By Elaine Wong • BSc Anthropology (alumnus)
To mask or not to mask? That is the question.Alyssa Pereira, SFGATE and Brandon Mercer (2018)
Even though more common and severe diseases have been around for much longer, the new coronavirus, COVID-19, has made buying face masks an extreme sport. By dividing the number of confirmed cases by the number of deaths, WHO statistics from March 25th suggest that the death rate of COVID-19 is about 4.4%, which is higher than that of the seasonal influenza, also known as the common flu, in the US (0.1%). Yet, the actual numbers of cases and deaths for the flu are significantly higher. Up to the same date, there have been 375,498 confirmed cases and 16,362 deaths from COVID-19 globally. In comparison, the Centers for Disease Control and Prevention (CDC) estimated about 45,000,000 cases and 46,000 deaths from the flu between 1 October 2019 and 22 February 2020 in the US alone.
We know more about the flu than we do about the coronavirus. But despite having a well-developed vaccine for the former, more people die from it every few months than those who do from the coronavirus. Here I ask: to what extent is the rational choice the ‘right’ one; and why do we evaluate danger by trusting certain numbers over others?
The Science of Politics
You may think Hong Kong people look irrational [because of the] coronavirus…[b]ut this behavior isn’t proof of an illogical and superstitious population: Call it the consequences of trauma.Ilaria Maria Sala (2020)
In the morning, you wake up and open the local news page on your phone. You read reports of new coronavirus cases in your area. You google for solutions to reduce the risk of contracting the virus. Some say, ‘face masks reduce your risk of getting the virus so put one on even if you aren’t ill!’ Others say, ‘they increase your risk of getting the virus so don’t put them on unless you are ill!’ After scrolling through 50 articles, you let out a huge sigh, feeling hopeless as there are just as many arguments for as there are against the effectiveness of face masks. But at least it’s better to be with a mask than without, right?
From queueing up overnight to buy masks to discussing mask models (e.g. N95 vs KF94) over dinner, local efforts in Hong Kong may seem very irrational to foreigners. However, Italy-born Hong Kong resident Ilaria Maria Sala (2020) argues that this frenzy is due to the “unresolved [political] trauma” of inappropriate communication from the local and Chinese governments. “The events of 17 years ago were responsible for cementing that distrust, when Hong Kong found itself alone for weeks as a mysterious new virus killed hundreds while central authorities in Beijing remained silent,” and “worsened last year over more than six months of protests that rocked Hong Kong.” Whether the reasons behind our actions are of political sentiment or rationality, the mask usage debate centres around something even more mind-boggling – our preoccupation with sanitisation.
The Politics of Science
“A scientist who led efforts at the World Health Organization to develop global policy to limit use of antibiotics told me that, philosophically, this is a lesson that runs counter to a century of marketing: We’re not safer when we try to eliminate every risk from our environment.” – Matt Richtel (2019)
In another article, I criticise our over-reliance on scientific knowledge to make decisions in everyday life. Whilst certain viruses and other pathogens are indisputably harmful, how we act upon such information is a completely different and highly subjective matter.
Initially proposed in 1989, the ‘hygiene hypothesis’ claims that if people do not have enough exposure to pathogens in their early years, their undertrained immune systems will be compromised (e.g. develop allergies). In other words, “[w]e’re too clean for our own good.” The promising study was still a work in progress, but mass media hastily packaged it into dangerously misleading slogans and the public jumped to conclusions. Medical experts have “even seen things in the media saying we shouldn’t wash our hands. What the hell are they talking about” (Scudellari 2017).
Some academics attempted to find middle-ground in “targeted hygiene.” That is, “eliminating the spread of [harmful] pathogens while promoting steps to restore a diverse [ecosystem of microorganisms in the body]. For example, one can teach children to wash their hands after handling raw chicken but also encourage them to play outside in the dirt” (Scudellari 2017). This sensibility can also be applied to mask usage. Research shows that people should not wear masks if they are indoors or have pre-existing breathing problems (particularly those of N95 grade or higher), as doing so would deprive the brain of oxygen. Yes, it is better to be safe than sorry, especially for the sake of those who are at greater risk. Still, let us not forget to rely
on other less extreme preventative measures (e.g. staying at home and washing hands more often) so that we do not lose our breath from mask-wearing before doing so from the virus. As I mentioned in my previous article, “this does not mean that we should stop being sanitary in hospitals, but rather that we ought to tone down our preoccupation with cleaning too much…so that we don’t end up in hospital” (Wong 2017).
Mask for Thought
If the critical apparatus of the moderns has made them invincible, why are they hesitating over their own destiny today?Bruno Latour (1993)
“To mask or not to mask? That is the question” (Pereira et al. 2018). Beyond the knowledge gap between academia and the public lies a human tragedy, where technological and intellectual advancement comes at a price. With every new piece of information presented, we tear our hair out over weighing our decisions on the increasingly complex intersection between science, politics and sensibility. In the words of French anthropologist Bruno Latour (1993), “[a]s for the human masses that have been made to multiply as a result of the virtues and vices of medicine and economics, they are no easier to situate…[a]re we in the realm of biology, sociology, natural history, ethics, sociobiology? This is our own doing, yet the laws of demography and economics are infinitely beyond us.” But instead of fearing our inability to have complete control over our lives, perhaps we should celebrate in having the freedom of not being held entirely responsible for our own destinies – mask for thought.
Latour, B. (1993) We Have Never Been Modern. Cambridge: Harvard University Press.
Pereira, A., SFGATE, Mercer, B. (2018) Wait, kids & people with breathing problems should NOT wear N95 masks? SFGATE.com. Available at: https://www.sfgate.com/california-wildfires/article/n95-masks-county-health-safe-advice-doctor-13399569.php [accessed 25 March 2020].
Richtel, M. (2019) Your Environment Is Cleaner. Your Immune System Has Never Been So Unprepared. The New York Times. Available at: https://www.nytimes.com/2019/03/12/health/immune-system-allergies.html?campaignId=7JFJX [accessed 25 March 2020].
Sala, I. M. (2020) Hong Kong’s coronavirus panic buying isn’t hysteria, it’s unresolved trauma. Quartz.com. Available at: https://qz.com/1798974/how-sars-trauma-made-hong-kong-distrust-beijing/ [accessed 25 March 2020].
Scudellari, M. (2017) News Feature: Cleaning up the hygiene hypothesis. PNAS 114(7): 1433-1436. Available at: https://www.pnas.org/content/114/7/1433 [accessed 25 March 2020].
Wong, E. (2017) Dirt: ‘Matter Out of Place’. Savage Journal. Available at: http://www.savageonline.co.uk/elaine-wong/dirt-matter-place/ [accessed 25 March 2020].