Podcast: When Can I Take Off My Mask?
The coronavirus pandemic has led businesses and governments to perform “hygiene theater,” which can give a false sense of security. But how do we thread the needle between being too cautious and too cavalier? Derek Thompson joins James Hamblin and Maeve Higgins to help us understand. Listen to their conversation on the podcast Social Distance:Subscribe to Social Distance to receive new episodes as soon as they’re published.What follows is a transcript of their conversation, edited for length and clarity:Maeve Higgins: Can you explain what “hygiene theater” is?Derek Thompson: I would define hygiene theater as activities that might make you feel safer, but don’t actually make you any safer from the pandemic. A great example of hygiene theater—something that I did a year ago in March and April of 2020—was washing all of my fruits and vegetables with soap. I thought that’s where the virus lived. I thought it lived on apple skins and potatoes. And it just doesn’t really.I’ve written a couple of articles about how individuals, but much more importantly companies and even governments, have put too much weight on surface transmission of this disease: shutting down schools to clean the walls and the desks or shutting down the Metro or the subway so that they can wash down the seats. This is an utter waste of money and time, and time and money are scarce and important. And I think we should stop it.Higgins: Is it still kind of good that everyone’s taking care and being cleaner?Thompson: This is a totally valid argument. And I constantly find myself having to distinguish between what I think of as hygiene theater and other behaviors that are just fine and not that important. If people want to wash their hands constantly during a pandemic, I’m definitely not going to criticize that behavior. Washing your hands in order to get rid of bacteria is a fine, smart thing to do, pandemic or no pandemic.Hygiene theater is a problem for a totally different reason: At a conceptual level, we should be fighting this disease where it lives, and not telling people to fight this disease where it doesn’t live. People only have so much time in their day. They only have so much money. They only have so much cognitive capacity that they’re going to spend for this pandemic. We want to tell them the truth. And the truth is that this is basically an indoor, talking disease. You should be cautious when you’re indoors [and] especially cautious when you’re talking, but otherwise, this virus does not seem to spread very effectively. And so we should be encouraging people to go outside and not think so much about this disease living like bacteria on our kitchen table.If you think about urban-transit authorities, is it good that they’re cleaning the subway a little bit more than they might have been cleaning it years ago? Yeah, that’s totally fine. But in a period when the New York subway is running low on money and they’re having to shut down service at night, I don’t want them spending scarce money on blasting their subways and buses with antimicrobial weaponry. That is a waste of scarce resources. And it builds a false sense of security. In spaces like restaurants, if you see someone scrubbing down a table vigorously and think to yourself that means the restaurant is safe, the virus isn’t living on the table and that elbow grease is totally theatrical. What matters is ventilation in that restaurant, if you’re not vaccinated. I want people to focus on the threat this virus poses and to not focus on the threat this virus doesn’t pose.James Hamblin: We only have so much energy. We don’t want to feel like we’re getting credit for something that’s not actually doing anything. That leads into your argument about outdoor masking probably being overdone.Thompson: I was getting drinks with a friend last week and I did something that sort of struck me as kind of funny: I wore a mask while I was alone outside and then I de–masked up at this outdoor patio when I sat close to a person for two hours. From an epidemiological perspective, that’s kind of the opposite of what makes sense. This virus poses no threat to individuals walking alone down the street, but in close encounters and less ventilated spaces, it is more dangerous.It felt like wearing a seat belt in a parked car and then unbuckling the seat belt just as I put the car in drive. It felt like doing the opposite of what safety precautions should dictate. So I wrote this piece essentially pointing out, based on lots of research, that this virus does not seem to spread very effectively outside and we should probably think about very soon lifting outdoor mask mandates while encouraging vaccinated and unvaccinated people to wear their masks in public indoor spaces.I want people to live their life as normally as possible while protecting themselves as reasonably as possible. And I think the way to do that is: masks inside, masks in crowds, no outdoor mask mandates for people just living their life outside.Higgins: If hygiene theater is what we’ve maybe been overdoing, what haven’t we been doing enough of that we should probably do more?Thompson: I’m really glad that you asked that. I think people listen to me and [often] they’re like: Oh, you don’t take the pandemic seriously. And I do. I just conceptualize of this pandemic very specifically. It’s an indoor, talking disease, for the most part. If you are talking or breathing inside in an exerted way, like at the gym, that’s where the threat is. I think that people have sometimes had a really backward idea of what they should be doing inside.I wrote this piece last summer about library rules for America. We should have signs on places like CVS or Trader Joe’s that say: Please Keep Your Voice Down. This disease truly does spread through the aerosolization that comes from our talking. So people who go into CVS with their masks on and then pull down their mask to talk more clearly into [their cellphone] have completely misunderstood how this virus works. Don’t do that. Keep your voice down. That’s a very reasonable thing to ask of people in these public spaces.But I’m for giving and taking. We should take away from people this freedom they might feel to chat loudly on the phone in CVS and Trader Joe’s, while at the same time giving them the removal of outdoor mask mandates. [We should be] giving them the outside, not shutting down beaches [or] shaming people for going out in a park without their masks on. We should be celebrating the outdoors, while more tightly regulating the indoors.Hamblin: I couldn’t agree more with you, Derek. This is an issue that, in covering health behaviors, I tend to run up against quite a lot. People see binaries. Something is either good or bad. And masks seem to fall in that category where it’s hard to emphasize that things are only good or bad in context.How do you think about threading that needle for people who are just like: I thought I needed to wear a mask. Now you’re saying I don’t need to wear a mask? I think Dr. [Anthony] Fauci sees that binary and thinks: We need to keep people in the “Masks are good” category and not the “Masks are bad” category. Thompson: Masks work, period. But they’re not doing that work when you’re outside and alone. Seat belts work, period. Are seat belts doing any work when you’re sitting in a parked car in a parking lot? So it doesn’t make any sense to write local ordinances that say people in parked cars must have their seat belts on. That’s how I feel about masks. I think the public can take a little bit more nuance.Hamblin: Yeah, I hear you. Masks are good and seat belts are good. But if you blend either of them up into a smoothie and drink them, that’s not good.Thompson: Yes, good things out of context can be pointless, especially if you blend them into smoothies.theatlantic.com
What Grief Tastes Like
The musician Michelle Zauner’s mother died on October 18, 2014, a date that Zauner would have trouble remembering in the years that followed. She wasn’t quite sure why she was always forgetting it. Maybe this amnesia was her mind’s way of protecting itself. Maybe she scrubbed the detail from memory because it seemed so minute compared to all else she endured as her mother succumbed to cancer.But Zauner hasn’t been able to forget what her mother ate. The older woman’s appetite was particular, Zauner writes in Crying in H Mart, her moving new memoir. Her mother would order minestrone with extra broth at Olive Garden “steamy hot,” a quirk of language that revealed her native Korean tongue. She’d feast on roasted chestnuts in the winter. She’d ask for extra vegetables with the spicy seafood noodle soup called jjamppong that she got from a Korean restaurant in Eugene, Oregon, near where Zauner’s family lived.Likely best known to the public as the singer and guitarist Japanese Breakfast, Zauner spends Crying in H Mart detailing the disorientation that her grief gave rise to, weaving food into her process of mourning. (The book feels particularly, if unintentionally, suited to this period in history, after the past year of accumulated grief.) Food is more than an anchor for Zauner as she navigates loss. She also uses it to construct her identity as a biracial woman, one she experienced in fractured terms being raised by a white American father and Korean mother in the States. Grief seems to split this internal crisis open. Building on Zauner’s popular 2018 New Yorker essay of the same name (which forms the basis of the first chapter), this expanded effort reveals the possibilities—and occasional constraints—of deploying food as a tool of memoir.The very act of eating, as Zauner shows, can buoy the bonds between loved ones. If Oregon could feel like a confusing place for her to come of age, she’d find comfort spending summers visiting her Korean family in Seoul. There, on sleepless nights, she and her mother would scavenge the refrigerator for any snacks they could find: cucumber kimchi, yellow sprouts with scallions and sesame oil, braised black soybeans. “This is how I know you’re a true Korean,” Zauner’s mother would tell her. These meals would tether Zauner to her Korean heritage. Yet her mother died early, at only 56. Zauner and I were the same age—25—when we lost a parent, and in the same way, to cancer. The loss felt seismic, and Zauner forcefully articulates the gravity of losing a parent at a pivotal age. “It was the year her life ended and mine fell apart,” she states early on.[Read: Why comfort food comforts]Zauner is specific in recounting her mother’s sudden diagnosis and swift deterioration, refusing to collapse into generalities about grief. She is precise and unsparing in describing cancer’s physical indignities, for example, and she’s especially graceful when placing food in these memories. Zauner recalls feeding her mother tteokguk, a soup of rice cakes in mild beef broth. She renders the scene in plain, effective terms: “Again she resisted, managing only a few bites, which she vomited later that night.” Later in the book, her mother’s body breaks down, and Zauner watches in horror. “Her tongue looked rotten—like a sack of aging meat,” she observes. Her mother’s final breaths resemble “a horrible sucking like the last sputtering of a coffee pot.” These food metaphors help capture the illogic of this disease, how cruelly it deprived her mother of life.Grief has long been fertile narrative terrain for food memorists, many of them women. Zauner’s book recalls the writer Molly Wizenberg’s A Homemade Life (2009), in which the death of Wizenberg’s father from cancer clarifies her desire to commit her life to writing about cooking. Donia Bijan starts Maman’s Homesick Pie (2011) by describing the freakish death of her mother, an immigrant from Iran who’d been run over by a car. The book reads like an elegy: Bijan perceives her mother’s trove of old recipes as a way to understand the enormous courage it took to leave Iran in exile at the start of the Iranian Revolution. A more recent entry in this micro-genre is Olivia Potts’s melancholic, often funny book A Half Baked Idea (2019), which begins, too, with her mother’s unexpected death from a stomach ulcer. I offer these comparisons with caution—each of these books comes with recipes, and Zauner’s does not—but in all of these memoirs, loss animates the appetite.[Read: Writing an Iranian cookbook in an age of anxiety]Though it lacks recipes, Crying in H Mart teems with descriptions of food, and one’s mileage may vary with them. Zauner front-loads her book with elaborate memories of consumption that sometimes have a flimsy connection to the narrative spine. She regales readers with recollections of an herbal tea she had in Seoul, writing that it “tasted like fruit rinds soaked in murky lake water and was the most bitter thing I’d ever consumed.” She describes how her grandmother would cook “large batches of yukgaejang, taking pounds of brisket, bracken root, radishes, garlic, and bean sprouts, and bubbling them into a spicy shredded-beef soup, which she would ladle into small plastic bags and sell to office workers on their lunch breaks.” Zauner devotes lines to the “decadent jjajangmyeon noodles, dumpling after dumpling served in rich broth, tangsuyuk pork with mushrooms and peppers, and yusanseul, gelatinous sea cucumber with squid, shrimp, and zucchini” she ate with her Korean family at a restaurant.Zauner illustrates these dishes with impressive clarity, yet her voice reads as uncharacteristically dutiful during these diversions, too, revealing the pitfalls of writing about food when there’s a larger story to tell. She starts to sound as if she’s reciting the items on a menu, or rattling off a cookbook’s recipe ingredients, rather than using food to glean insight into her characters and their moods. In the book’s weaker junctures—primarily in the stretch before her mother’s diagnosis—Zauner’s food descriptions seem to function primarily to stimulate the reader’s appetite. It may seem inane to fault a food-centric memoir for devoting too much real estate to food, yet these minor missteps expose the genre’s limitations. Reading certain passages, I am reminded of the times in my career as a professional food writer when editors have pleaded with me to bring the story back to the food, as Zauner does here. This is the food writer’s dilemma: So often, our implicit job is to make our reader hungry. But fulfilling that brief can easily cause a writer to lose sight of their tale’s focus. As lovely as Zauner’s indulgent sketches of meals are, they slow her momentum.But agile writers know how to mine food for emotional truth, and Zauner finds her footing as Crying in H Mart progresses. Near the end, she connects food to her own unmooring. She looks back on miyeokguk, the nutrient-rich seaweed soup that she ate in Seoul after her mother’s death. That dish, she writes, is one that women often eat postpartum, or on birthdays as a way to celebrate one’s mother. For Zauner, her mother’s loss imbued this soup with symbolic weight: “It soothed me, as if I were back in the womb, free floating.” Later, she remembers how she “had thought fermentation was controlled death.” In these instances, food isn’t just an object; it’s a character. It reveals Zauner’s renewed awareness of the cycles of birth and death. Everything she eats is a reminder that she’s still here.Meals, too, can summon someone’s spirit long after they’ve left us. The most arresting example of this is when Zauner recounts how she sought solace in the YouTube videos of the popular Korean chef Emily Kim, known to many as Maangchi. “Every dish I cooked exhumed a memory,” Zauner writes. “Every scent and taste brought me back for a moment to an unravaged home.” Here, Zauner realizes food’s full narrative potential: It triggers memory with such force that the dead nearly spring back to life. The recipes—for Korean fried chicken, for black-bean noodles, for mandu filled with tofu and bean sprouts—are time capsules. Food can teleport us to a lost moment from the past, a version of the world where we can find those we’ve lost.theatlantic.com
We Are Turning COVID-19 Into a Young Person’s Disease
Like many parents, Jason Newland, a pediatrician at Washington University in St. Louis and a dad to three teens ages 19, 17, and 15, now lives in a mixed-vaccination household. His 19-year-old got vaccinated with Johnson & Johnson’s shot two weeks ago and the 17-year-old with Pfizer’s, which is available to teens as young as 16.The 15-year-old is still waiting for her shot, though—a bit impatiently now. “She’s like, ‘Dude, look at me here,’” Newland told me. “‘Why don’t you just tell them I’m 16?’” But because certain pharmaceutical companies set certain age cutoffs for their clinical trial, she alone in her family can’t get a COVID-19 shot. She’s the only one who remains vulnerable. She’s the only one who has to quarantine from all her friends if she gets exposed.In America, adults are racing headlong into a post-vaccination summer while kids are being left in vaccine limbo. Pfizer’s shot is likely to be authorized for ages 12 to 15 in several weeks’ time, but younger kids may have to wait until the fall or even early 2022 as clinical trials run their course. This “age de-escalation” strategy is typical for clinical trials, but it means this confusing period of vaccinated adults and unvaccinated kids will not be over soon. And the pandemic will start to look quite different.How different? Vaccination is already changing the landscape of COVID-19 risk by age. In the U.S., hospital admissions have fallen dramatically for adults over 70 who were prioritized for vaccines, but they have remained steady—or have even risen slightly—in younger groups that became eligible more recently. This trend is likely to continue as vaccines reach younger and younger adults. Over the summer, the absolute number of cases may drop as mass vaccination dampens transmission while the relative share of cases among the unvaccinated rises, simply because they are the ones still susceptible. The unvaccinated group will, of course, be disproportionately children. By dint of our vaccine order, COVID-19 will start looking like a disease of the young.This means vaccines are working, but it also means many Americans are flipping how they think about COVID-19 risk. Adults who spent the past year worrying about their elderly parents are now worrying about their kids instead. The risks are not equivalent, of course: Kids are 8,700 times less likely to die of COVID-19 compared with those older than 85. But “even if the risk is not particularly high, you’re still going to be extra protective of your kids,” says Sandra Albrecht, an epidemiologist at Columbia. “It’s just human nature.”In coming months, parents may find themselves going back to normal while their kids still have to wear masks indoors. “It’s a very strange relationship to feel protected when your kids are still not,” Jennifer Nuzzo, an epidemiologist at Johns Hopkins, told me. But some 30 million households have children still too young to be vaccinated; in these families, parents and caretakers, especially of the youngest children, will have to keep navigating this incongruous world.The biggest risk factor to consider for unvaccinated kids, experts told me, is simply how much COVID-19 is spreading in the community. The U.S. is currently vaccinating at a good clip, and even partial herd immunity will slow transmission of the coronavirus. Seasonal effects may drive case numbers even lower in the summer. “If there’s very little virus circulating, that’s a pretty low-risk situation,” says Sean O’Leary, a pediatrician at Children’s Hospital Colorado.Experts have pegged the threshold where general restrictions can relax at 5,000 to 10,000 cases per day—the point at which risk of COVID-19 is roughly comparable to risk of the flu. (For context, the seven-day average of daily COVID-19 cases in the U.S. reached a low point of 20,000 last summer and peaked at 250,000 during the winter surge; that number has since plateaued at 70,000.) Not everyone will feel comfortable with the same level of risk though. Even before the pandemic, O’Leary points out, parents with children who have high-risk medical conditions were very careful about, say, traveling during flu season. COVID-19 might be another reason for these families to be vigilant.But already, momentum in the country is shifting toward reopening. States are ending their mask mandates and COVID-19 restrictions. How low cases go in the U.S. later this year will depend on the speed at which we inoculate harder-to-reach populations, as well as continued vigilance among the still-unvaccinated. Letting up after a year of social distancing is tempting, but as my colleague Katherine Wu writes, our vaccine cheat days add up.Variants may also influence case levels, but it’s not entirely clear how much. Early on, scientists in the U.K. thought the B.1.1.7 strain might be disproportionately more contagious among children than among adults, but the pattern has not held up. That may be because the variant was first detected after schools in the U.K. opened in the fall, explains Oliver Ratmann, a statistician at Imperial College London who has modeled the implications of the variant for kids. Then schools closed and mobility patterns changed over the holidays, which complicated the preliminary trends. The earlier pattern of B.1.1.7 in kids might just have reflected who had a chance to spread the virus at the time, especially because U.K. schools took fewer precautions, such as mask wearing, compared with many in the U.S. The evidence on whether this variant causes more severe illness is also mixed.What is clear, though, is that B.1.1.7 is more transmissible than the original virus among all age groups. In some places, that could tip the balance toward rising cases, but other factors are clearly at play too. For example, Michigan has a lot of B.1.1.7 cases and is experiencing a terrible COVID-19 surge, but Florida, which also has high numbers of B.1.1.7, is not. “The variants don’t help, but they’re not fully to blame,” Nuzzo said. The same precautions that worked before—including good ventilation, masking, and social distancing—still work against B.1.1.7.All of these concerns could come to a head in schools, which are one of the main places where unvaccinated people—e.g., kids—will congregate. As the U.S. is already seeing, school outbreaks do happen, but they can be contained with precautions in place. This means younger kids, who likely won’t get vaccinated before the fall, may have to continue to wear masks indoors. But the benefits of in-person schooling are significant enough, experts told me, that schools should open even if kids can’t get shots yet.The trickier question is what kids can do outside of school when it comes to playdates, sports, and extracurricular activities. In Michigan, officials have suggested that high-school athletics and the socializing around sports—rather than classes themselves—are driving the uptick in cases among teens. Parents and kids will have to decide together which risks are worth taking. Newland told me his 15-year-old daughter sees her core group of friends and plays sports. But she’s decided to keep taking virtual classes, even though her risk of contracting COVID-19 at school is low, because exposure to any cases at school could trigger a quarantine that keeps her from playing sports, which is important to her. That’s the tradeoff they’ve decided to make, but they’d of course prefer not having to make it. As Newland said, “I feel much better about my other daughter, who got vaccinated at 17.”At least 15-year-olds have an end in sight; they are likely to be eligible for Pfizer’s vaccine soon. Parents of younger kids may have to keep making these split decisions a lot longer. In their strange world, a dinner party with their adult friends is fine, but a birthday party for their 5-year-old could still spread the virus. When I asked several experts about a hypothetical party for unvaccinated preschoolers in the fall, they told me they would continue to think about ways to reduce risk, such as keeping the gathering small and outdoors. These assessments are hard to make in advance: We don’t know exactly what the situation will look like and how much the virus will still be circulating. Perhaps COVID-19 will have faded enough that people won’t be spending every waking minute thinking about the virus anymore. Perhaps not.To make these decisions more difficult, the situation probably won’t be the same everywhere in America. Already, rural residents report less interest in getting the shots than people living in cities and suburbs. Whether because of vaccine hesitancy or unequal access, “I think there’s going to be a huge amount of variation geographically,” says Whitney Robinson, an epidemiologist at UNC Gillings School of Global Public Health. The virus may continue to circulate in pockets of the country where not enough eligible adults are vaccinated. These adults plus still-ineligible kids could add up to a pretty large pool of susceptible people.Ultimately, the risk to unvaccinated kids later this year depends on the actions we take now. The faster we vaccinate and the better we suppress cases through other measures, the safer the situation will be for anyone who remains uninoculated in the fall. Then, finally, parents can stop telling kids to do things that they themselves are not doing—which, as former kids I think can agree, is literally the worst.theatlantic.com