A cancer survivor vulnerable to serious illness, Chany Reon worried as the coronavirus swept through China and then northern Italy last winter. When, she wondered, would it reach her remote corner of the United States.
Now it has, with the force of a hurricane. Reon lives in Flathead County in northwestern Montana, home to Glacier National Park and one of the worst-hit parts of the state. Montana did well early on, preventing spread of the virus with lockdowns and travel restrictions, but precautions were loosened in June and it now has one of the worst Covid-19 rates in the country.
Reon, a 42-year-old nonprofit consultant, has been working from home and avoiding public spaces and crowds. When she was asked earlier this fall to teach a course at the local community college, she agreed, thinking that students would be following Montana’s statewide order mandating face masks be worn indoors. Minutes after the first class started, however, her students removed their masks. A week later, she was diagnosed with Covid-19. She had what’s considered a mild case, but that still meant weeks of breathing difficulty and nausea.
“It’s cognitive dissonance, for people don’t believe the virus exists,” Reon said in an interview, her voice still strained from the effects of the illness. “It was frustrating to me when I am taking the precautions, and then to have a work setting where those precautions were disregarded.”
As President-elect Joe Biden prepares to take office in the midst of a devastating pandemic that has already killed more than 250,000 Americans, he’s already begun urging broader use of masks, and many public health experts hope one of his first actions is to declare a national mask mandate. Montana could offer clues about how that might work — or not work.
Biden, who wears a face mask in public, has spoken repeatedly about the need to make masks non-political, a mantra he has continued since the Nov. 3 election. This month, he called masks patriotic and said wearing them is everyone’s responsibility.
“It doesn’t matter your party, your point of view. We can save tens of thousands of lives if everyone would just wear a mask for the next few months,” Biden said at an event in Delaware.
Masks have proven effective around the world to slow the spread of the virus, but President Trump and a litany of Republican leaders down the line, from members of Congress to governors and state legislators, have refused to wear them.
The result has been widespread confusion and skepticism about the value of masks and the politicization of a basic tool against the virus. While multiple surveys show mask adherence increased throughout the year, to 85 percent of people reporting they had worn masks in August, there is still a partisan divide. A Pew Research Center study in August found a 16-point gap between Democrats and Republicans on wearing masks in public settings.
The divide is evident in Republican-controlled states across a wide swath of the Great Plains and the northern Rockies, many of which were late to adopt mask mandates, or where they don’t exist at all. South Dakota, which now has the highest daily Covid death rate in the world, still has no mask rule and many local governments have refrained from stepping in. From the Dakotas to Idaho, Utah and Iowa, rising cases and resistance against masks has led to heated confrontations and political fights. In many places, local health departments have hesitated to impose and enforce mask mandates in the face of heated public opposition.
In Montana, the Democratic governor, Steve Bullock, imposed a mask mandate months ago in all but a few tiny counties with very few Covid cases. However, enforcement has been largely left to businesses, and from bars to the state capitol in Helena, resistance has cropped up. In at least two cases, angry anti-maskers have threatened bar and restaurant employees with guns. As a result, whether people wear masks largely depends on their politics and the strength of the local health board.
In Flathead County, a member of the local health board who early on stirred skepticism about the deadliness of the virus, has cultivated a large following that routinely defies standard public health guidance. The health board has refused to limit the size of gatherings — despite a state mandate limiting crowds to 25 when social distancing isn’t possible — and with more than 5,500 testing positive for the virus to date, the county accounts for roughly 10 percent of all of Montana’s diagnosed Covid cases.
Mask defiance is not contained to the northeastern corner of Big Sky Country. A group called the Freedom Protection Project has toured the state campaigning against the mask mandate and raising money to fight it in court. In an email, the group framed its mission in language similar to vaccine skeptics’ talking points. “The media has grossly mischaracterized our group,” its statement said. “We are not an anti-mask group. We are a pro civil liberties organization. We have not had any anti-mask events.”
When state legislators met recently to elect the leadership for the legislative session that begins in January, dozens of Republican House and Senate members met in the Capitol, unmasked. Multiple Republican legislators did not respond to requests for comment on the issue.
Similarly, Gov.-elect Greg Gianforte, a Republican, was frequently photographed during the campaign not wearing a mask. Republicans swept the state on Nov. 3 in a historically lopsided election. Though they declined to be identified, several people who work in and around the Montana Legislature said they are concerned about a potential outbreak in the Capitol.
The county health board sent a letter to the state GOP leadership asking members to limit their travel and opt for a virtual session, but there’s been no public response.
Public-health experts say mask wearing is not a lost cause and a national mask mandate could turn things around by lifting the burden off of local and state officials.
Dr. Abraar Karan, with Brigham and Women’s Hospital and Harvard Medical School, said national political leadership in the post-Trump era needs to reframe masks as an easy-to-use weapon against the pandemic, with very little downside. For the remaining states without mask mandates, and those having trouble with enforcement, having a national rule to be the theoretical bad guy will ease the pressure on local health officials.
“The other way to look at this is that if you have a national mask mandate, it becomes more normalized,” said Karan. “It’s got to come from the federal government. It will be harder and harder for individual governments to go against a national mandate.”
Dr Leana Wen, a former Baltimore health commissioner and a visiting professor at the Milken Institute School of Public Health at George Washington University, said a national mask mandate would be a herculean task to implement, but is also a gravely necessary measure. Getting local musicians, writers, sports figures and others to take up the cause could make a major difference, she told STAT.
For people like Chany Reon, a national mask mandate might be arriving too late, but she still believes it’s necessary and people can change.
Since she got sick, she said, “l have friends, who have changed their views slightly.”