Introduction: Mask wearing in other cultures
Mask wearing, along with social distancing and hand washing, are one of the three effective measures of prevention against COVID19 until vaccines become available. In Asia, masks have been a part of daily life for years before the COVID19 pandemic’s onset. Asians are used to wearing masks and they do it without complaint. Thus, Asian governments do not have a struggle to persuade their citizens to comply. As a result, these countries have been successful in containing the COVID19 pandemic in contrast to Western countries where mask wearing is not part of the culture. People in those countries wear masks because they have faced other pandemics before; thus they are more aware of the importance of their use to prevent contagion than we are in the West.
Mask Wearing in the United States
But in no other Western country has mask-wearing become such a controversial issue as in the United States. No other country, nor party, has made such a political statement about the issue of masks use as the Trumpist wing of the Republican party in the United States.
From the beginning of this pandemic, the federal government kept on sending off the wrong messages about the COVID19. Initially, they sent the wrong messages about the measures to take in order to prevent the propagation of this virus. And in December 2019 they also lost critically valuable time by considering the COVID19 epidemics as “a zone limited event” that exclusively happened in China and that was never going to reach us here in the US.
Then, when the first cases appeared in the US in late January, they told us that “everything was OK and under control.” At that time, the president refused to coordinate ANY national measure, to provide the medical materials for the COVID fight to the states (especially those with Democratic governors), and he adamantly refused to give clear universal recommendations for the entire country to wear masks as a part of our defense actions against COVID19. This attitude of his was paired with a refusal to ground the planes and to put the entire nation under lock down, mistake that he is repeating now with dire consequences for all of us. This administration continued this policy for months until they finally reverted it–but only partially.
This is so–to such an extent–that in February 2020, I (and many other physicians and health institutions) had to issue a You Tube video recommending mask use as an integral part of our COVID19 protection armamentarium.
But our federal government continued to send out mixed messages about the importance of mask wearing for another 3 months before it finally came around and started recommending mask use. These three early months of the COVID19 invasion were critical to determine the course of the pandemic in the US. We are now suffering the consequences of these early errors in management.
But, then, by the late spring, wearing masks in the US took another non-medical, non-scientific turn, in a presidential election year. This happened at the time that some people in the US had already started wearing masks. At that time, President Trump and his loyalists began a campaign of opposition and of discredit of mask wearing. This was associated with an attitude of sheer minimization of risk and defiance. They tried to portray those who wore masks as chickenshits. This ideological gap about wearing masks created by this administration grew to a point that, in the last few months, you could tell who belonged to which party by looking at their faces. You knew that someone was a Democrat because he/she would be wearing a mask, or a Republican (but particularly a Trump loyalist) if he/she had a bare face.
This mishandling of the COVID19 pandemic by the federal administration led the US–the country with the allegedly most advanced medical system in the world–to become the Number One country in number of infections and deaths. And this situation, in spite of billions of dollars thrown at the problem, has not been improved to the present. In fact, it has gotten much worse in the last weeks of electoral madness with a president caring more about electoral results than effective pandemic containment.
The Questions that linger
This ridiculous situation begs the questions: What are we dealing with at a psychological level here? What kind of “madness” has taken over half of the American people that we as individuals even go against our most basic survival instincts? Why would so many people follow suit and take an absurd stance of resistance to wearing protection from a deadly enemy defying science and Medicine in this effort?
Moreover, what are the reasons why people go against their own health and risk their lives assuming these reckless attitudes? How can it be that so many people–not only do not care for their own safety–but they also have sheer disregard for others’ including their loved ones’?
The effects of culture on mask wearing
Well, here I will advance some reasons why people refuse to wear masks in the United States in spite of the evidence that they are useful to protect us from COVID19 infection:
- There is in the US a long history of “radical individualism” as part of the American psychological make up. This individualism is more extreme in this country than in any other Western democracy. This form or radical “individualism” sometimes takes the form of uncaring narcissism.
- This type of egocentric attitude in individuals is clearer in a public health crisis such as this one in which every individual’s behavior counts.
- A need for a community-oriented conscience is necessary to fight a pandemic of this dimension and this is absent in large number of Americans. This narcissistic attitude, on the contrary, is one of “I do what I want and could care less about your well-being or what you think about it.”
3- Because of their extreme individualist views, many Americans-reject any attempt by government (or by any authority for that matter) to impose on them anything. They associate this type of interventions from government with “socialism.” For this unfounded reason, they take the medical recommendations to wear masks as signs of the “government intruding into their private lives.” These extreme individualists associate having to wear masks as “a sign of a limitation of their individual freedoms.” They have thus transformed a medical issue into an “individual freedoms” issue.
4-What is more disturbing yet is the fact that many pastors from the pulpits of American churches have encouraged defiance against mask wearing. They have done it by implying that “God will protect us” and thus it is useless to take ANY precautionary measures because “We are in God’s hands”. Some of these defiant individuals even paid with their lives for this attitude. Many of the people attending these churches who were misled also adhere to this president’s views, measures, and policies and they identify with his reckless arrogance and defiance.
4-Many individuals in our culture have oppositional traits in their personality. They just have an allergy to obedience. This is evinced by a attitude of opposing any dictums from ANY authority. It is enough that some authority says they “have” to wear masks for them to oppose wearing them. It is interesting to see that people that learn obedience to God and humility in Christian churches cannot come around to being humble and obedient when it comes to protecting themselves and their neighbor by wearing masks.
5-Many people in the US ignore the most basic public health matters and hygiene measures. This is clear a failure of the American educational and Public health system. But people are always influenced by the model presented to them by their authorities.
We humans are imitative beings. If these people see our president and our government officials take an attitude of defiance against mask wearing, they are much more inclined to follow suit and refuse to wear them themselves.
6-This country is–and has been for decades–fertile ground for conspiracy theories. These paranoid tendencies in large swathes of the American population are at least in part grounded on past lies told to them by the American government. This mass of lies doled out to the American public go all the way back to the Viet-Nam war era and the 1970s Watergate case. As years went by, this proclivity of the US government to conceal information from the public has created massive distrust from many in the American public of their government and institutions.
7-Paranoid fears are now increased further by fear, angst caused by the pandemic, and by the widespread use of cannabis products (THC products) by large numbers of individuals.
Cannabis is a drug that is now being legalized in many states. Unknown to most people, this is a psychoactive substance whose chronic use produce low-grade paranoid ideation. This type of paranoid ideation in an environment of distrust of government and of political opponents produces many more opportunities to develop conspiracy theories.
Remember: Wearing masks protect us and unite us
World leaders and the lesson not learned
8-From the beginning, large numbers of people in America have believed—or have been led to believe—that this is just “a “hoax.” This attitude has been promoted by the Trump administration and by other right-wing populist western leaders of the same ilk. This is the case of Brazil’s Jair Bolsonaro and British PM Boris Johnson. For all their defiance, these three men eventually became infected with the virus (God’s punishment for defying Him with their hubris???). They all survived the illness thanks to the top-notch medical care they received; care that most of their conationals cannot access or afford to have.
But, of the three, only Boris Johnson learned his lesson because he got a more severe form of the illness that almost took his life. Interestingly enough, on his behalf, Johnson is the only member of this trio of populists who has come around to a more rational view of COVID19. As a result of this realization, he is now promoting a more aggressive set of measures for the protection of British citizens as the UK goes into the winter months and experiences a massive surge of infection rates.
The Challenge and its benefits
9-Let’s face it. Wearing masks is a pain in the neck for all of us. Whether we agree we their use or not, and regardless of political affiliation. And its daily use involves more organization, more planning–and more discipline\–than not wearing them.
The valid reasons for refusing to wear masks
Keep in mind that some people resist wearing masks for medical or psychiatric reasons. This can be the case because they suffer from psychiatric or medical conditions. Here is a list of some of the non-political factors that influence mask-wearing by individuals:
- People may suffer from panic disorder or claustrophobia and they feel they suffocate with masks on.
- Some children do not tolerate wearing masks, especially infants.
- People with COPD or breathing problems may find it hard to breathe with masks on.
- Workers that are forced by their employers to wear them for long periods of times feel exhausted in them.
- People that wear glasses (especially older people) and who have vision problems have problems wearing them because they cloud their vision.
Wearing masks is not easy or fun FOR ANYONE. And Western governments now, who have finally recognized their utility, are cornered into requiring compulsory mask-wearing. This is the result that many people do not have enough social conscience to care about others and do it out of their own good will.
The near future
10- The problem authorities face persuading people to wear masks to prevent infection propagation they will have to deal with in the near future with the national attempts at universal vaccination.
In this regard, many people have mistaken ideas about vaccines, their use, their effectiveness, and their risks. As much as the medical community has struggled to persuade the public to wear masks, now we will have to deal with the same opposition when it comes to people accepting vaccinations. It is to be expected that the same groups that opposed mask wearing will also be against universal vaccination. This is the next challenge in our national strategy to combat and beat the COVID19 pandemic.
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Till then, stay safe and sound,
Dr. T