Most of the debate over COVID-19-inspired mask mandates addresses their alleged benefits, such as reduced illness and death; much less focuses on the potential costs.
New research, however, suggests the costs are significant:
Our research … collected survey data from over 4,000 respondents in February 2022…. The survey … asked each respondent to report the amount of money they would be willing to pay to be exempt from a mask mandate for three months ….
Our results reveal that 56 percent of respondents would not be willing to pay any amount to be exempt from a three-month mask mandate, while the average amount that respondents would be willing to pay is $525. This suggests that a minority of the population perceive that wearing masks has a high cost.… Difficulty breathing was the top reason for not wanting to wear a mask, reported by 48 percent of respondents, followed by discomfort (45 percent), not being verbally understood (36 percent), and missing facial expressions (28 percent).
We used these estimates of respondents’ willingness to pay for an exemption to calculate the number of lives that would need to be saved for the benefits of a three-month, nationwide mask mandate to equal the mandate’s costs. … Our survey findings imply that a three-month masking order in the United States costs roughly $164 billion in 2022 dollars. Thus, a nationwide mask mandate would need to save 13,333 lives over a three-month period to be cost-effective.
Research on the public health benefits of masking presents mixed findings. Nonexperimental studies suggest that masking reduces COVID-19 infection rates by 70–80 percent. But controlled experimental studies suggest that masking does not reduce infection rates or leads to smaller reductions of 12 percent or less. If the estimations of larger reductions are correct, then a three-month nationwide mask mandate would have been cost-effective. However, if the estimations of smaller reductions are correct, then such a mandate would have had higher costs than benefits.
This uncertainty over the net value of mandates likely explains the backlash, vaccine hesitancy, and broader skepticism about public health guidance that emerged during COVID-19.
And this backlash constitutes a potentially high further cost of mandates: reduced take-up of other, useful vaccines. When an action like vaccination is beneficial, many people will do it without a mandate. When the case is less obvious, the risk of backlash is higher.
Thus, while infectious diseases generate externalities—which might imply a role for government—vaccine mandates generate their own externalities—backlash.
This article appeared on Substack on September 8, 2024.