As the COVID-19 pandemic continues and the University of Utah prepares for a safe return to school, face coverings have gained importance as an inexpensive and effective measure to slow infection. But wearing face coverings, particularly as mandated by governments or retail outlets, has became a hot political topic, in Utah and elsewhere.

We spoke with University of Utah political scientist Phillip Singer, who studies the politics of public health policies, for some context. The debate over face coverings echoes those from public health measures, he says, even as far back as the 1918 flu pandemic. But wearing a face covering can transcend politics—and become an action that benefits an entire community.

Many public health measures such as seatbelts are widely supported. Why are face coverings perceived differently?

The politicization of masks fits within the broader patterns that we’ve seen with other public health interventions going back decades. The example that you raised is a seatbelt. I was actually just recently reading an article from a legislator from the state of Michigan in the 1980s. Michigan was making some regulations around seatbelt usage. And this legislator mentioned that people were writing him letters, calling his office, calling him a Nazi and other distasteful language because of his support for a seatbelt mandate.

That is one in a long pattern of opposition to a variety of public health interventions. We might hope that we wouldn’t politicize something that saves lives, but that is not what we see in actuality. Groups of people view these public health interventions as an infringement on their freedoms. Which fits with what public health tries to do—it prevents something from happening. So, in the case of seatbelts, you can’t prevent the car crash, but maybe you can mandate seatbelt use and prevent the really bad outcomes from happening.

The thing to remember is that humans are flexible, we get use to changes in laws and changes in our environment. These things quickly become the “new normal.” Think about the last time your favorite website made some change to their platform, how it looks, how it works. There is usually an immediate revolt over those changes, but fairly quickly that goes away as people learn how to navigate the changes. In the case of seatbelts, it feels weird now to not wear one. It has become an ingrained behavior for lots of people. You get to your car, you turn it on and you click in your seatbelt. But, in the U.S. we don’t have a history of wearing face masks. In other countries, every flu season you will see lots of people out wearing masks. We don’t have that yet. So, there is this element of a mask feeling weird, forgetting to have one on you or feeling like you stick out by wearing one.

So what factors beyond political affiliation would influence a person to wear a mask or not?

Political affiliation is a really important driver for the adoption of a variety of social distancing behaviors, including wearing a mask. Over the last six months, there have been a lot of surveys asking about health behaviors and the most consistent finding across the surveys is that political factors explain what we do and how we view this virus. Individuals that self-identify as conservative are more likely to believe COVID is not dangerous or as exaggerated, are more likely to believe conspiracy theories about the disease and are less likely to adopt social distancing behavior.

There are other reasons that influence the decision to wear a mask. Some people have expressed reticence because it looks and feels claustrophobic or it can make it difficult to breathe, but really politics is the important factor explaining views on a face mask.

Is there a parallel between this moment and other health movements in the past?

There are, very much, parallels to the past. In 1918, we had a devasting worldwide flu, killing tens of millions of people. In the lead-up to the 1918 midterm elections you had a Democratic president, Woodrow Wilson, and Democratic control over both chambers of Congress. Republicans really used the failures to contain the flu as a political cudgel against Democrats and against Wilson. And it worked. Republicans gained six seats in the Senate and 24 seats in the House of Representatives and took back control of Congress for the first time in a decade. You can go back to the archives and find old newspaper articles from 1918, where it’s very similar language about the infringement of freedoms, about how masks shouldn’t be worn or shouldn’t be required to be worn. Even going back a century, we see the same sort of sort of themes and politics that we see in 2020.

I, and some colleagues, have studied different, prior infectious disease outbreaks. You look at public opinion data from the Ebola virus in 2014 and you see this same partisan divisions that we have going on today. In that case, we had Barack Obama in the White House. In the lead up to the 2014 midterm election we see Republicans using Ebola to score political points and have a successful midterm election. At that time, individuals that identified as Democrats were less concerned about Ebola; they didn’t think it was that big of a deal or that big of a problem. They expressed more confidence in the federal government. They believed the CDC and they believed the news from the Obama administration. And we see a flip-flop today, right? It’s Republicans who trust Donald Trump for giving them the correct information.

This is 2020, and COVID-19 fit a pattern of at least for the last hundred years how infectious disease and public health have been perceived by the public and how it’s been used by elected officials for their own electoral outcomes.

What helps a society or individuals become comfortable with a public health measure that initially meets opposition?

As of five months ago, I don’t think I’d ever worn a mask. Now I’ve gotten to the point where just by acting on those behaviors, it’s become much more second nature. One of the big challenges is getting people to just start with that behavior. That’s why, frankly, mandates occur so frequently with public health interventions, because if we’re just relying on the willingness of an individual to adopt the behavior, we’re going to be waiting a long time.

So that’s why, even over the last couple of weeks, we’re seeing the winds shift towards depoliticizing mask wearing. We’ve got a Republican governor of the very conservative state of Alabama and a Republican governor of Arkansas coming out with mask mandates. President Trump, a few months ago, was saying, “Anybody who’s wearing a mask is doing this to make me look bad,” which is telling his supporters, “If you want to support me, don’t wear a mask.” He recently tweeted out a picture of himself in a mask and connected it to patriotism. So we’re see a little bit of change on this. And I think that’s probably because more than 160,000 people have died in the U.S. and the U.S. has failed to contain and mitigate the danger of COVID. Getting people to initially adopt these behaviors is really challenging. If there’s a mandate, then people get used to it. That’s really when you see these shifts in those behaviors.

What helps someone to adopt a behavior when it’s not required by law?

This is one of the central problems for public health practitioners. Because there is such a wide partisan divide on wearing masks you need to think how you conduct outreach in a way that “speaks” to different people. For example, this might mean having to think through how concepts of freedom might vary across groups of people and convey information that is meaningful and can transcend political differences. Freedom can mean that you are keeping your neighbor, someone walking down the hallway at school or at the grocery store or at work free from the virus.

Do you have a personal favorite face covering that you wear?

I think the most important thing is the functionality of the mask, that you are wearing it properly and that it is comfortable for you.

But besides that, I want to give a shout out to my wife, Jen. She is an incredibly talented and creative person. When the shutdowns started happening in mid-March, we had already bought masks for each member of our family. But she started making masks for our extended family, our neighbors and friends who didn’t have masks because of the shortages. The reason I love the masks she made is because ultimately our decisions with COVID are about our compassion and love for other people. We are connected and a pandemic helps teach us that. The masks that she made for her family and loved ones are a physical manifestation of that love, that compassion that we can have for each other. There is this really lovely scene in Albert Camus’ book “The Plague” where two friends are swimming together in the sea and their movements in the water begin to weave together. That is what COVID requires— recognizing our individuality, but also our shared humanity and to act together.