A comment to my post of my wife's article at http://rygb.blogspot.com/2020/10/point-counterpoint-to-mask-or-not-to.html received the following comment:
This is my wife's response:
To Anonymous: I was explicitly asked not to address or present arguments about the science in the Jewish Press column, so I tried to present arguments of another nature – based on hashkofas haTorah.
In response to your first suggestion,
I actually do NOT think the arguments I presented depend on a positive answer to that question ("Does the vast majority of people wearing masks save hundreds of thousands of lives?"). Your suggestion to focus on that empirical question – which by definition cannot be definitively answered - is actually a diversion from the points I made.
In addition, I would NOT answer “yes” to that question because I don’t know for sure the number of people who would be saved by people wearing masks.
Here are examples of arguments I made that have nothing to do with the question of whether masks save hundreds of thousands of lives:
It’s the law. To follow the law does not require agreeing with the factual basis of the law. You might believe that income tax is a horrible idea that should be abolished. But you will still pay your income tax, because it’s the law. You would not educate children that they should flout the law whenever they disagree with it. OK, this argument does not depend on the answer to your question.
We are in galus. From Navi – from the Gemara – we are taught that our imperative is to act in a manner that does not bring upon us the ire and suspicion of our fellow countrymen. If they live near us, or have to interact with us in public spaces, and we are not following what 71% of them think is our basic social obligation to keep them safe – it is not anti-semitism for them to feel threatened and resentful. We are visible even when we don’t make fools of ourselves seeking publicity. This argument also does not depend on the answer to your question.
(I think this might not have made it into the article) Wear your mask to save a shopkeeper or restaurant owner from having to pay a fine because they did not enforce the local regulations. This also does not depend on the answer to your question.
Wearing a mask communicates to everyone that it is worth your inconvenience to try to protect the lives of older and vulnerable people. Refusing to wear a mask demonstrates to 71% or so of Americans that you do not think the lives of our zekeinim and cholim matter all that much. This does not depend on the answer to your question.
Now you don’t have to agree with all of these – just one is enough, if it’s convincing.
For argument’s sake though, let’s take a look at your empirical question, in case none of the former reasons is convincing.
I have no specific proof of how many lives would be saved if masks were worn by the general population. I do not think a Torah hashkofa differentiates between saving hundreds of thousands of lives, or hundreds of lives, or dozens of lives. We are not talking about shutting down schools or the economy here, we are talking about wearing masks on a temporary basis – an inconvenience to be sure, but not an actual sacrifice. Would you dump poison into the water supply if nobody could absolutely prove to you the number of people who would die as a result? Maybe it will kill thousands, or hundreds of thousands, or nobody, maybe it will be filtered out, maybe it will just cause people to suffer but they won’t die, maybe maybe maybe. Why not just go shlep that poison to the proper disposal location?
There is an estimate out of IHME that something like 100,000 lives would have been saved already had we been masking as a society since March or so. They have projections of the number of American lives that could be saved in the next couple of months under various conditions – 80% mask wearing, 85% mask wearing, masks + social distancing, etc etc. Their projections are certainly sobering. But they would be the first to say that their projections will change based on changing circumstances affecting the variables. I am not familiar with their model - the calculations that form the basis of their numbers, which factors they take into account and how those variables interact and are dealt with statistically - and I’m not an epidemiologist anyway, so I am not in a position to judge their methodology; but thus far they have been pretty accurate – if anything, their predictive numbers have tended to come in a little low.
Try rephrasing the question thus: Might the vast majority of people wearing masks save hundreds of thousands of lives? If there is evidence pointing to a positive answer – even if the evidence is not yet conclusive – it would be rather stone cold, it seems to me, to refuse the temporary inconvenience.
Now let’s get something out of the way. When I read the comments on the websites of some of the anti-masker influencers, I eventually get to the place where someone challenges the germ theory of disease. Lots of people start to then chime in with various “proofs” that germs do not, in fact, cause sickness, and that the whole thing is a conspiracy. If someone subscribes to this belief, obviously he does not think masks prevent the spread of Covid19 or anything else. He will find the entire basis of what I and almost everybody else writes to be illogical. I can’t help that person. I advise that when you come across advocates against masks, double check whether or not they or their followers also question the germ theory of disease.
You suggest a meta analysis of current research. Do you mean research on individual effects (whether a mask does or does not cause fewer respiratory drops with virus to get into the air) or population-level effects of a policy? You can analyze research on population effects between counties, states, or even countries with and without mask mandates; but I don’t think there is any research on places where nobody wore masks during an epidemic.
I think it is important to remind ourselves that for over 100 years, masks have been a standard tool of public health. When there is a harmful virus that is caught by exhalation and inhalation – of which there have been many over the years – masks are used as one of the standard, unquestioned techniques to contain the spread of the virus. During the 1918 Spanish Flu, masks were mandated. For SARS, MERS, etc. - masks.
When it comes to strategies for containment, masks are only one element; but they are in our individual control and the costs are really very few. It happens that the respiratory transmission epidemics in our lifetime mostly took place in Asian countries, and Americans have not had the experience of walking around with masks. If you look at pictures, you will see that even before Covid19, many residents in Asian countries walked around all the time with masks. They protect themselves from viruses and also from pollution. They are used to it. If masks killed people, impaired their cognition, made them catch more viruses or any of the other wild ideas out there, the world would have figured that out by now.
There are now studies modeling the plumes of respiration that are produced by breathing, talking, singing, coughing, sneezing; determining the percentage that are droplets and fall to the ground (and how far away), and the percentage that are aerosolized and float in the air (for how long and at what distance). These studies use physics and engineering to study the effects of indoor physical distance between people, ventilation systems and rates of air replacement, number of people in the indoor space, and masks; also the effects outdoors, how fast the aerosolized particles disperse depending on temperature, humidity, and wind. Other scientists are looking at average amount of this virus in various sizes of exhaled particles at different ages and stages of infection, with and without various sorts of masks; while others have to study how much virus must be inhaled in order for it to lead to a mild or a severe case. All of this will help companies and schools to adapt indoor spaces and develop outdoor protocols that can support health while everything is opened up. These studies are being undertaken quickly and are not all that complicated. And of course there are multiple scientists working on a vaccine. Why can’t we agree to wear masks until these studies are completed so we can more rationally discuss whether or not we are saving hundreds of thousands of lives?
I’d like to say one more thing. If a person l”a needs to call Hatzola on Shabbos, we do not expect the person on the other end of the call to say: How old are you? Do you have pre-existing conditions? Are you definitely going to die? I have to decide whether it’s worth being mechalel Shabbos for you. No, in our religion we value life and health so greatly that we are even mechalel Shabbos – and I’m not sure we remember any more that this is a very serious major deal – for the chance of saving one person’s health or life. Now we are acting as if wearing a mask is worse than being mechalel Shabbos! Hayitochen??
You ask other fair questions about the validity of various numbers being cited. I can’t answer all of this right now or I will never get this response to you! Questioning public health numbers is not off limits; and sometimes it is proper; but sometimes it is a misunderstanding. I have seen no evidence that systematic overreporting the number of deaths attributed to Covid19 is a serious concern. Obviously there are usually multiple contributing factors when a person passes away r”l, but there are rules governing the way hospital records and death certificates codify causes of death. Complications from virus X is a perfectly legitimate cause of death even though those complications were exacerbated by a person’s pre-existing condition. (That is not called a comorbidity, btw.) If the virus hastens the death of a person with cancer, for example, via any sort of complication like pneumonia or heart or kidney damage, the virus is the cause of death. The person wasn’t able to live long enough to see whether or not s/he could have beaten the cancer. Would you make a similar argument if someone with cancer were shot and killed? Well, he would have died anyway?!
If a hospital fudged the numbers in order to get additional funding (and I’m not clear why hospitals would be rewarded for coronavirus deaths), this is fraud. Let someone investigate and find an instance of this. And let the hospital suffer the consequences. Just speculating that fraud might happen, or could happen, is not an argument that it did happen. (You should be aware that Holocaust deniers use arguments like this which cannot be proven true or false.)
Why do you need an exact number of deaths? I’m just wondering. Even if the truly exact number is under or over the reported cases, haven’t we lost enough people, including gedolim, to make us realize it is deadly and to motivate us to make sure not to spread it?
As for social consequences of mask wearing or impacts on child development or rights and freedoms – each requires a separate response. Too briefly: I am pretty sure that a child who loses a parent r”l to this disease will have a worse childhood than a child who lives in a masking world for a year or two. Kids are actually quite resilient, and it is often the parents who are freaking out over masks at schools who are creating the anxiety. Rights and freedoms – yes, this was the argument against seat belt laws and drunk driving laws and bans on indoor smoking and child car seat laws and countless others. Do you also cite this when in a hospital visiting a person in the ICU – forcing me to wear a mask and wash my hands impinges on my rights? What about responsibilities? Isn’t that supposed to be the difference between a secular and a Torah approach to morality? Also - What about the rights of other people to life, liberty, and the pursuit of happiness that you may be infringing upon by refusing to keep your respiratory droplets to yourself? There are emergency situations, like a fire in a crowded building or a pandemic, that limit our individual rights to endanger others.
I hope this answers some of your questions. Clearly more thorough responses to some of them are necessary.
Kol tuv,
S Bechhofer
I believe the root of the disagreement lies in a basic premise which could be summarized in the following question: "Does the vast majority of people wearing masks save hundreds of thousands of lives?"
I think Dr. Bechhofer would say yes and Rabbi. Green would say no. And based on their understanding of the affectiveness of masks they draw their conclusions.
So I believe if agreement is to be reached a meta analysis of the current research should be done.
Also to Rabbi Green it's my understanding that woman including Jewish women in the times of the Tanach may have covered their faces examples such as Tamar and Rochel moshe also wearing a mask after returning of har Sinai. And the masks worn to prevent the spread of desease have nothing to do with avoda zara and have a specific stated purpose (whether affective or not). But I think the bottom line is if wearing masks truly does save hundreds of thousands of lives I think you'd agree that would overrides any of your other halachic and hashkafic considerations you raised.
To Dr. Bechhofer I also have some comments. I do wonder how accurate the 200,000 death number is. Firstly it includes those with comorbidities such as cancer. So the question is did Covid cause the death or was it something else in each case? Also early on there wasn't testing and my understanding is that people showing any symptoms were often said to have died of Covid when they may have had the flu or something else. Further more I've heard that hospitals get money for cases or deaths from covid which may also skew the numbers. Also early on there ws little known a out how to treat it and therefore anymore may have died than would die going forward. Also early on there were reports of patience be neglected and not fed adequately because staff were sacred to get the virus. So these are all things that I think have to be looked at. Further more we must also not only consider the cost of not doing anything but also the cost of our actions. For example what are the consequences of having everyone wear masks socially, on education on child development, people's frustration, our rights and freedoms. And the same for the affects of lockdowns on mental health, suicide, domestic violence, social isolation, job loss, business closures, economy etc.