Masking our fears

Society’s response to mask-wearing tells us a lot about ourselves

One of the (many) interesting things about Covid-19 has been the emergence of mask-wearing as a signal of political allegiance — with the left choosing to wear masks, and the right refusing to.

In the US, this has been taken to ridiculous levels by the Trump administration, with both the President and Vice-President touring laboratories and other frontline locations without any form of face mask, while the doctors, scientists and administrators surrounding the politicians are wearing personal protective equipment (PPE).

Meanwhile in Britain, the initial ‘no need for masks’ proclamation has now been replaced by a statutory £100 fine for not wearing one in shops and supermarkets. Mind you, that came after Boris Johnson was hospitalised with the novel coronavirus; his infection likely to have been picked up when he made political capital out of parading unprotected around hospitals to show how harmless Covid-19 really was.

Those of us in the caring professions understand the biological realities of this virus: The scientific method that gathers observations, proposes hypotheses, and then chooses the best hypothesis based upon the results of careful experimentation. One would have thought that during times of uncertainty, a clear, scientifically-based conclusion would ring true.
It used to be that the vast majority of scientifically-derived hypotheses were not contentious. Political opinion to the contrary was usually confined to despots and leaders of questionably sound mind. But that was before the modern tendency to distrust experts along with the rise of the fake news phenomenon that has driven vaccine hesitancy and other anti-health campaigns.

There is a range of types of masks providing different levels of protection. The key is choosing the right type for the right task, often paired with other appropriate safety equipment. The N95 mask has a filtration device able to stop 95 per cent of 0.3 micrometre particles. Even though the coronavirus is estimated to be about 0.7 to 0.9 micrometres, virus particles are normally carried in droplets somewhat bigger than this, making the 0.3 micrometre limit quite adequate for protecting the wearer when combined with other protective equipment. This is in contrast with cloth masks, which let a lot more air and particles through compared with the N95 masks. The most optimistic estimates suggest that cloth coverings only have a minor effect on your chances of breathing in droplets containing a virus. A small study concluded that a “home-made mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection”. But larger-scale research published in The Lancet, which analysed data from 172 studies in 16 countries, found that wearing a face mask reduced the risk of contracting Covid-19 to 3 per cent.

From a scientific perspective, it seems a well-designed mask combined with the right safety equipment and behaviour is protective, but significant doubts remain. The World Health Organisation (WHO) says that masks “on their own” will not protect from Covid-19. It says there is no evidence that healthy people wearing one in the community will prevent them from being infected with respiratory viruses, including the coronavirus.

So why such a variable acceptance of mask-wearing amongst the public in certain countries? Alongside greater distrust of experts and a certain lack of scientific agreement about the effectiveness of masks, the pandemic has created a great deal of fear. Could it be that demonstrating that you are doing something is better than the helplessness of feeling you can do nothing? Signalling to others that you are taking this seriously and trying to respect their safety as well as your own is a clear statement of solidarity.

Perhaps Covid-19 takes us back to a time when untreatable airborne diseases were a constant threat, and any ideas about how to combat them, however unscientific, were welcome. Are masks seen as comforters, to enable people to be less fearful about returning to normality? Maybe we should be guided by behavioural psychology if we are looking for a uniformity of safety behaviour.

As Covid-19 spread in Britain, commentators took to comparing the pandemic to the Blitz. But some historians question the usefulness of Blitz comparisons. Coronavirus does not reduce buildings to rubble. The ‘Blitz spirit’ existed alongside the looting that followed German bombing. And while there may be drama in comparing similar death rates in the Blitz and in the pandemic (so far), there is not much substance.

Here in Ireland, we have largely proceeded on the basis of solidarity rather than legislation. A sense of social solidarity has driven the high rate of compliance rather than a fear of prosecution. And thankfully, we have been spared the misuse of the Covid-19 outbreak to push extreme right- and left-wing agendas.