I wore a mask when I was the orderly at an outpatient hospital in Palo Alto. My father snagged the job for me during the quarters I took off from college. Both my parents deny that they were pushing me to become a doctor, but it’s hard for me to draw other conclusions based on the evidence. My father and his brother were doctors. My grandfathers were doctors. One of my great-grandfathers was a doctor. I think it was assumed I would be, too.
At the outpatient hospital everyone except patients wore masks in the operating room area. Outside the operating room area, it was anything goes. So, if you’re thinking that healthcare workers wear masks primarily to protect themselves, that was not the case where I worked. We wore masks to protect patients from us when they were vulnerable to infection during surgery. If our goal had been to protect ourselves from patients, we would have worn masks outside the operating room area, too.
That’s why the current situation with Covid-19 confuses me, the insistence on wearing masks. I still haven’t bought one. I’d guess that about 2/3rds of the people walking on Barcelona’s streets during our communal exercise periods wear masks. I’m not religious about the issue of masks and wearing one certainly reduces the chance that a contagious person infects others.
I worry that people aren’t thinking things through, though, that they’re creating a false sense of security when they don a mask. Masks are a great opportunity for everyone going through Covid-19, but not necessarily for safety.
You may be scoffing at me, thinking I’m being selfish. Maybe I am being selfish, but before you scoff any further, check out this Twitter thread Brad found. (For the record, I have no idea where Brad finds this stuff, but he saves my ass writing these Covid Diary BCN entries).
If you’re an information sadist, read the entire thread. The point is this: a wide range of data indicates that Covid-19 transmission mostly takes place in closed environments with prolonged exposure. In other words, Covid-19 is not lurking in every nook and cranny waiting to hop in your nose. In other words, social distancing is your best defense against infection.
Since isolation started, I have been to doctors’ offices about once a month where I would maintain extra social distance. I’ve spent 30-60 minutes a week inside stores that have a closed environment. I go to these stores when they are not crowded and maintain distance. I’ve spent none of my time in closed environments with prolonged exposure to Covid-19 virus. I’ve spent none of my time in crowded environments. On top of all that, I wash my hands every time I return home and don’t touch my face while I’m outside. Please pardon my graphic comparison, but at this point wearing a mask to protect others from me seems like wearing two condoms instead of one to prevent the spread of sexually transmitted diseases.
I did make out with a guy. Okay, I admit that’s a weak point in my argument. But what are the chances? He was asymptomatic. He wore a mask. Before we made out, that is.
Masks make sense to me sometimes. If someone is sick, he or she should wear a mask. It contains 50%-80% of the viral load.
If I were in a closed environment for long periods, I would wear a mask. I wouldn’t wear it to protect me, though. I would wear a mask because, even if there is the teeny-tiniest chance I’m contagious, that teeny-tiny possibility is multiplied by the hours I share a closed space and the number of people I’m sharing it with. Ditto if I’m in a crowd outside, but where do I find a crowd outside these days?
You still may be scoffing at me, telling me I’m rationalizing my beliefs. You may have seen the erroneous meme that says if everyone wears a mask, the chance of transmission goes down to 1.5%. I’ll post again a Twitter thread about masks from Dr. Christine Eady Mann that I posted a while ago.
Also you can read the WHO mask recommendations here. If you’re too lazy to click through, here’s a summary:
- If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.
- Wear a mask if you are coughing or sneezing.
- Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
- If you wear a mask, then you must know how to use it and dispose of it properly.
I can’t write about masks without discussing their cultural significance. For instance, if you’ve ever been to Bali, you know masks play an important part in its rituals and that the use of masks changes along with the island.
Sacred masks are used in various [Balinese] processions from massive temple rituals to ceremonies celebrating personal milestones like weddings or funeral rites. But as the uses and functions of dance and performances extend to non-spiritual purposes, the use and meaning of Balinese masks follow. During social or entertainment dances, the masks serve as symbol or impression of certain characters in the story.Culture Trip, ‘The Sacred Meanings of Balinese Masks,” 15 January 2019
It seems so quaint right now to take a trip to Bali.
Regardless of the efficacy of masks during the pandemic, Covid-19 masks are here to stay. In Barcelona, we’re required to wear masks when we take public transit. My friends in San Francisco have to wear masks in a number of situations outside home.
The use of masks during the Covid-19 pandemic creates fashion opportunities and political tensions. Although I mostly see plain paper medical masks, Covid-19 masks also let us play with our identities.
Washington Post had a story yesterday about Covid-19 masks and fashion, but I can’t share it with you because it’s behind a paywall. That doesn’t keep me from having a couple observations about mask fashion.
First, my friend David mentioned that the fashion industry is figuring out how it markets casual products for a growing shelter-in-place population. Fashion brands have to figure out how to position so they don’t appear to be taking advantage of fear. Do you want to project power when you’re queuing for groceries? On top of that, these brands have to figure out why brands matter at all to consumers sitting at home all day. Does an Yves Saint Laurent mask say “I’m healthy” around the neighborhood better than a paper medical mask?
Second, my friend Heidi is selling masks for causes. For many masks she gives away part of her proceeds to good causes. Plus you can breathe blue all day.
On the political front, the Vice President refused to wear a mask at the Mayo Clinic last week, then apologized. Yesterday, Trump refused to wear a mask at, of course, a mask factory. Very meta way to draw attention to his need to end to the pandemic years before it will be over, Covid-19 being inconvenient for his re-election campaign.
People argue online about masks. It is yet another topic for heated dispute with powerful memes and informational articles on both sides of the argument. Choose your point of view on masks and you can hide behind your own mask of cherry picked facts.
I took acting class to overcome my stage fright. It worked. I learned that if I stayed in character, the audience had no idea I was blowing my lines. For one of the early exercises in class, my teacher Rhoda handed out masks. Acting is all about role play and masks give everyone permission to play a role regardless of ability.
Even if we don’t put on a mask, we still are wearing a metaphorical Covid-19 mask. Everyone has to figure out new roles and new behaviors. Everyone has a new scene. As I learned from Rhoda, no matter how small the part, it is an opportunity to play the role of a lifetime.