More than half of Hawaii residents recently surveyed said they would still wear a face mask even if there are no COVID-19-related mandates requiring them to do so, according to SMS Hawaii, a market research and consulting company.

The seventh Community Pulse Survey of 551 residents statewide, from March 30 to April 11, found that 57% would wear a mask for an in-person visit to their doctor or dentist appointments, while 56% would still wear one while traveling.

Another 53% would wear one at a shopping center, compared with 39% who would not; 51% said they would mask up at a movie theater, compared with 36% who would not; and 49% would prefer to remain masked at their workplace, compared with 42% who would not.

When the results were posted online to Reddit Hawaii last week, they elicited a broad range of comments, ranging from those who welcomed the news and said they intended to keep masking to those who questioned why to continue masking given that mandates have been dropped and federal authorities have greenlighted such moves.

The survey, the first this year, was conducted when COVID-19 case counts had plummeted from the peak of the omicron surge to a “sweet spot” of daily averages in the low-100s range, and before the increases being reported now. Also, it was also conducted shortly after Hawaii, the last holdout among U.S. states, ended its indoor mask mandate March 25.

The prior survey was conducted in November, after the end of the summer delta surge and prior to the winter omicron surge.

On Thursday the U.S. Centers for Disease and Control and Prevention moved Hawaii into the yellow, medium-risk category, up from the green, low-risk category for COVID-19, where the state had been for weeks.

Under CDC guidance, those living in medium-risk communities should have a plan for rapid testing if needed and talk to their health care provider about masking and whether they are candidates for treatments such as antiviral pills.

Wearing a mask is currently optional for medium-risk communities regardless of vaccination status, and recommended only for red, high-risk communities.

On Tuesday, however, the CDC restated its recommendation that Americans wear masks on planes, trains and buses, and in airports, despite a court ruling in Florida in April that voided a national mask mandate on public transportation.

The CDC recommends that everyone age 2 and older wear a well-fitting mask over their nose and mouth on public transit to protect themselves and those around them, particularly in crowded or poorly ventilated areas. This recommendation, the CDC said, is due to circulating variants and projected COVID-19 trends in coming months.

The mask debate

To wear or not wear a face mask, and whether it should be mandated to protect public health, continues to stand as a divisive issue in Hawaii and elsewhere United States. Jack Barile, professor of psychology at the University of Hawaii at Manoa, said he did not have a simple answer for why.

“The broader response is why all of it has been politicized,” Barile said. “I don’t know if masks are any more political than a lot of COVID-related restrictions.”

The CDC as a federal agency needs to balance the best interest of the public with measures that would most likely be adopted and are broadly applicable, he said, or risk losing buy-in from a large segment of the population.

Some Americans maintain that mask mandates infringe on their personal liberties and individual rights. Pandemic fatigue also plays a role, with some saying they want to move on by reverting to pre-pandemic routines.

The lawsuit challenging the federal mask mandate on public transportation was brought by an organization called the Health Freedom Defense Fund, and two Florida plaintiffs — Ana Daza and Sarah Pope — who said masking caused them anxiety.

In court documents Pope said the “constricted breathing from wearing a mask” provokes or exacerbates her panic attacks. She decided not to join her family on a trip to Hawaii because the thought of wearing a mask on the long flight gave her anxiety, The New York Times reported.

But it appears that a sizable portion of Americans would prefer it if people still masked on public transit. The results of the SMS Hawaii poll on masking while traveling were similar to an April poll by The Associated Press-NORC Center for Public Affairs Research.

The latter found that 56% of Americans favor requiring people on planes, trains and public transit to wear masks — compared with 24% opposed and 20% who were neither in favor nor opposed.

The SMS Hawaii poll found 56% of residents traveling interisland and outside of Hawaii planned to keep wearing a mask even if not required to do so, compared with about 33% who would go mask-free. The rest said they did not know what they would do.

Masking trends

When asked about going to a shopping center or seeing a movie in a theater, Hawaii’s mask rates appeared slightly higher than the AP-NORC poll, at 53% and 51% respectively. However, the questions were not worded in an identical way.

The AP-NORC poll asked whether people strongly or somewhat favored masking for people attending crowded public events like concerts, sporting events or movies. That poll found 49% in favor of masking, compared with 28% opposed for those activities.

Outdoor mask requirements here were dropped on May 26, 2021. Some 60% of surveyed Hawaii residents said they would go mask-free while playing an outdoor sport; 26% would wear a mask; and much of the balance of respondents were unsure whether to mask for an outdoor gym or group class.

When compared with older residents, those under age 35 were less likely to wear a mask for travel and a broad range of activities. The survey turned up little difference, however, between Oahu and neighbor isle residents or between males and females.

For several months, Tim Brown, an epidemiologist at the East-West Center, has been urging the public to “up (its) masking game” by using high-quality masks such as N95s and KN95s to fend off currently circulating highly contagious variants.Echoing that sentiment, Barile said because these masks can be effective, “if you can wear one, you should.”

With current omicron subvariants rated as more contagious than the original strain, mask-wearing now can be key to preventing infection. While these subvariants have not proved to be more deadly, some healthy people can still develop long COVID, or long-term symptoms that last months to years after infection.

Even so, studies show that social pressure is the strongest predictor of behavior.

“People look around, compare notes and see what other people are doing,” Barile said. “To some extent it matters what you think as an individual, but ultimately you’ll decide what to do and what not to do in balance with what’s socially acceptable or what the majority of people are doing.”

The SMS survey also found the majority of respondents, 54%, felt the pandemic situation in Hawaii was slowly getting better, while 17% thought it was just about over and 12% believed it had hit a plateau.

Additionally, anxiety levels were relatively low, with only 18% saying they were very worried that they or someone in their family would get sick from COVID-19, compared with 30% who were not too worried.

The SMS Community Pulse surveys are independent, nonsponsored surveys with a sampling error of plus or minus 5 percentage points.