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We follow laws on seat belts and smoking. Why not on masks? | Opinion

How come so many in the U.S. aren’t following relatively simple mandates to prevent the spread of COVID-19, which has killed more than 200,000 Americans?

Unmasked supporters of President Donald Trump cheer as he arrives for a campaign rally at Harrisburg International Airport, Saturday, Sept. 26, 2020, in Middletown, Pa.
Unmasked supporters of President Donald Trump cheer as he arrives for a campaign rally at Harrisburg International Airport, Saturday, Sept. 26, 2020, in Middletown, Pa.Read moreEvan Vucci / AP

I was a reporter in Rome in 2005 when Italy banned smoking in restaurants. I was skeptical. For many Italians, having a cigarette with after-dinner coffee was simply part of the meal, like dessert. Also, Italians are famously lax about following rules: They dodge their taxes and park on sidewalks. As I wrote back then: “Smokers declared — basta! — they would never comply.”

But to my shock (and ease of breathing, since I have asthma), very quickly everyone did.

If the Italians could do it with cigarettes, how come so many people in the United States aren’t following relatively simple mandates to prevent the spread of COVID-19, which has killed more than 200,000 Americans?

Thirty-four states and Washington, D.C., have some sort of mask mandate, but many citizens and law enforcement agencies are blatantly ignoring them.

On Sept. 13, President Donald Trump held an indoor rally with thousands of mostly unmasked supporters in Henderson, Nev., in violation of a state mandate that prohibits gatherings of more than 50 people. Last week — before announcing that he tested positive for COVID on Friday — Trump held a rally in an airport hangar outside Pittsburgh, where thousands of mostly maskless people were crammed, cheering, cheek-to-jowl, even though the governor had asked the campaign to follow the state’s COVID-19 rules on mask use and social distancing.

» READ MORE: What Trump’s positive coronavirus test means for his health and recovery

Some conservative groups have challenged governors’ broad authority to order COVID-19 prevention measures. Last week, a judge appointed by Trump overturned Pennsylvania’s limits on gatherings, though a federal appeals court temporarily reinstated those limits Thursday. But the legal standing is relatively clear. “Governors absolutely have the authority during a public health emergency to make laws — to force people to wear masks, to limit gatherings,” said Jaime King, an expert on health law at the University of California Hastings College of the Law. “So I’m perplexed at why people say, ‘You can’t force me.’”

People who act as if these rules are optional might point to a double standard, asking why they should have to obey when others — such as protesters against racial injustice this summer — didn’t. But at the protests I observed in Washington and New York City, everyone was wearing masks and mostly kept at least three feet apart, outdoors, and moving. Yes, some people broke curfews, but there were very visible attempts at enforcement.

We routinely obey — and police officers routinely enforce — laws with which we don’t entirely agree. Many people originally objected to seat belt laws as an infringement on personal freedoms, but who doesn’t buckle up these days? Not smoking in restaurants and stores is now inviolable. My family had a dog in New York City when the Canine Waste Law took effect in 1978, and it was gratifying to watch women in minks suddenly start doing their pooper-scooping duty.

A big part of the reason adherence has been so variable is that governors generally declare the mandates, and local and city officials are left to decide how to enforce them. And these simple, sensible laws to protect public health have been politicized and wrapped up in controversy as no such laws before.

» READ MORE: Pa. crowd limits are in effect again after court order, though Wolf hints he’s considering fans at school sports events

So now we have some law enforcement officials announcing that they won’t enforce masking laws or limits on gatherings imposed by their own governors in states like Ohio and Wisconsin.

“A sheriff or police chief giving advance notice that it’s OK to break the law?” said Hall. “There’s a new level of lawlessness to that.” Imagine the authorities announcing it was fine to ignore stop signs.

The Italians’ miraculous turnaround on restaurant smoking offers lessons. There was consistent messaging: The law was there to protect nonsmokers’ health. And there were fines: 275 euros, around $320 today, for people smoking, and 220 euros for the restaurant managers or owners.

Gov. Andrew Cuomo was one of the few American governors who approached the coronavirus edicts almost militaristically (so un-New York) and got a tragic outbreak under control. In Maryland, a state with a Republican governor, a man who had two parties of 50 people at his home was sentenced to a year in jail.

» READ MORE: At Harrisburg rally, Trump vowed to win

But more governors have enforced these mandates timidly, almost apologetically. In many states, the message was muddled. In Pennsylvania, where disobedience could, on paper, lead to a $300 fine or up to 30 days in prison, state officials announced it wouldn’t be enforced against individuals. Officials announced businesses could face citations if they didn’t enforce the law, but the state was otherwise relying on citizens’ “good sense and cooperative spirit.”

The repercussions from the Trump rally that defiantly ignored Nevada’s mandate? An angry tweet from the state’s Democratic governor criticizing “reckless and selfish actions.” Donald Ahern, the businessman who allowed the event to take place in his company’s warehouse, was fined $3,000.

Enforcement is difficult when “permission comes from the top,” said King. How can we expect Americans to mask up when they’re watching a Trump rally and “even he is breaking the law”?

Elisabeth Rosenthal is editor-in-chief of Kaiser Health News, a nonprofit news service covering health issues, where a version of this piece originally appeared.