'You can't make me wear a mask!' Experts weigh in on why people reject masks or deny COVID-19 is a real threat

People are angry, and they don't want to wear masks. Masks have become a statement that a person is either for or against the COVID-19 pandemic due to a variety of reasons. Mercy Health psychiatrist Elizabeth Shelley, who is based in Lorain, said there is more than enough evidence showing that masks should be worn in public. In some other cultures, particularly in East Asia, masks have long been used to prevent the spread of disease. But patients here told Shelley the "apocalyptic" feelings they experienced seeing masks begin to appear on faces in grocery stores and retail stores this spring. There are practical reasons why masks aren't popular, she said: They're hot. They're itchy. They fog up glasses. They don't mix well with beards. And they stop us from reading facial expressions, which can be unsettling. But there's no evidence masks are harmful, Shelley said. A lot of misinformation stirred up opposition to masks this spring, she said. While scientists were still trying to get a handle on the virus and how to keep it from spreading, others took to social media to spread false ideas — and many people latched on. "It's not healthy when we turn a blind eye to evidence that's contradictory to our beliefs. But unfortunately, all of us do it," Shelley said. There's several big reasons for people's responses to wearing a mask, University Hospitals psychiatrist Patrick Runnels said. One of those is stress. The virus produces an increased emotional response that makes people respond in ways that might not be logical, and Runnels said it blocks people from learning new information effectively. "Some people respond by wearing a mask all the time, even when it's not helpful," he said. "And then there's people who respond by not wearing a mask at any time." Lynn Skunta, a licensed professional clinical counselor at Olmsted Psychotherapy in North Olmsted, said people are afraid. The effects of quarantine, the abrupt end to the school year, missing out on graduation celebrations, working from home or losing jobs and wearing masks are all issues clients have talked about in therapy, she said. They are upset they have missed time with grandchildren and have lost physical contact with friends because of the virus. "When there is loss — and this is a loss — people are grieving. They are going to be confused," Skunta said. "They say to me, they think it's not real. I tell them that people are dying and you need to pay attention to the medical information that's coming to us," she said. Across the United States, there are 3.53 million cases and 138,000 deaths. Twenty-one states now have mask mandates in place. That doesn't include Ohio, which only requires them in counties that have tipped into "red" emergency status as cases climb. Gov. Mike DeWine said that accounts for about 60 percent of Ohio's population. Diab Almhana, a family psychiatrist at Quest Therapeutics in Avon, said resistance to wearing masks isn't that different from the way people cope with other issues. "Unfortunately, people might not see they need to lose weight to avoid diabetes. They might not see that they have to stop spending so much to avoid debt," he said — and refusing to wear a mask to protect against COVID-19 is a similar defense mechanism. Almhana said he's talked with clients about looking past their anger about masks. If they can't see beyond that anger, they will continue to see masks as "suffocating their limited sense of freedom." The root of the problem is a feeling of helplessness, he said. Almhana said Americans are reacting to COVID-19 is much the same way they reacted to the pressures of the Cold War with the Soviet Union. Only then, the USSR was a visible threat, while the virus is an invisible one. There's also the political component, which Runnels said both sides are to blame for mixed messaging. Unified leadership across local, state and federal levels would have been the most helpful, he said. But that did not happen. "With COVID-19, you want a leadership response that is consistent and clear and that everyone across all the spectrum agrees on," Runnels said. "Absent that, people turn to local leadership they feel they can trust. We have a major divergence of what that should look like. That is probably a bigger driver of why you're seeing resistance to masks: it's become political." When people refuse to accept facts because staring down the truth is too difficult, it's called denial, said psychologist Diana Santantonio of Psych & Psych Services in Elyria. She said America's denial over COVID-19 and the subsequent rebellion against wearing masks is largely the byproduct of a deep political divide. And she lays much of the blame at the feet of President Donald Trump. "If from a top level it's called a hoax, then there's a trickle-down effect," Santantonio said. Since the start of the pandemic, Trump has insisted the media, the doctors and authorities can't be trusted, she said. That's what many people wanted to hear, even though it doesn't match up with science, and it created "the perfect storm" for anti-mask sentiment. Santantonio compared the situation to a dysfunctional household with feuding parents — when children are forced to side with either Mom or Dad, "invariably the kid will side with the parent who gives them their way," she said. If it weren't for the nation's political infighting, people probably wouldn't see wearing masks much differently from other things we do to stay safe, such as obeying traffic laws or carrying insurance. But with extremes in how we view racial injustice, immigration, social safety nets, abortion, gay rights, gun control and other divisive issues, polarization over the pandemic was inevitable, she said. It's a uniquely American form of denial, said Santantonio: "This isn't happening on near this level anywhere else in the world." COVID-19 isn't the only arena where politicization is taking a toll, Santantonio said. She said she has counseled several couples in the past year where ideology has contributed to divorce in a big way — the partners have disagreed so deeply over news sources and alternative facts that they couldn't stay together. Without a consistent response from all political parties, people began to look toward other sources that may not be health experts. And even in states that flattened the curve, Runnels said it took a while to get consistent messaging out. Along with politicalization, Runnels said it's worth noting that people were experiencing different types of pain, and were frustrated with others who weren't experiencing their pain. Regional differences also affected people's responses because they felt different types of pain from the virus, Runnels said. Many urban areas have experienced a higher number of COVID-19 cases, while many rural areas in Ohio have seen lower case counts. However, rural areas still felt the economic pain. "When you add all those on top of each other, you get people being very hard in positions," Runnels said. "And when we're angry, we start to feel contempt. And that blocks our ability to see people as human. Instead we see them as objects." The speed at which the pandemic swept across the nation was a big part of the problem. Skunta said it was a shock to the system that left people startled, and they've had trouble recovering. The natural response to surprise is to be afraid, she said, and fear leads to anger. People should understand they are allowed to be angry. It's the first stage of grieving, Skunta said. But basing decisions on fear isn't healthy, she said. Take wearing masks — that's a sound logical decision that helps protect people around you, while railing against masks is a fearful reaction rooted in feeling like you have no control, she said. "They say, 'If I can push back, or if I can get my way, I am in control,' " Skunta said. It's hard to change someone's mind if it doesn't want to be changed, Runnels said. But it's important to have compassion to people's stress levels and reactions, while also not ignoring their responses. Runnels said continuing a dialogue and working with people where they're at can be essential. Another aspect to harsh reactions toward wearing a mask is threat perception. Jim Jordan, a psychology professor at Lorain County Community College, said people in this age aren't used to dangerous infectious diseases. Because of that, people tend to have an optimism bias, which Jordan said is good at times but it also avoids any negative emotions. "If the worst befalls other people, the negative emotions go away. If I can ignore or think the best of this virus, I won't have negative emotions," Jordan said. "I'm not old; I'm not compromised, so it's not going to happen to me, so I don't worry too much. Therefore, I don't follow public health warnings." Emotions over facts can often affect behavior, so Jordan said people will seek out the studies or sites that say wearing a mask doesn't help to reinforce the belief that they're not at risk. "I'll focus on the study that goes along with me not feeling bad, me not having negative emotions," he said of people's reactions. "I'll focus on the warnings and I'll be really critical about that so that way I have a justification." None of this is new, Jordan said. A paper published in 1919 — after the Spanish flu — in a science magazine studied the lessons from the influenza. One was people don't appreciate the risk they run, two is it goes against human nature for people to shut themselves up in rigid isolation as a means of protecting others and three is that people often unconsciously act as a danger to themselves and others. Jordan said the same could be said of people today. People don't want to be distant from others during a crisis, and they also don't like being told what to do in American culture. "People say it's my right to not wear a mask," Jordan said. "But it's also not your right to drive 100 miles per hour down 57. Or speed in a 25 mile per hour zone. It's to protect others. We're so independent that it's hard for us to realize that no, you don't have a right to do everything. Why have a department of public health if they can't do anything?" Contact Jason Hawk at news@lcnewspapers.com. Contact Laina Yost at lyost@chroniclet.com.