In the early days of the COVID-19 pandemic, experts and officials largely cautioned Americans against wearing face masks in public. Surgeon General Jerome Adams had tweeted, “Seriously people- STOP BUYING MASKS!” to encourage basic hygiene measures and social distancing instead. The CDC dissuaded healthy people from wearing masks as well, recommending they don facial coverings only when exhibiting symptoms. Even President Obama tweeted, “Save the masks for health care workers.” Together, the message was clear: the novel coronavirus, spread by respiratory droplets, could only travel so far. The public didn’t need masks. Social distancing and handwashing would be sufficient.
On April 3, however, the CDC rolled out new recommendations urging the exact opposite: Americans now should “wear cloth face coverings in public settings,” especially in areas with increased community transmission. This came on the heels of new studies showing the critical role of asymptomatic carriers in fueling global outbreaks. One study estimated that up to 30 percent of COVID-19 positive individuals show no symptoms, while other studies documented asymptomatic transmission, creating numerous hotspots worldwide.
Another, more insidious consideration is the unmasked individual with ambiguous symptoms such as fatigue or nasal congestion, that they misattribute to stress or seasonal allergies instead of the early stages of COVID-19.
Almost overnight, the CDC’s new stance made public mask wearing a compelling measure in fighting COVID-19. Unfortunately, widespread adoption of the practice has yet to be seen, as cultural attitudes threaten to delay the public’s cooperation given current government guidance. Today, a mask wearer today can be perceived as uncool, selfishly hoarding, ignorantly panic spreading, and — given the CDC’s prior stance — ineffective and possibly harmful. Moreover, the wearer could look sick, risking a stigma that burdens them with knowing they are making others feel unsafe. Propagating these attitudes alas is President Trump, who stated he himself would not wear face masks at the risk of being judged by dignitaries, despite announcing new CDC guidelines suggesting all Americans wear one.
Racialization of face masks produces a more concerning stigma, labeling wearers as “Asian.”
Not only does this dissuade non-East Asians from wearing masks, as the practice is seen stemming from a foreign niche instead of a national effort to protect Americans, but it dissuades East Asians from wearing masks out of fears of harassment.
A universal mask policy stands to greatly benefit the nation. For a nation whose peak in cases is still a week away, where 29,211 new cases were confirmed on April 6 alone, America only stands to lose by waiting for masks to organically embed itself into our social fabric.
A universal mask policy that mandates face masks for anyone going out in public would speed the process by diminishing social stigmas, complacency, and hesitations regarding efficacy. It would create a unified message to solidify mask-wearing as an American norm.
In East Asia, where memories of the 2002 SARS outbreak remain strong, wearing face masks in public has become an ingrained cultural ethic. In addition to providing personal benefits by blocking air pollution, donning face masks is now a civic duty to reduce pathogen transmission. This sense of fate-shared consequently created a stigma opposite to America’s: A person not wearing a face mask is left to be judged for putting others at risk.
Mask wearing as an existing social ritual sharply reduced the lag time in public mask use during the East Asian COVID-19 response. An estimated 90 percent of Hong Kong and South Korean residents were wearing face masks in public during the critical early stages of the coronavirus outbreak. Contrast this to the United States, where only 7 percent of people wore masks in early March.
Despite these successes, China still placed public masking mandates in the populated centers of Beijing and Shanghai, where community transmission was especially high. The Czech Republic soon followed as the first nation to introduce compulsory mask measures in Europe. This leaves America to follow suit, creating a national universal mask policy that, at the very least, covers urban centers.
Of course, a universal mask policy alone is not a panacea. Face masks do not come with the freedom to ignore social distancing rules. However, it nevertheless houses enormous potential in America’s response to COVID-19.
Varsha Venkatakrishna is a medical student and is affiliated with #GetUsPPE.
Image credit: Shutterstock.com
