Masks or Not: the Cultural Differences Between the West and East

COVID-19 put a mask on everyone in China soon after the outbreak in Wuhan. A focus for many people is whether they should wear masks amid the spread of COVID, and if so, what kind.

People could get confused by all kinds of directions given by the government from different parts of the world — some countries are requiring the use of medical masks from an early stage of the virus in public, some countries don’t encourage masks at all, and some countries encourage people to wear cloth masks but not medical ones. But which choice responds to COVID-19 most effectively?

In South Korea, the first positive confirmed case was reported on Jan. 20, 2020, the same date as the first positive confirmed case in the U.S.. While in the U.S. the number has reached to 532,879 positive cases with a growing trend of cases increased daily,  South Korea has had 10, 521 positive cases and shows a daily decrease as of Apr. 11. An essential South Korean component of their social distancing strategy is wearing masks in public, observed Sociologists Kim Jin-won and Kim Jae-Hyung from The Independent.

In the 2003, during the epidemic outbreak of Severe Acute Respiratory Syndrome (SARS), a viral respiratory illness also caused by a coronavirus, researchers found that washing hands more than ten times a day was 55% effective in stopping transmission, about the same rate as wearing a glove. Wearing masks, on the other hand, had a 68% effectiveness in reducing the risk of infection. In five Hong Kong hospitals, where the study took place, surgical and N95 masks helped significantly. However, paper masks were never recommended as a precaution against respiratory droplets – they were easily wet by saliva. None of the 69 staff members who reported being infected did all four things. Still, nothing guarantees full protection from the virus, and the intervention effects of doing all four does not grant complete immunity from the disease either.

Many medical authorities have urged people to not use the experiences of SARS to deal with COVID-19. Though the viruses that caused COVID-19 and SARS are genetically related, the diseases caused by the viruses are quite different. Facing the insidious COVID-19, there is a lot of uncertainty. No one is fully familiar with this virus that currently has no cure. One of the big differences lies in asymptomatic cases. Almost half of the positive cases on the Diamond Princess cruise ship (46.5%) were asymptomatic. In fact, according to the director of the Centers for Disease Control and Prevention, Robert Redfield, 1 in 4 who get infected may not show any symptoms. However, they still can transmit the illness to others. There are no asymptomatic cases in the outbreak of SARS. Due to the feature of presymptomatic and asymptomatic transmission of COVID-19, wearing a mask would help.

“I’ve been slightly dismissive of masks, but I was looking at them in the wrong way,” Bill Hanage, an associate professor of epidemiology in Harvard said in an interview with Ed Yong, a staff writer at The Atlantic.

“You’re not wearing them to stop yourself getting infected, but to stop someone else getting infected.”

Currently, CDC is recommending the use of nonmedical cloth face coverings as a health measure, a DIY cloth mask, or even a “tucked-in bandanna,” combined with social distancing, for non medical professions. Though most countries are recommending or requiring mask-wearing in public, views on masks are sometimes fundamentally different between the West and East.

“‘There’s a virus outside, so I wear a mask only to protect myself, whereas collective reasoning, in Asian societies, is to say, ‘I wear a mask to protect others.’” Frédéric Keck, a French anthropologist, said.

With this logic, in Asia, you could find people wearing masks in all four seasons for reasons that might be shocking to most people living in the West. It could be because of seasonal allergy, pollution, cold, sun, or as an extra layer for warmth. Masks in Asia give people comfort, a sense of safety awareness of protecting themselves and others. In Japan, for example, the “mask culture” seemed bizarre for foreigners. For instance, on Dec. 7, “taisetsu” (great snow), forecasting chill weather, several Japanese people would wear masks if going out.

“I am often asked (by people overseas) why Japanese wear a mask even when they don’t have a cold.” Yukiko Iida, researches masks in the Environmental Control Center Co. said.

In almost all Western countries, it’s assumed that masks are associated with sickness or crime. Particularly in Europe, the Burqa bans made face masks harder to be accepted. France is the first country in Europe to ban face-coverings including veils in public to increase security in the country. Overcoming the cultural resistance there are four European countries, Austria, Czech Republic, Slovakia and Turkey, requiring people wearing masks to go out currently. As a result, mask demands increase while the stocking is limited. Due to this concern, medical masks are left for medical professions and not suggested for the general public use. However, this doesn’t mean medical masks are effective for doctors but not the public.

“Doctors and healthcare officials are the ones who need the masks right now […] they are on the front lines fighting the disease, supplying them with as many masks as possible” junior Angela Xiao said.

Backed with dwindling supply, medical professionals who are putting their lives at high risk by facing direct contact with the airborne COVID-19 need to disinfect their masks ten to twenty times. Both surgical and N95 masks are single-use, designed for doctors to throw away after every patient they see. A pediatrician in Washington State uses her mask and, to make her tiny collection last, she sprays alcohol after every use. Many doctors and nurses are afraid amid a shortage of Personal Protective Equipment, including masks, gowns, gloves, and several other equipment. In response to the shortage of N95, on Friday, Apr. 3rd, the US Food and Drug Administration (FDA) announced that the agency will authorize the KN95 mask for use in healthcare settings if certain criteria met.

Unfortunately, the lack of masks is not fulfilled with KN95. Both in the U.S. and internationally, medical professionals are facing COVID-19 all day, and without proper protection their lives are in a dangerous place. Facing the severe shortage of masks, the U.S. should reference how South Korea and Taiwan are solving this problem, and adopt a safer technique.