The Mask: Life Guard

SHOULD YOU WEAR or not wear a mask? It’s a question that has kept coming up repeatedly during this pandemic. The most widespread scientific opinion has been an emphatic no. It has largely been considered silly, since the virus spreads not through the air but through respiratory droplets that might contaminate surfaces.

Masks were meant for the sick, as the guidelines go, to stop respiratory droplets that might contain the virus from being released; or for people in very close proximity to the infected, such as healthcare workers or family members at home. The WHO still maintains this position. Masks were seen as alarming. They could lead to an infection since people constantly touch their faces to adjust their masks. They may give a false sense of security and encourage people to engage in riskier behaviour like going out more often or not washing their hands; and if they began to be used widely, it might create a shortage for medical professionals.

This question has a cultural hue too. Throughout this pandemic, societies and governments in eastern Asian nations have expected people to wear masks at all times when they step out. People here tend to wear masks more often—as some have explained, because of past epidemics such as the 2002-03 SARS outbreak—to the extent that it was considered impolite even before this pandemic for a person with a cough to step out without a mask.

In most other countries, a masked individual tends to elicit a very different response. There are anecdotes of people wearing masks being abused or treated suspiciously in the West. In India too, in the early days of the pandemic, there were reports of people wearing masks being treated with suspicion.

But an interesting change of opinion appears to be taking place, not just around the scientific benefits of wearing a mask, but also on social perceptions of it. Several European countries, such as the Czech Republic, Austria and Slovakia, have made it illegal to enter public spaces without wearing a mask. Although Germany hasn’t issued any nationwide recommendation, some places like the eastern city of Jena has made its use compulsory in supermarkets and on public transit. The US is also reconsidering its stance against it. Donald Trump recently suggested using scarves as masks. “You can use a scarf,” he said. “A lot of people have scarves…scarves would be very good.” There have been social media influencers showing people how to make DIY masks; reports of European prisons where inmates are sewing them; there is even a trending hashtag (#Masks4All).

The Indian Government has now announced it is re-examining its recommendations against masks. The Principal Scientific Advisor recently issued a detailed manual on how to prepare homemade masks using items like old vests, T-shirts and handkerchiefs. Such DIY masks, the evidence shows, provides some basic protection.

This change in attitude is coming about because recent studies show that a lot of transmission is occurring through people who display no or very few symptoms. A study in Iceland, with tests even on asymptomatic people (believed to be the highest in the world in Iceland in proportion to its citizens), has found that about half of those who tested positive displayed no symptom. In China, it is estimated that about a third of all positive cases showed no symptoms. Such individuals, if we follow the current WHO guidelines, would never wear a mask since they would not know they were infected. Also many of the places geographically close to and with ties to mainland China, and yet have managed to keep the number of cases largely under control (South Korea, Taiwan or Hong Kong), are also places where people tend more to wear masks.

The mask also provides a behavioural nudge. Every time you see someone with a mask, it serves as a reminder that the virus is very much around and you have to be careful. The burden of responsibility is now shifting from just the infected individual to the larger society. The logic being: if everyone wore a mask, sick or not, symptomatic or asymptomatic, it would help stop the spread of the virus. Wearing a mask doesn’t just protect you, its champions say, it protects others too.

When this pandemic comes to an end, it will change many things about us. The mask too might become an ordinary part of our lives.

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