30 December 2020 — 0654 mst
Set a good example, but swing a big stick
Gov-Elect Gianforte should continue Montana’s mask-up mandate and other Covid-19 containment measures
Gov-Elect Greg Gianforte plans to get vaccinated against CV19 and to wear a face mask while working in Montana’s capitol, both for the protections masks provide and to set a good example for Montanans. That sets him apart from President Trump, whose derision of masks as proof of cowdardice undoubtedly led to many preventable infections and deaths.
Gianforte will leave some of Gov. Bullock’s coronavirus containment directives in place. According to the Kaiser Health News’ Matt Volz:
Gianforte doesn’t plan to scrap everything the outgoing administration has done to fight the pandemic. For example, he said he and Bullock are “on the same page” when it comes to prioritizing distribution of the vaccine to health care workers and vulnerable residents.
On masking-up, however, Gianforte is keeping his options open:
“I trust Montanans with their health and the health of their loved ones,” Gianforte said in a recent interview with KHN. “The state has a role in clearly communicating the risks of who is most vulnerable, what the potential consequences are, but then I do trust Montanans to make the right decisions for themselves and their family.”
The Centers for Disease Control and Prevention says masks help prevent transmission of COVID-19. At least one study has found that states with mask requirements have had slower COVID growth rates compared with those without mandates.
“We’re going to encourage people to wear masks,” Gianforte said. “I’m personally going to lead by example, wearing a mask in the Capitol.”
Under intense pressure from loud little groups of media savvy belligerent barefacers to discontinue Montana’s mask-up mandate, and confronted with a decrease in new CV19 cases, Gianforte may be tempted to relax or discard Montana’s existing mask-up mandate because of the apparent decrease in new cases attributable to the mandate.
Last month, Gov. Bullock imposed a statewide mandate for wearing face masks in buildings accessible to the public and tightened restrictions on bars, restaurants, casinos and gatherings of 25 or more people. At the time, new Covid-19 cases in Montana were averaging 1,000 a day.
In the past 10 days, the state has averaged about 450 new cases a day and below 300 since Christmas. Source: Mike Dennison, KXLH, 28 December 2020.
Below are plots of daily new cases and tests in Montana. The Y-axis uses a Log2 or doubling scale. The for printing PDFs of the plots employs dark markers and text against a paper white background.
Both daily new cases and tests for Montana are down from their highs in November. But CV19 numbers produced during the holiday season may have much wider than usual error bars. According to CNN:
The White House coronavirus task force warned states of incomplete and “unstable” Covid-19 data due to the ongoing holiday season, making it difficult to track the pandemic’s trajectory as concerns rise over continued or accelerated spread.
“Data are currently unstable, outside of daily hospital admissions, due to inconsistent reporting and incomplete data over the holidays; there will be a reporting ‘surge’ in cases and deaths as reporting catches up,” the task force said in multiple reports sent to state officials dated December 27 and obtained by CNN.
The Covid Tracking Project, the nation’s best source of CV19 daily data, warns “With the winter holidays, we expect a number of reporting and data anomalies for the next few weeks. We urge caution in using these figures.”
Montana’s recent CV19 data may not be reliable — but even if they are, if the new cases curve is bending downward, that is no more a reason to abandon masking-up and other containment measures than a decrease in one’s blood pressure justifies discontinuing one’s blood pressure medicine.
During the deadly 1918 influenza pandemic, reports Lawrence Wright in The New Yorker, communities that kept their disease containment measures in place fared better than those that did not:
In 1918, Americans faced the same confounding choices as today. Twenty-five cities closed their schools once; fourteen did so twice, and Kansas City three times. More than half the cities were “double-humped”—suffering two waves of the flu. “They raised the bar too early because the natives got restless,” Markel, who is now a professor at the University of Michigan, told me. “They each acted as their own control group. When the measures were on, the cases went down. When the measures were off, the cases went up.”
After Philadelphia permitted a Liberty Loans parade, there was a huge uptick in cases. St. Louis, by contrast, cancelled all parades, and local officials broadcast a unified message. The city’s health commissioner published an op-ed alerting citizens to the threat, immediately closing entertainment venues and banning public gatherings.
St. Louis’s death rate was half of Philadelphia’s. By quickly imposing several nonpharmaceutical interventions, a city could dramatically lower the peak of infection—on a graph, it would look more like a rainbow than like a skyscraper. Markel compared each intervention to a slice of Swiss cheese; one layer by itself was too riddled with holes to be effective, but multiple layers made a profound difference. “Early, layered, and long” was the formula.
JAMA published the study in 2007. The authors declared, “We found no example of a city that had a second peak of influenza while the first set of nonpharmaceutical interventions were still in effect.” In the century since 1918, technology has transformed so much, but the tools for curbing a novel pandemic haven’t changed. Masks, social distancing, and frequent hand washing remain the only reliable ways to limit contagion until treatments or vaccines emerge.
That’s what will happen in Montana if the mask-up mandate is lifted before vaccinations in Montana produce herd immunity to the coronavirus that escaped from Wuhan, China.
Gov-Elect Gianforte is half right. Montana’s must take personal responsibility for masking-up. At home, masking-up is a personal choice. But in public, in the presence of others, masking-up is a civic obligation that must be observed and enforced. Setting a good example will not be enough. Gov-Elect Gianforte must wear a mask — and he must carry a big stick to cudgel the barenosers, barefacers, and just plain ornery troublemakers, who flout their civic obligations thereby putting the rest of us at unnecessary, preventable, risk.