spaces are kept well sanitized.

As for policymakers, they could compel companies to maintain these measures as a condition of being open. And they could design regulations that require people to continue to wear face masks in public or don gloves when entering public buildings, while lightly punishing those who don’t comply. Small penalties can have a huge impact on behavior.

The longer these behaviors are maintained, the more likely it is that they’ll become habitual, overcoming the problem of their benefits being intangible. And society will be able to get back to some semblance of normal while keeping the lid on the coronavirus.

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  1. Amfortas the hippie

    well…it appears that i’m back to being almost the only one wearing a mask, again.
    aside from my wife and the boys.
    and a handful of folks i know to be sick and/or immunocompromised. These latter report that they mostly just stay home.
    Texas’ “Reopening” is the direct cause of this…but it merely pushed the buttons within people that were already there.
    as if it’s all over, and we can get back to “normal”.
    cousin, still living in his truck outside of houston in order to do roofing jobs…is stuck waiting on his customer’s insurance companies to “adjust” and bring forth the checks for the roof repairs(lots of hail and other storm damage down that way)…says the ins. co reps tell him that the companies have laid off as much as half of their workforce, yet require the remainder to adjust and handle all the work…which is presenting a major bottleneck to him doing his job(and getting paid).
    meanwhile, his sort of girlfriend…the physical therapist in waxahachie, who had worked at a nursing home, saw more than half of those residents die from covid, contracted it and recovered, then was fired and got a job at a hospital…she now thinks she has it again.
    home from work, waiting on the test results.
    on the one hand, she’s in the belly of the beast, and getting a high “dosage” of the virus…on the other, what does this say about potential immune response?
    way out here…not just on the farm, but in our tiny little isolated town…it’s easy to forget what’s going on in the world…these protests and burning cop cars…the what?…40% unemployment?…the ongoing pandemic…
    everything looks almost normal when i go to town.
    of the 30+ folks who’ve tested positive here, none have died…and only 2 have gone to hospital. everyone else describes somewhere between “bad allergies” to “bad allergies, plus extreme fatigue”
    so it’s no wonder that people aren’t taking it seriously.
    add in all the purposeful confusion emanating from high and low, and it’s really to be expected.
    I dread this fall.

    1. Gregorio

      I’m guessing that those insurance companies are soon going to be hiring those laid off workers back to handle all the claims from the George Floyd protests.

    2. Rob Dunford

      ~as if it’s all over, and we can get back to “normal”~
      It’s very ironic that this ‘normal’ is what got us into this pickle in the first place.

  2. Ignacio

    I would frame the question in a different way. We are generally considering here personal risks but more important, IMO would be to frame it in terms of societal risks, which have already been shown to be very high. So, regarding the drugstore employee, she could more easily by frigthened by the prospect of loosing her job because the neighbourhood might suffer lockdown again simply because she, and many more, are getting too relaxed about the spread of the disease. The drugstore will be closed or you will receive less clients because it can be seen as a risky place. What if some indignant customer tweets that this place is unsafe?

    But because many will refuse to consider societal risks it is always necessary to keep a vigilance system that detects ASAP new clusters, can raise alarm bells and order precautionary measures, like enforcing obligatory mask use in drugstores and shops and possibly closing those not compliant.

  3. PlutoniumKun

    One issue missed from this is the ‘critical mass’ concept. While I hate to delve into nudge theory and related areas social science has long recognised that there are tripping points where certain behaviours become normalised. Once, it was considered acceptable to throw waste on the streets. Then, it became unacceptable. The process is rarely gradual, it just becomes the ‘norm’. An obvious example is that in Asia it is socially unacceptable not to wear a mask in certain circumstances (such as if you have a sniffle and are on a train). Nobody feels embarrassed wearing one. That didn’t happen by accident or through genetics, it is because it because constant messaging and social encouragement made it so (in addition of course to a certain degree of scare mongering). This is one reason why I think the confused public health messaging over masks in Europe/US was so disastrous.

  4. Democrita

    Seat belts — an example? The harm reduction is difficult to “sense” as an individual, but by making a law, and at least occasionally enforcing it, we changed mass attitudes toward them.

    I think it has a lot more to do with the mixed messaging from ‘authoritative’ sources such as the president, WHO, CDC, media, etc. and the very real and in-the-now fears of being jobless or homeless or hungry.

  5. John

    I encountered Asian mask wearing behavior for the first time in 1970 while in the USArmy in Korea. It’s an old established practice. That helps.

  6. Edward

    An alternative way to engage with unmasked people could be to ask them why they chose not to use masks. This could be more persuasive then simply asking them to put on a mask, because the facts are on your side, which you can deploy in a discussion, and you have invested the time to learn them. You probably don’t have time to do this, but another possibility is to try and write a guest editorial in the local paper.

    1. Clive

      Most people are quite happy to tell you why. But then what do you do if you don’t like their answers?

      And we can’t escape the class aspects of this. As an example, here’s a song pen’ed and sung by a bit of a hero in the HVAC community https://www.youtube.com/watch?v=D913cUloLsM

      Now, not since Phoebe’s rendition of “Smelly Cat” in Friends has such a lack of talent graced our airwaves but the point in important. As is the obviously strong motivation of the person who’s dulcet tones convey their message to us. If, for example, your A/C is out (and I think you guys, certainly in the West / South West there are having a very brutal heatwave at the moment) and you want it repaired, is it going to be you crawling around in your attic (which is probably 120-130F) trying to fix it (and if you didn’t want it fixed, then you probably wouldn’t have called the HVAC tech over)? No, it most certainly is not. And if you want it repaired and the tech says “yeah, but I’m not wearing any damned mask in these conditions?” what are you going to do? Your bargaining power isn’t the greatest in this situation.

      It’s worth reading the comments in the YouTube responses, too. The one from the service technician called to a walk-in freezer which is inop is short but packs a punch. He states, not pussyfooting around, he isn’t wearing a mask in those unpleasant, almost unworkable, situations. When he stated his demands, the owner (presumably of a restaurant or take-away or other business which stores foodstuffs) simply said, yes, sure, ignore the signs to wear a mask, don’t worry about it. How was the business owner to do otherwise? It was either that or let $1000’s of worth of frozen food turn into unsaleable, unusable, gloop in front of them.

      Who is right and who is wrong here?

      And it is that unavoidable imbalance of power between the workers and the served which is, I suspect, behind a lot of the outpourings of authoritarianism. We don’t like it when someone has power over us. We like it even less if those people are, by many definitions, the lower social orders (the people who’s work isn’t sitting in relative comfort in a sedentary position but is, rather, working 10+ hr shifts and long days in hard, often drudgery, ways).

      And I speak as someone who’s never done a proper day’s work in his life; there’s a reason for that, which is that manual or standing-on-your-feet-all-day work is tough. If we’re not prepared to do the kinds of jobs where mask non-compliance seems the most rife, who are we to judge those who lack our whole-lot-nicer choices and have to do that work for us? It’s a tale as old as time the bourgeois left ends up taking the real working class to task for not doing what it’s telling it to do. It’s rarely a good look. I’m not saying the ask isn’t a legitimate one, but asking someone else to do something that you won’t, or can’t, do yourself then insist they don’t get a say in how they do it (and why they don’t necessarily want to do what you’re demanding) is a textbook definition of a lack of empathy.

      1. Edward

        Other countries have managed to mask. It can be a nuisance, but anything we do collectively can be a nuisance. Is Covid-19 going to be defeated with no effort? There are basically two arguments for masking:

        1) Safety
        2) Economic recovery

        If someone doesn’t mask, IMO, they should face a fine, but that isn’t happening, at least not yet. A year from now, when the situation may be worse, who knows? Authoritarianism, classism, and suspicious motives are always a problem, but this is one time where I think the demand to mask is needed. It is similar to the problem environmentalists face trying to persuade society at large to incur an immediate cost for an environmental good. Basically, Americans need to mask and the question is how should society encourage/enforce this? In situations where a mask is problematic there may be workarounds such as wearing a face shield instead. It really comes down to levels of motivation. If someone is cleaning up a chemical spill, they will wear a Hazmat suit, even if the temperature is 100 degrees.

        1. Clive

          Basically, Americans need to mask and the question is how should society encourage/enforce this?

          Which sounds, intentional or not, like “I’ll listen to your concerns carefully and, after reflecting on them deeply and conscientiously, will remind you that you can jolly well Do Exactly As I Say — and be quick about it”. And that never convinced anyone to do anything.

          Coming as it does after not-exactly-an-unqualified-success of trying to lawfare face coverings into ubiquity, it smacks of a phony attempt to make like you’re going through the motions of being empathetic but have no intention whatsoever of modifying the demand in any way, shape or form. If the suggestion had come first and the lawfare last, it might have been more convincing.

          The hazmat suiting is an interesting angle. It kind-of makes the point. Anyone can do anything in a context of doing it just for a while. Doing it day-in, day-out, for the foreseeable future is something quite different.

          1. Yves Smith Post author

            I don’t know why you are so defeatist.

            Birmingham had a mandatory mask policy for the first two weeks after the lockdown. Everyone over 2 had to wear a mask if not at home or in their car. Only exception was exercising outdoors. They went to stores and ticketed people to show they were serious. They got very high compliance as a result.

            1. Clive

              If deemed to be unconstitutional then any tickets will be quashed by an unconvinced AG. I’m not local to the events described but according to local media policing in Birmingham was patchy to non-existent https://www.al.com/news/2020/04/alabama-ag-calls-birmingham-mask-ordinance-excessive-threatens-suit.html

              And certainly here poorly drafted and confusing legislation has lead to fines similarly being cancelled https://www.theguardian.com/law/2020/may/15/rushed-uk-coronavirus-laws-led-to-wrongful-convictions-say-police — which just emboldens noncompliance by those who are already predisposed to it.

              If people were genuinely put off from breaching ordinances, there’d be no or few problems with the laws being ignored. It’s very difficult to legislate in a way which is legally watertight and won’t be thrown out if tested in the courts. If (or “when”) that happens, it just encourages more evasions.

              1. rd

                Not clear why it would be unconstitutional. Public nudity laws seems to do ok as the courts appear to accept a general public morality. Requiring citizens wear face masks in public places for public health seems like a similar requirement.

              2. Yves Smith Post author

                It didn’t take much enforcement to get compliance.

                I hardly go out, but I overheard discussions of the ticketing in several spots while waiting in line the weekend the ordinance went in place.

                And local news broadcasts the next week showed pretty much everyone wearing masks….on general news stories. As in the stories were not about the masks, they were contemporary outdoor shots of people going in and out of some spot with the newscaster nattering in a mask out in front. Even in my suburb, which was not subject to the ordinance, mask wearing looked to be at the 75% level.

                In other words, the ticketing the first weekend got enough attention to get a good level of compliance. It didn’t take much, it was at some popular big box venues.

                And the Birmingham mask ordinance was not confused. You have to wear a mask if you are not at home or in a car and are over 2. Exceptions were that using a cover over a stroller for kids over 2 was OK, and you didn’t need to wear a mask when exercising outdoors.

                And I watch the local news. The AG threat story got zero broadcast news coverage, at least on the big early evening and 10 PM show on the NBC local affiliate, so it might as well have not existed for the little attention it got. My mother’s aides to a person knew which communities had mask requirements and when they expired, and none of them mentioned the AG saber-rattling. So the data points I have say the locals gave it no regard.

                And logically that makes sense. The mask requirement was a lockdown transition measure, intended for 2-3 weeks. It would take the AG that long to get a suit going. It would look silly and petty to waste scarce state AG resources on the fairly small fines on an issue that had become moot.

                And the Supreme Court just upheld California’s right to keep churches closed, which strongly suggests the AG would have lost his case in light of such a powerful on point precedent if his suit had seen the light of day.

          2. Edward

            “Doing it day-in, day-out, for the foreseeable future is something quite different.”

            There are occupations where you have to wear a mask all the time or other protective equipment. Steel workers, for example, I think where special suits. It can be done.

            If you can argue, using science and data, that masking is unnecessary for public safety and the economy, I will change my position. Otherwise, personally, I think governments should probably mandate the use of masks. There are practical questions here; can COVID-19 be defeated without masking? How much more expensive in costs and lives is the no-mask scenario? How do the transmission probabilities change in which situations?

            It may be possible to defeat COVID-19 without masking, but at this point I feel it is a reasonable measure against a very serious problem.

            While I do feel the government should mandate masking, such a position does not bar me from trying to persuade others to wear a mask, nor does it make my arguments disingenuous.

            1. Clive

              This is the whole problem with this debate.

              You don’t need to convince me. I’ll obey — as I always have and always will — any government law or any guidelines issued.

              The question is how we sort out the miserable lousy mess — which both sides of the question are responsible for creating — in a fair and effective way. And what a mess it has become https://www.nytimes.com/2020/05/15/us/coronavirus-masks-violence.html

              If you seriously believe that more laws or some fantasy of omnipresent policing (the inevitable twin of “government mandating”) is really gonna fix this, I think you’re in for a big disappointment. How, after — what, nearly two months now? — is the lawfare and threats working out in terms of on-the-ground adherence? “not very well” according to even the comments posted here.

              1. Edward

                I think we are talking across one another to some extent. I am not sure what I am supposed to write to show “empathy”, as you define it. Am I supposed to be making an argument for wearing masks, rather then assuming, as I did, that you already agree on this point?

                I never said a law requiring masking was practical. You are putting words in my mouth. I simply think that it is an appropriate step for the government to take against the epidemic. Unfortunately, we have the Trump government, which has politicized this issue, and far from contemplating such a law, opposes masking. If the situation becomes worse this may change, but for now there is zero chance of such a law at the federal level. I am not familiar with the legal issues, but I would be surprised if such a law is not possible, because epidemics are not a new problem; humanity has been fighting epidemics for ages and there are probably legal precedents for such measures.

                I also never said masking alone would end COVID-19. That is also putting words in my mouth. I simply think it is a relatively simple but useful measure against the disease.

                1. Clive

                  Did you miss that the state Supreme Court in Wisconsin ruled that the even easier to justify stay-in-place order was too broad https://www.theguardian.com/us-news/2020/may/13/wisconsin-supreme-court-stay-at-home-order ? It’s no use blaming courts for refusing to uphold dubiously drafted laws. If a law can’t be drafted in a constitutionally-compliant way at state level, it can hardly be done any easier or better at a federal level. This is the difficulty with trying to manage a public health issue with legislation. If people aren’t convinced by the public health message because of the strength of the message itself, laws are of limited or no help.

                  As for empathy and how to demonstrate it, all I can add is some free advice from an outsider’s perspective, which, as with all such things is only of value (or not) in the eye of the beholder. Which is: America will not heal while everyone is apparently rigidly and immovably intent on telling everyone else what they should or shouldn’t be doing. You all can keep trying it, but I suspect you’re way past the event horizon of anyone paying the slightest attention to what you (or you together with the group of other who think the same as you do) are increasingly desperately demanding.

                  The solution to this impasse is of course to stop demanding and start suggesting. The difference between a suggestion and a demand is that the proposer is willing to hear “no” as a reply to a suggestion but will not tolerate that response to a demand.

                  No-one can change another’s behaviour so as to make them deescalate “demands” into “suggestions” (or “requests”). But equally well, in the theatre of public health, no-one has ever in recorded history been able to “demand” widespread compliance to a public health policy merely be the force of edict. So the choice, as always, is ours. We can either continue to stomp our feet insisting others do as we want to make them do — which is likely to only increase their frustrations with us and ours with them. Or we can begin the slow, careful and often arduous process of convincing them and thus bringing about cultural change. But the outcome we seek is not in our gift and is not in any way assured.

                  I see no sign of this whatsoever. Watching from a distance, the irony of one group asserting its right to individuality inducing the wrath of another group asserting their right to individuality to quell the right of individuality in the other group, would be funny if it wasn’t so tragic for all concerned. Both sides are merely mirror-images of the other. Yet neither can see how they are simply both different manifestations of the same defects of character — selfish self-will dressed up as self-servicing societal concern.

                  1. Edward

                    There is probably some truth in your complaint about Americans. My father used to complain, once in a while, that Americans don’t talk to each other, and the situation now is much worse then when he was alive. Politicians seem to exacerbate the divisions to their advantage.

                    All the same, in some ways I think you oversimplify the problem. What you can get away with in terms of demands depends on the context. It is not fixed in stone. The demands you can get away with are relative to the attitudes and beliefs of society. There are situations in which you can make demands and pass laws.

                    You also seem to be pigeon-holing me as a “demander”. I think it is appropriate for the government to require masking. This has nothing to do with whether this is realistic, or whether other people agree with me, or even whether I want to persuade others of this. This is my belief about an appropriate role for the government. As far as the process of having such a law adopted is concerned, I don’t have to be a demander, I can be a suggester. Yes, laws by their very nature are demands, but the process of having laws adopted can involve suggestions, not demands.

                    The question of the feasibility of a masking law is a complicated one. The government has many tools at its disposal, and if it ever decided, in a unified way, to do this, I think it could. Right now, though, for the moment, the Republicans are opposing masking. It is quite a train wreck.

                    I also wonder if you are overestimating the opposition to masking. Despite a lot of Republican noise, there are also many Americans who support measures to contain the virus.

                  2. Yves Smith Post author

                    The Supreme Court backed California keeping churches shuttered. Most legal scholars considered the Wisconsin ruling to be pretty dodgy. Wisconsin had good odds of winning if it appealed to the Supremes, but it is moot now.

      2. Jeremy Grimm

        I have done a small amount of proper work — for myself. Often the work had to be done in the same hot, cramped, dusty-dirty, nasty places your hypothetical techs in the South West might have to enter. After a few efforts unprotected and haphazard I started wearing masks and goggles for my own comfort and safety in the attic or under a sink. Before Corona I kept a face mask and ear plugs ready for doing vacuuming around my house. Even in the hotest of work areas I wear long pants and long sleeve shirts to keep the grime off me — for my greatest personal comfort.

        However — I have encountered the odd mindlessness of workment you described. I worked in a noisy area where decibel levels were just under OSHA levels. I was the only person who wore hearing protection. I worked in a tank barn where the mechanics fire up giant diesel engines and screaming turbine engines and again I was one of the only people who wore hearing protection. Half of the older workers were deaf or nearly deaf. I believe irrational risk assessment or concerns for personal comfort fail to explain these human behaviors. I don’t think the psychologist who authored this post is close to understanding why people do or don’t wear seat belts or a facemask or keep their distance.

  7. The Rev Kev

    Oz lived up to it’s reputation as “The Lucky Country” and we never got badly hit by the pandemic – knock on wood. In going out, you would only ever see two or three people wearing masks in my neck of the woods but I put that down to the fact that the number of victims were low and the media was reporting where new clusters showed up. Yeah, we got lucky. But that is obviously not the situation in the States.

    Because of a botched handling of the pandemic and a neoliberal mindset, the Coronavirus may now become endemic to the country. So the virus will be working like a slow burn as it moves through different parts of the country. Amfortas’s report of that girlfriend possibly having a second bout of this virus is certainly a worry. This being the case, it looks like the best way to safety is through constant habits made second nature such as wearing masks & gloves, social distancing and all the rest of it.

    So no happy news here. As I said in a previous comment, Coronavirus is the Iceman of viruses: “He wears you down, you get bored, frustrated, do something stupid and he’s got ya.”


    Living in rural northern California, all masks have been disgarded since this Democratic hoax is now OVER…according to my community. We had a high school graduation this weekend in my tiny town and it was drive thru —because mean ole’ public health crushed the hopes and dreams of the community and cancelled the planned in-person soiree. Still, terrifying. We lined up three-deep in tight lines in the parking lot and waited for 45 minutes until the procession began around the football field. I saw one mask. ONE. For that 45 minutes in the sardine-can parking lot, our family and the car next to us sat with windows rolled up, engine off (didn’t want to pull in outside air via the air conditioner) watching the inoculation party around us. Everyone hugging, shaking hands, kissing, talking, laughing, taking pictures…literally zero social distancing, zero contamination avoidance; we felt like WE were the crazy ones. I looked at my husband and asked him what was wrong with this community. By the way, we are in 100% Trumpland, the heart of the desire for the state of Jefferson. Trump signaling no mask is required will kill so many. Isn’t that a paradox? He kills off his base? Our kids also saw on social media after the ceremony, all the “in crowd” and their parents and friends/family hosted an enormous party at the neighboring park. More virus spreading. Thankfully, our kids have our mindset and refuse to mingle and fear the virus; they also have the belief it is their social responsibility to protect others…so mask-wearing when out, staying home, and isolating.

    Spot on post; I needed to read it this morning to re-affirm I was not losing it practicing sound public health practices.

    1. carl

      We feel this way here, down in San Antonio, every time we go out. The politicalization that Clive refers to is quite evident. Deadly too, I’d say, for many people. We’re getting hoisted on our own petards, as a country.

  9. rd

    Some potential good news. I would definitely classify this as unsubstantiated, but if the coronavirus is mutating into a less lethal form in Italy, that would definitely qualify as good news: https://www.businessinsider.com/coronavirus-losing-its-lethality-in-italy-according-to-doctors-2020-6

    Previous studies have indicated that the US West Coast got hit with an early version from Asia that was less lethal than the one that ravaged southern Europe and hit the Eastern US, especially NYC.

  10. Charles 2

    It is one thing, as a client, to wear a mask for 10-30 minutes when one goes shopping. It is another to have to wear it all day long, especially if the environment is hot or even a minimum of exertion is required. In that case, A glass separation is more appropriate.Choose retailers that provides them.
    Second, one should use will power wisely : contact tracing show that most infections are airborne, not much by touching infected surfaces, so it is better to focus it on mask wearing than on compulsive hand washing.
    Similarly, there is very little outdoor contamination, so restricting mask wearing to crowded or indoor spaces also helps to save willpower for when it counts.

    1. Yves Smith Post author

      No, a glass separation does not solve the aersols problem because the barriers typically are not very high nor very wide. At a checkout with a moving belt, the entire belt path is exposed in every store I see, for instance. They presumably help but they are not a replacement for masks.

      Both droplets and aerosols are means of transmission. And if you look at the vids of how droplets disperse after a cough, they go very high and wide as well as forward. This is still a very much debated topic. The big problem is it appears Covid-19 can infect with what would seem to be de minimus exposure:

      Another paper, recently published in the New England Journal of Medicine, showed that infectious SARS-CoV-2 virus can remain in aerosols for at least three hours—and for several days on various surfaces—in a laboratory setting. But the amount of viable virus diminished significantly during that time. Scientists do not know the infectious dose of SARS-CoV-2. (For influenza, studies have shown that just three virus particles are enough to make someone sick.)


      A face shield would be a better compromise if you really think people have trouble breathing. I’ve worn a surgical mask for well over an hour and have had no difficulty.

      And only a properly-fitted n95 mask makes it hard to breathe. A surgical mask, which is enough to protect others, does not.

  11. Duck1

    One issue for masks is availability. No doubt in Korea they are easily purchased. I have asked here in a relatively low infection US area at the drugstore and the supermarket and neither are selling masks. Even better, offer free masks at the door. Is their still an availability problem? At the neighborhood quickimart I saw a display of bandanas, so somebody is being opportunistic. And I see internet ads as well.

  12. Dan

    I didn’t need a behavioral scientist to tell me why people get sick of social distancing and an inordinate amount of hand-washing. But thank you.

    Someone please tell me when they’ve achieved the nonhuman state of being “constantly vigilant” about something.

  13. Anarcissie

    Being of a certain age, I’ve decided that very strict preventive measures are desirable, and being surrounded by people who are afraid not to be too cool for school, I decided to stick the measures in people’s faces if possible. I’ve constructed a mask (out of a pillowcase) that looks like one of those birdlike medieval things from the Black Death and I wear that around outside. It’s black and has a sort of beak. I can tell it bothers people, but not enough to beat me up, so I’ve hit the sweet spot. I’m going to decorate it with fangs when I have time. A friend of mine with similar misanthropic tendencies is making masks that look like the faces of skulls, which is possibly even better.

    In regard to ‘[O]ne study found that people were willing to pay much more to reduce a pesticide risk from 5 in 10,000 to 0 in 10,000 than from 15 in 10,000 to 10 in 10,000, even though the actual reduction in risk was identical.’ I am surprised to read this coming from a statistics-flogging psychologist. The risk differences are not identical at all. Materially, going from 5 in 10000 to 0 in 10000 is a 100% reduction of risk, whereas from 15 in 10000 to 10 in 10000 is a 33% reduction in risk. If the thing risked is significant, like one’s life, then psychologically the first is ‘something I don’t have to worry about any more’ to ‘something I still have to worry about, just about as much as I did before.’

  14. anon in so cal

    “If all the sacrifices people are making pay off in the form of lower infection rates, people will point to those low rates as evidence that the sacrifices weren’t actually necessary.”

    This, as you pointed out, is the fallacious argument used by those advocating for quick reopening. Someone’s take: “my parachute has slowed my rate of descent, so I can take it off now and didn’t need it in the first place.”

    Otherwise, while the CDC did modify its warnings about fomite exposure, it maintains the warning:

    “Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen [italics added].”


    Here in southern California, where the daily case and fatality count keeps rising, I have become obsessive about this, to the point of disinfecting any surface that someone may have touched and every item that comes inside the house. My most frightening experience was sending a bottle of Vitamin D to an elderly relative, using Shipt, having them report they immediately opened the bottle and took one, without washing the bottle. Waiting 14 days is agonizing.

    Re: social distancing, hand washing, mask wearing:

    Social theorist, Norbert Elias, provided fascinating insights into the adoption and internalization of personal and societal norms, ranging from everyday etiquette, to laws governing fox hunting in Britain, in his major work on state formation and the development of civilite.

    The Civilizing Process


    1. anon in so cal

      I have an expanding collection of horror stories associated with my obsession with disinfecting everything. The first time I got gas during the pandemic, I disinfected my credit card. Unbeknownst to me, this deactivated the strip. So, the next time I needed gas, the credit card wouldn’t work. Fortunately, I had a $20 bill with me. But even with a mask on, there was no way I would go inside the gas station store. So I had to knock on the window of the store until the clerk came outside (a naturally occurring breaching experiment). She was also wearing a mask but I didn’t want to get close enough to hand her the cash. So I dropped the bill on the ground, pointed to my car, walked back to the car. Fortunately, the clerk was very understanding so I was able to get gas.

  15. John Wright

    One of the example cases seems quite reasonable behavior to me (but the original study is paywalled)

    “A similar study concluded that people were more attracted to a vaccine said to entirely eliminate a 10% risk for a disease than to one that reduced the risk from 20% to 10%.”

    If I’m reading this correctly, people were more attracted to a vaccine that completely eliminated a 10% risk of EVER getting a disease over a vaccine that left them still at a 10% risk.

    This seems to be a quite reasonable choice given those taking the first vaccine need never fear getting the disease while in the other case they remain at a 10% risk.

  16. allan

    Time to start disinfecting fish (for those who can afford it).
    Would you like your line-caught sockeye salmon in an isopropyl alcohol ceviche?

    American Seafoods factory trawler returns to Seattle after 85 crew members test positive for COVID-19
    [Seattle Times]

    A Seattle-based factory trawler cut short its fishing season off the Washington coast after 85 of 126 crew tested positive for COVID-19, according to a statement released Sunday by American Seafoods, which operates the vessel.

    The test results for the FV American Dynasty are a somber finding for the North Pacific fishing industry, which has been trying to keep the novel coronavirus off the ships and out of the shore-based plants that produce much of the nation’s seafood. The outbreak also underscores the toll coronavirus continues to take on the food processing industry across the nation. In Washington state, outbreaks in meat plants, fruit and vegetable fields and packing facilities prompted Gov. Jay Inslee to order new protections for agricultural and food processing workers.

    As part of the effort to keep outbreaks from impacting the seafood industry, the American Dynasty crew, before heading off to sea May 13, were screened for the viral infection and underwent quarantines of at least five days. They also underwent additional testing for the antibodies created by the virus.

    “Only if there were no signs that they were actively infected or contagious were they cleared to board their vessel,” said American Seafoods chief executive Mikel Dunham, in a written statement.

    Somehow, the virus still found its way on board. …

    At some point, short of a safe, effective and close-to-free vaccine, people, and their employers,
    are just going to give up trying. Eat, drink and be merry, for tomorrow …

    1. Jeremy Grimm

      “Would you like your line-caught sockeye salmon in an isopropyl alcohol ceviche?”

      Please substitute ethanol or Everclear — and the ceviche sounds pretty good.

      1. Amfortas the hippie

        Lemon/Lime juice should be sufficient, all else being equal.

        the nearest place to get seafood(aside from “bait”, like fishsticks, etc) is 50 miles away.
        they have had no fresh seafood in the case since this started…all frozen solid, in the reach-ins.
        as I am generally and habitually a stickler for food-handling protocol(chef), and for the most part Cook my food, I haven’t worried too much about transmission from that source.(rule of thumb danger zone is between around 40 degrees and 140 degrees(F)–which, however, varies considerably over time in the official standards)
        I have been pretty obsessive regarding fresh fruits and veggies that we eat raw…until the gardens and environs started producing—but even then,lol…i regularly spray fermented fish guts and compost tea on everydamnedthing…so we wash everything anyway.
        Remain Calm.
        We still maintain some agency.

  17. Alexandra

    I was a bit surprised that no one has pointed to certain treasured American* cultural values that get in the way of consistent/continued mask wearing.

    *Yes, I know there are many cultures within America, which lest we forget is a huge landmass. I can only offer my perspective as someone who partly grew up in Europe, and has lived in California (North and South), South Texas, Minnesota, and now Appalachia.

    In my little Appalachian village, no one wears a mask except Kroger cashiers who are forced to by the company (and complain about it). Notably, the store manager, who has more job security, doesn’t wear a mask.

    Historically, these isolated hollers have been protected from pandemics, and many people figure that continues to be true. We aren’t on the way to anywhere, we get no tourists in these parts because it’s grindingly poor and there’s not much to see except plants.

    But I think a bigger factor is the general resistance to authority, whether it be from a politician (left or right) or a lab coat. “I do what I want and look after my own” could be the regional motto. It is hard to scare these people into anything, especially as they have a long history of finding ways around any law.

    Now I know Appalachia is not representative of the whole country, either in terms of risk or culture. But I don’t think I’m over-generalizing too much when I say that what I have seen everywhere I’ve lived in America, is a prioitizing of individual freedom and comfort over a more distributed kind of responsibility. You cannot compare American mask behavior to that in East Asia without factoring that in; methods that worked there simply won’t work here.

    Add to that the detrimental psycho-biological effects of social distancing and identity concealment on us social primates, which are genuinely wearing people down, and I have to say I don’t think threats of punishment are going to be as effective as the authors of this article believe. Maybe in densely populated areas where individuals are more heavily surveilled, but not in flyover country. If the proposed punishment is minor, it will be ignored, and if it’s major it will contribute to rancor that, in the best case scenario, sees Trump re-elected, and in the worst, blends with the economic disruption to cause more civil unrest.

    1. rd

      They weren’t protected in 1918-19. Initially they were, but the second and third wave got into most of those communities with a lot of deaths. The more recent pandemics had much shorter durations for a variety of reasons, including vaccinations. The primary thing that will save the appalchian communities this time around would eb a mutation fo the virus to a less lethalf form or a vaccine.

  18. WS

    I’ll confess that all the measures I take are for the sake of others, or at least for the sake of appearances to that effect. I’ve found it well nigh impossible to maintain much concern for my own well being, despite (possibly because of) the horrific potentialities. My attitude on a day to day basis can be summed up approximately by an exchange between Bart and The Waco Kid in Blazing Saddles:

    “A man drinks like that and he don’t eat, he is going to die!”

  19. Jeremy Grimm

    With all the government work devoted to face recognition and other means for tracking our every move I hope wearing masks in public will become an expected norm with or without Corona, as they were and are in the Orient. Besides I believe masks do reduce the spread of colds and other flu viruses. No one in the US can really afford to be sick with even a garden variety flu and even if they have an allotment of sick days who could want to suffer a fever or a bad headache.

  20. LC Cool

    Here’s my theory. If you know someone who has been seriously ill or died from Covid, you’ll be vigilant. But most people don’t know anyone who had been seriously ill or died from Covid. Almost everyone knows someone who has been injured or died in a car wreck, so wearing a seatbelt makes sense to virtually everyone. Everyone also has either experienced the flu or knows someone who had a bad flu or even died of it. (I can say Yes to both of these)

    So many people are willing to be vaccinated annually for the flu and wear a seatbelt. Covid just hasn’t been as dangerous to most people as expected. The vast majority who get Covid have minor or no symptoms. And I have yet to know someone who was hospitalized or died from it. However, I do wear a mask in a store but not outside.

  21. False Solace

    Here in Minnesota I’m horrified every time I’ve gone to the store in the last 3 weeks. Less than half of shoppers are wearing masks. Young people particularly I’ve observed loitering from aisle to aisle, maskless and handling all the merchandise in sight and generally wasting time as though they’re bored and have no other activities available to occupy their time. I’m not really surprised. In this state, when things finally warm up and weather turns nice you just want to go enjoy yourself. Pity that people can’t take a once-in-a-century pandemic a little more seriously. We still have increasing rate of infections and deaths here.

    Personally I continue to wear mask and gloves when I go out, which is only for food. After several disappointing experiences with food delivery I’ve decided it’s not worth the moral hazard, expense, or waste. (Every time I received “substitutions” for items I didn’t order and would never buy on my own.) I have no problem continuing to wear a mask. I view people who don’t wear them as dangerous and somewhat insane. I’ve observed some of them back away from me, which believe me I appreciate.

    This is not a virus a rational person would want to tangle with, in terms of the possible long-lasting health effects and the financial outlay of a multi-week hospital stay. I have no idea what people are thinking. I guess
    I should remind myself that human cognition is replete with inherent biases and short-term thinking. We shouldn’t expect people to act rationally without a lot of coaching and societal support.

    The most stressful thing for me is dealing with my blase retired parents in Florida, who are full of praise for their governor’s handling of the pandemic and want the economy to reopen immediately. My father goes out shopping every day. I know they have masks but I have no idea if they wear them. Both are in their 60s and have significant health issues. In my mother’s case, even if she recovered from the virus it would likely leave her unable to walk for the rest of her life. Yet every time I talk to her she’s full of complaints about being bored at home. Like, figure out a new hobby, maybe? They’re both planning on coming here at the end of the month to visit for several weeks. I just don’t know how I’m going to deal with that. The house is so small that if anyone gets infected we all will. Especially with the lengthy incubation period and the evidence that suggests you’re most infectious 1-2 days before you show any symptoms.

    It’s all stressful, and this on top of the riots and the Fox News brain on display has left me not really looking forward to seeing them.

    1. Amfortas the hippie

      tell them you have the flu.

      i told my brother, back in late february, when he was still all PMC nonchalant and blithely taking his girls on playdates, that when it got bad down there(Kingwood), and they tried to come out here(like they do when there’s a hurricane), they would spend 2 weeks in the barn, peeing, etc in a bucket, and having no contact with anyone closer than ten feet.
      “I’ll quarantine your ass..with rope if necessary”.
      he didn’t call me for months,lol…until our dad went to the hospital(old people heart stuff) 2 weeks ago.

      My Place, My Rules.
      I don’t smoke in his house, now do I?

      put yer foot down.

  22. dk

    This article makes important and valuable observations and then ignores them, repeating the kinds of errors of logic it points out. It happens even within the space of two sentences:

    In addition, we get no feedback about how a particular protective action has changed our probability of getting infected. If all of our actions work, the outcome is that we don’t get sick.

    How it that not feedback?!? Of course, one can’t detect much of anything if one hasn’t established one’s own baselines for comparison. But not getting sick in a scenario where others did is certainly an outcome providing feedback on the course of the event (of exposure). It’s a single instance, not in itself conclusive, so we have to collect a lot of these, continuing to test (aka experiment). Such is life, even nominally civilized life.

    Obviously I reject the premise of the entire article, although several of the points made are valid. Rather than a boring self-indulgent point-by-point, I’ll offer a self-indulgent alternative approach.

    Let’s just take a look at how cumulative mitigation works, in a hypothetical where we’ll assume a 100% certainty of event E without any mitigations (E=1).

    We’ll collect some mitigations and their effectiveness as estimated from empirical research (using deliberately reduced figures to make a point, actual estimated rates are higher)
    “wear a mask” : 20%
    “6′ social distancing” : 10%
    “frequent had washing” : 20%
    “Avoid long/repeated exposure” : 10%

    The net risk after all (simultaneous) mitigations against E is the product of E and the reciprocals of the mitigation rates:
    (1) * (1-0.2) * (1-0.1) * (1-0.2) * (1-0.1) = 51.84%

    So application of these four measures, each almost trivial in isolated effectiveness, together reduced a 100% certainty to just a bit worse than a coin toss. But is every social or environmental interaction a 100% chance of infection? No. Even in hazardous closed-space scenarios, infection rates are not 100%, as we see in numerous studies. Plug in E=0.95 and we’re down to 49.248%. And we can add more mitigations, assess the base risk E well and reduce our time in high risk scenarios, and come in further and further under the wire of coin-toss chance of infection (from a single event).

    Not good enough? Risk is never completely eliminated, a thousand mitigations will never reach 0 risk. Concepts like “I am safe now” or “I will be safe through period x” (where x is sometimes given as “for the rest of my life”) are unserious and useless because of extrapolation to the non-existent extreme, and also because of instability. How about “I am safer now” or “I will be safer through period n if certain conditions can be met for some duration”? These are proportionate and rational statements, and they operate differently in our minds from the static implications in “I’m safe/not safe!”. If we can’t speak to ourselves this way, we’re already lost and hopeless, and compound that condition with denial. The “r” in “safer” is the difference between reasonable hope and surreal fantasy.

    These are self-contained, selfish calculations. The intelligent selfish person immediately realizes that some self-serving actions are also altruistic. Behaviors the contribute to robust communities are net own gain. But the ideally disease-resistant community is very self-disciplined and necessarily intolerant of recklessness, that mainstay of US “freedom”.

    I am certain (having asked practically everyone i know and meet irl) that you the reader have at least attempted this calculation yourselves, and the author likely has a well. Yet they make no effort to shed light on the positive rational for careful behavior, of which masks can be a component; but success can be achieved without masks if other care is taken.

    I consider articles like this to be the largest part of the problem. Self satisfying cynicism that offers no constructive value. It’s only excuse is that practically everybody else does it too. “Realistically, however, neither of these approaches is likely to have much traction due to the intangibility of the effects of preventive behaviors.” Failure to think is no excuse; reason and patient observation makes the effects tangible. If one then complains about their insufficiency, one should obviously keep looking, and collect more, and share. One can’t credibly accuse others of insufficient effort when one doesn’t make one’s own.

    And then there are preventive strategies, Krystyn Podgajski’s modest proposal for zinc supplements and other simple actions: https://www.nakedcapitalism.com/2020/05/links-5-24-2020.html#comment-3364577 (and she’s made more, I just haven’t indexed them all).

    Every survivor of covid, from the asymptomatic to the acute, lives because their immune system worked and keeps working. Yours is keeping *you* alive right now, as it has for your whole life, even if you immune system is flawed or damaged. That’s why familiarity with one’s own “normal” operational baselines is valuable, especially for the immune-compromised (who usually learn it from necessity). Masks and social distancing are good additions to the tactical arsenal, but the foundation is and must be one’s own body’s immune response, and one’s intelligent support of it.

    Old kungfu maxim: The most effective defense is a collection of small advantages.

  23. Sara

    One of the most memorable lessons I had in the 5th grade was the science experiment where everyone in the class handle a peeled potato, which was then put into a plastic bag. Then we were all sent to the bathroom to wash our hands, and immediately afterward we handled a second peeled potato, which also went into its own plastic bag. We spent weeks watching what happened to those two potatoes, and re-bagging the no-handwashing potato as it turned into smelly goo really fast. The handwashing-potato was still recognizable as a potato a month later.

    It took something intangible – the germs we wash off our hands with soap and water – and turned it into something tangible – stinky potato goo vs. better-smelling potato that looks like a potato.

    I’ve been diligent about washing my hands ever since, though I admit that I didn’t wash for 20 seconds before the current pandemic.

  24. Luke

    Best line I’ve heard on the mask issue is this:

    “If masks work, why isn’t everything already fully reopened?
    If masks don’t work, why do we have to wear them?”

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