What is it about a little piece of cloth hanging off our faces that turns “mask” into a four-letter word?
“Thank you Governor Stitt for continuing to not trespass on our constitutional/human right to medical freedom!! We support you!” said one of more than 1,000 commenters on the Facebook video of Thursday’s press conference at which Gov. Kevin Stitt said he has no plans to impose a statewide face mask mandate.
“You people who refuse masks because of rights should be forced to have covid (sic),” another commenter retorted.
In a time of uncertainty and change, Americans are squared off over a simple piece of medical equipment. Somehow, it has become an icon of righteous outrage for both those who wear them and those who don’t.
“It becomes a marker for either being uncaring about your fellow humans or of being compliant and part of some other side,” said University of Tulsa psychology professor Bradley Brummel.
“As soon as it takes on that nature, it picks up all that baggage we see most clearly in political identification,” he said.
In some ways, this is rooted in American history and perhaps in plain human nature. One of the issues that politically divided the early republic was the treatment and prevention of smallpox.
With virtual unanimity, experts say masks of almost any kind are better than no mask at all, and a good mask properly worn can substantially reduce the spread of COVID-19. They say a mask protects others more than it protects the wearer.
But a substantial number of Americans don’t believe the experts, or at any rate don’t believe COVID-19 is a serious threat to themselves and those around them.
“We’re not very good as humans at understanding or estimating risks, especially when they’re low base rates,” said Thad Leffingwell, head of the psychology department at Oklahoma State University. “Right now the rate of contracting coronavirus is still low and dying from it is even lower.”
But even those low rates result in significant illness and death. That math is one of the reasons several Oklahoma communities, including Tulsa, have instituted mask ordinances or are considering them.
One objection to such ordinances is the difficulty of enforcement, but Leffingwell said that misses the point.
“The main utility of these types of ordinances is to set the community norm, to say this is what we expect people to do in public,” he said. “People mostly want to conform with community norms.”
Leffingwell and Brummel both said they believe active resistance to masks and mask ordinances is magnified by social media.
“I think people are not having angry outbursts about masks nearly as much as it seems,” said Brummel. “Any time anyone does something truly outside the norm it gets shared on social media and gets amplified and shared. The attacking people and yelling at people in stores is really pretty rare.”
Michael Brose, CEO of Mental Health Association Oklahoma, thinks resistance to wearing masks is more complicated than is often portrayed.
“It’s a very layered, multi-pronged issue,” Brose said. “Whether people choose to wear them or not wear them, or when they wear them or when they don’t wear them, is very complex.
“There’s been a lot written and said about the politics of it, but I really think it’s a lot more nuanced than that for a lot of people,” he said.
“For a lot of people, it’s a courtesy thing,” Brose said. “ ‘I don’t want to infect you and would really prefer you didn’t infect me.’”
Brose said he believes some people truly have difficulty breathing through masks, particularly in the heat, and some people are thrown off by no longer being able to read others’ faces.
And, the three psychologists agreed, face masks are a very visible reminder that “things are not normal” — something a lot of people want desperately not to be so.
Interestingly, this is not the first time wearing masks during a pandemic has divided American public opinion.
According to a recent study, face masks were resisted more than any other measure taken to combat the influenza epidemic of 1918-19. One San Franciscan was so upset by that city’s mask ordinance he mailed a bomb to the city’s chief public health officer.
The bomb, fortunately, was discovered and defused before it could explode.
Things haven’t reached that point in Oklahoma, but the argument has gotten intense. On the one hand are those who believe wearing a face mask — or, more to the point, being required to wear one — is an invasion of personal liberty. Some maintain it is unconstitutional.
On the other are those incensed that their lives are being put at risk over a nebulous concept of individual freedom and what some see as sheer stubbornness.
“The well-meaning people who are trying to encourage mask use are really doing their cause a disservice when they mock, threaten, insult anyone not wearing a mask,” said Brummel. “If your goal is to help people see the wisdom in it, you’re going to get that immediate shutdown reaction.
“Otherwise,” he said, “we just jump into our camps and go find people who agree with us, call the other side idiots, and go on about our day.”
COVID-19 basics everyone needs to know as the pandemic continues
How it spreads, who's at risk

Studies have shown many infected people show no symptoms or have symptoms so mild they may go undetected; those people can still transmit COVID-19 to About 20% of patients diagnosed with COVID-19 require hospitalization.
The disease can be fatal, especially for vulnerable populations: those older than 65, living in a nursing home or long-term care facility, and anyone with underlying health conditions such as diabetes, heart disease, lung disease or obesity.
Science of virus spread

COVID-19 is spread mainly from person to person via respiratory droplets produced by an infected person. Spread is most likely when people are in close contact, within about 6 feet. A person might also be infected with COVID-19 after touching a surface or object that has the virus on it and then touching their face. According to the CDC, evidence suggests the novel coronavirus may remain viable for hours to days on surfaces, though that form of transmission is said to be minor.
Transmission between people more than 6 feet from one another may occur in poorly ventilated and enclosed spaces, the CDC says, especially where activities cause heavier breathing, such as singing or exercising.
The infectious period for patients can begin up to 48 hours before symptom onset.
List of symptoms

The CDC recently expanded its list of possible symptoms of COVID-19. The symptoms can appear from two days to two weeks after exposure.
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
This list does not include all possible symptoms and will continue to be updated by the CDC. One symptom not included is "purple toes," which someone may experience with no other symptoms, sometimes several weeks after the acute phase of an infection is over. The coloration and pain is caused by a lack of blood flow to the toes caused by excessive blood clotting, a late-stage concern with COVID-19 infections.
Kinds of testing

Those getting tested may experience different kinds of swabs. The viral test, known as PCR, involves a deep nasal swab that can be painful.
Other tests that require less-invasive swabs may produce results faster, but with less accuracy. These should not be used diagnostically.
It is not yet known whether COVID-19 antibodies can protect someone being infected again or how long protection might last.
The 'serious seven'

The "serious seven" refer to close contact environments where residents should take extra precautions if they choose to attend. The seven are gyms, weddings, house gatherings, bars, funerals, faith-based activities and other small events, according to Tulsa Health Department Director Bruce Dart.
Treatments being investigated

The FDA has allowed for antiviral drug remdesivir, previously tested on humans with Ebola, to treat more severe cases of COVID-19 in adults and children. Safety and effectiveness aside, preliminary studies have shown it can shorten recovery time for some patients.
After previously approving an emergency use authorization, the FDA as of July 1 cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial. A review of safety issues includes reports of serious heart rhythm problems and other safety issues, including blood and lymph system disorders, kidney injuries, and liver problems and failure.
Convalescent serum therapy

Some patients are receiving convalescent serum, meaning the antibodies made by people who have recovered after a COVID-19 infection. Antibody-rich blood plasma is being given to severely or critically ill COVID-19 patients, including Ascension St. John, Saint Francis Health System, OSU Center for Health Sciences and Hillcrest HealthCare System in Tulsa.
From June to July, requests for convalescent plasma from the Oklahoma Blood Institute multiplied seven-fold.
Recovery, as defined by CDC

To be considered recovered (without a test), these three things must happen, the CDC advises:
- No fever for at least 72 hours (three full days of normal temperature without the use of medicine)
- Other symptoms improved (no more cough, etc.)
- At least 10 days since symptoms first appeared
Randy Krehbiel 918-581-8365
randy.krehbiel
@tulsaworld.com
Twitter: @rkrehbiel