Opinion: Why Telling People They Don’t Need Masks Backfired

Pierre Van ZylCovid19, Opinion

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Almost as soon as the COVID-19 pandemic started, so too did the panic-buying, hoarding, and price-gouging. Items of particular interest (besides, of course, toilet paper) have been hand sanitizer, disinfecting wipes, and face masks.

People everywhere have been purchasing these items in an effort to protect themselves and their families, but the messages they have been receiving from public health authorities have been decidedly contradictory. 

Health officials across the country have been not only asking the public not to purchase face masks, but telling them that they are not useful or necessary. One professor, however, believes that this message is incorrect and that it has done nothing but exacerbate the problem.

A Message that Backfired

Dr. Zeynep Tufecki is a professor of information science who specializes in the social effects of technology. In a piece she wrote recently for the New York Times, she argued that in an effort to fix the shortage of personal protective equipment (PPE) across the country, authorities sent out a message to the public that made them untrustworthy, which only made the problem worse [1].

On February 29, the surgeon general said in a Tweet that surgical masks are not effective for the general public, but that they are needed for frontline healthcare workers [2]. Many people responded to his message asking the obvious question: why are face masks effective for healthcare workers, but not for the rest of us?

Many health experts have echoed his sentiments, and Tufecki says that this has left the public in a general state of confusion [1].

Read: Former CDC Chief: Vitamin D May Reduce The Risk Of Coronavirus Infection

Ordinary People Don’t Know How to Use Them

After the initial backlash that resulted from this confusion, authorities justified their stance by telling people that unless they knew the proper way to wear them, face masks, particularly medical-grade respirator masks such as N95 masks, were essentially useless, and could even put your health at greater risk.

According to infection prevention specialist Eli Perencevich, MD, professor of medicine and epidemiology at the University of Iowa’s College of Medicine, the average healthy person does not need a mask and should not be wearing them.

“There’s no evidence that wearing masks on healthy people will protect them. They wear them incorrectly, and they can increase the risk of infection because they’re touching their face more often,” he said [3].

In Dr. Tufecki’s opinion, however, this message was also counterproductive.

“Many people also wash their hands wrong, but we don’t respond to that by telling them not to bother,” she said. “Instead, we provide instructions; we post signs in bathrooms; we help people sing songs that time their hand-washing. Telling people they can’t possibly figure out how to wear a mask properly isn’t a winning message.” [1]

Read: New York Hospitals Are Treating Coronavirus Patients With Vitamin C

There is Evidence that Masks Work

According to Tufecki, despite what many public health authorities are saying, there is evidence that face masks provide some benefit. She points to CDC recommendations that include wearing a facemask as a preventative measure against the flu, specifically in the case of H1N1 [1].

According to the CDC, however, there is very little information on the efficacy of face masks and respirator use in community settings. Thus, they have made recommendations based on public health judgment, as well as historical use of face masks in various settings.

The CDC does not recommend that people who are healthy and are considered low-risk wear a facemask unless they are working in a healthcare setting and are taking care of an infected person. This goes the same for high-risk people, with additional recommendations involving avoiding certain high-risk situations [4].

The CDC does, however, say that face mask use could be considered by both healthy and unhealthy people in certain circumstances, such as in the event that there is an infectious disease within the community, like H1N1 [4]. 

These recommendations do not, however, include any information regarding the current COVID-19 outbreak. Tufecki, however, also cites her experience with SARS, in which health officials advised people in many high-risk Asian countries to wear masks.

Tufecki highlights that while masks aren’t perfect, and they certainly do not replace proper hand-washing and social distancing, they can work alongside these important practices to reduce infection rates [1].

Her opinion is backed up by research. In a study published in The Annals of Internal Medicine, researchers found that face masks, when used in conjunction with proper handwashing, were effective at mitigating an influenza pandemic [5].

Asymptomatic Transmission Means Anyone Could be Sick

Public health officials have stated that the only people who should be using face masks are those who are already sick, to prevent transmission to healthy people. Tufecki argues that this recommendation is pointless since more and more evidence has emerged showing that many people could have the virus but be asymptomatic.

For this reason, she argues that since there is no way of knowing who is sick and who is not, it makes sense that everyone wears a mask just in case [1]. 

Read: Antibodies Identified With Aim to Treat Coronavirus

Universal Mask-Wearing in Some Countries Appeared to Work

Tufecki also points to the success of other countries, like Hong Kong and Taiwan, who were able to control the virus much more effectively than other countries around the world, despite their proximity to mainland China.

After the SARS outbreak of 2003 that devastated many cities in Asia, these countries were much more prepared to handle the COVID-19 pandemic. Taiwan, Hong Kong, and Singapore were much quicker to act against the virus and put many proactive measures in place such as public health screenings and travel bans before any human-to-human transmission was reported [6].

Residents in Hong Kong are all encouraged to wear face masks whether they are sick or not. Cheryl Man, who was born and raised in Hong Kong but is now living in New York City, began wearing her mask when the outbreak began, and was often questioned about her choice.

“It’s a civic duty,” she says. “If I have a mask on, and if—touch wood—I’m infected, I could cut the chain off where I am. That could save a lot of people.” [7]

This is what is taught all across Hong Kong, and in many other countries in Asia, and is why people in these countries have been wearing masks for weeks- ever since hearing the initial reports about an unidentified type of pneumonia in Wuhan [7].

Contradictory Statements Leads to a Lack of Trust

Tufecki believes that the reason so much hoarding and price-gouging has occurred in the United States is because of the conflicting messages that have been given by public health authorities. She argues that this leads to a lack of trust, which leads to hoarding and misinformation [1].

“It used to be said that back in the Soviet Union, if there was a line, you first got in line and then figured out what the line was for — people knew that there were going to be shortages and that the authorities often lied, so they hoarded,” she said [1].

Read: Coronavirus symptoms start slowly, then might worsen quickly

Authorities Should Tell the Truth

Tufecki believes that instead of giving the public misinformation about the efficacy of masks, they should just tell the truth- that we were unprepared for this pandemic, and because of that there is a shortage of masks throughout the country. While it would be beneficial for everyone to have masks, it is more important for frontline healthcare workers to have them, since they are in the highest-risk environment [1].

She argues that instead of telling people who have hoarded masks that they don’t need them, authorities should be asking them to donate their excess to local healthcare facilities. She explains that research shows that people can be surprisingly selfless during times of crisis, but interventions by authorities can make the situation worse if they fuel mistrust [1].

Read: You Can Kill Coronavirus With These Common Household Cleaners

Try Making a Homemade Mask

While a homemade mask may not be as effective as a medical-grade surgical mask and certainly not as effective as a respirator mask (i.e. N95, N99) they can still be better than nothing and will spare more commercially-made masks to be used by frontline healthcare workers [8].

If you would like to make your own mask at home, you can find instructions here, as well as the template used in the instructions here.

Anna Davies, a researcher at the University of Cambridge, says there are a few extremely important things to remember when wearing a homemade face mask:

  1. Always wear your face mask in the same orientation, i.e., you should always have the same side facing outward (the contaminated side).
  2. Face masks should be machine-washed frequently to eliminate any residual flu particles.
  3. Remove your mask by taking the straps from the back of your head and pull forward — do not touch the material part of the mask.
  4. If you do touch the mask, wash your hands with soap and water before and after you touch your mask [8].

Tufecki, of course, says that wearing a mask does not replace proper hand washing and social distancing (these are overwhelmingly important), and states that cooperation from everyone around the country is the only way we will get through this pandemic [1].

Keep Reading: Nobel Laureate: Why Coronavirus Crisis May Be Over Sooner Than Many Think

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.

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