Honest questions:
1. Do you think if masks had been used in the United States starting in late February we would be in a better place now?
2. Do you think if Fauci had come out in late February and said "please use masks" it would have mattered (by "use" I mean recommend, not require - I think a requirement would have been nearly impossible to implement in the US, particularly in late Feb/early Mar)?
My opinion below:
For question 1, I'd answer yes, and for question 2, I'd answer a little. There would have been some people that heeded the recommendation (maybe 20-30% of Americans) and it would have slowed things a little, but not as effectively as we've seen in other countries because of American ideals of freedom to do whatever they want, without regard to its impact on their fellow citizens.
History and context matter. In early March, when things first started surging in the U.S., there was not yet much evidence that cloth masks, would have an impact whatsoever on the virus. At that time, when we looked at most other countries and saw people out everyday wearing masks (e.g., Japan), it seems they were generally wearing medical grade masks (N95 or other styles close to that level of protection). That seems to be a tradition in countries that were more effective at going to a full mask environment - I remember seeing people with those masks on several times in the past through previous flu, etc., epidemics.
I think Fauci and others did not want to see a large run on medical masks, not because they wouldn't help, but to keep supplies available for those that would definitely be facing COVID on the front lines - medical personnel.
As evidence came in that cloth masks had a measurable mitigating impact, you started to see recommendations. Had Trump merely said that when he was instead rambling on about hydroxychloroquine and ingesting lysol, it would probably have had a positive impact.
(My guess) I think Fauci was hesitant to recommend cloth masks early on before evidence was in of their usefulness since he may have thought "Americans will put on masks and just abandon all social distancing." Had this happened and there was no impact on masks reducing the transmission rate, we would probably be worse off than we are now. I think he did a risk mitigation analysis and went with the best possibilities based upon the scientific evidence at the time. As additional data has come in, he's modified his statements.
Most high ranking doctors are generally risk adverse - sort of a like a societal implementation of "First do no harm". Does that mean that some methods that would help get started later? Yes. But beyond having people with ability to see the future, what do you recommend?
