The Debate over Face Masks

face mask

I’ve seen much debate on social media and out in public in general over the wearing of face masks. The CDC recommends everyone (with a few exceptions) wear a face mask when out in public and in many areas it is mandatory. Yet there are those who, for various reasons, refuse to wear a face mask even if it is mandated by their local government.

In this post, I’m going to give you the information on why you should wear a mask and hopefully give you some insight as to why some refuse to wear one.

Who should be wearing a face mask?

The Center for Disease Control (CDC) says:

“Cloth face coverings are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the cloth face-covering coughs, sneezes, talks, or raises their voice. This is called source control. This recommendation is based on what we know about the role respiratory droplets play in the spread of the virus that causes COVID-19, paired with emerging evidence from clinical and laboratory studies that shows cloth face coverings reduce the spray of droplets when worn over the nose and mouth. COVID-19 spreads mainly among people who are in close contact with one another (within about 6 feet), so the use of cloth face coverings is particularly important in settings where people are close to each other or where social distancing is difficult to maintain.”

The CDC recommends that everyone two-years-old and up wear a cloth face-covering in public, when around others who don’t live in their household or when social distancing is not possible or is limited. And if you are sick or think you may have COVID 19, the CDC recommends that you wear a cloth face-covering even inside your home if you are around others.

The CDC knows that in some cases wearing a cloth face-covering may not be possible for some people. In these cases, the CDC recommends that you look for an alternative such as;

clear face mask

A clear face-covering if you are deaf or hard of hearing or if you are in contact or care for those who are hearing impaired. If a clear face-covering is not available, the CDC recommends looking for an alternate form of communication like written communication, closed captioning, or decreased background noise. This is just one example of those who need to seek an alternative to the regular face-coverings that most of us should be wearing.

There are two other types of face-coverings that I’ve seen people using in public. The first is the face shield:

face shield

It is not known if the face shield protects others from COVID 19 and the CDC does not recommend their use for normal everyday activities or as a substitute for a cloth face-covering.

The second type is the surgical mask or N95 respirator masks:

surgical face mask   N95 face mask 

The CDC does not recommend that the public wear this type of mask as they are needed by medical personnel and first responders.

The Science behind the CDC’s Recommendation

There are several categories of evidence supporting the use of face masks. One category is laboratory studies of respiratory droplets and how different masks blocked them.

One experiment using high-speed video showed that hundreds of droplets were generated when saying a simple phrase, but almost all of the droplets were blocked when the face was covered by a damp washcloth.

But the strongest evidence comes from real-world scenarios. UC San Francisco epidemiologist George Rutherford, MD, said “The most important thing are the epidemiologic data.” This epidemiological data has come from what are known as “experiments of nature.”

A recent study published in Health Affairscompared the growth rate of COVID 19 before and after mask mandates in 15 states and the District of Columbia. The study found that mask mandates slowed down the COVID 19 growth rate. In the first five days after the mask mandate, the daily growth rate slowed by 0.9% and after three weeks the daily growth rate had slowed by 2%.

So why do people refuse to wear masks?

One reason could be the conflicting messages we have received from the CDC and other public authorities. At first, the CDC stated that healthy people did not need to wear a mask, but as they learned more about the COVID 19 virus; they realized that wearing a face mask was an important part of stopping the spread of the virus.

In an article on, California-based psychiatrist and author Gayani DeSilva, MD, says “Messages lose credibility when they are presented as fact one day, only to be described differently the next, on the other hand, credibility increases when data and opinions are presented with factual backing. The public can be told more about how the evolving information changes the official message, and then there will be more public buy-in. Adults do not like to be told what to do without understanding the reasons behind it.”

In that same article, New York psychiatrist Margaret Seide, MD, agrees that it’s easier to do something—even if you don’t entirely want to—when one clear and concise message states that it’s the best step to take. “When it seems like there are a menu of options out there, naturally you will choose the thing that seems most appealing to you,” she explains. “Lots of people may feel like the mask is an imposition on their life and feels uncomfortable, so if there is a public message that validates that, you are going to tune into that. If you don’t want to wear masks, you can find a stream of information online that reinforces your decision.”

Another reason people refuse to wear masks could be denial. I know I’ve heard people say “this virus is nothing more than a really bad cold”, or “this virus is not real”, etc.

“Denial kicks in automatically when someone can’t handle the depth and seriousness of a situation,” Dr. DeSilva explains. “The COVID-19 crisis is traumatizing, and many psychological defenses will arise to help individuals cope. Denial leads to avoidance, and then leads to not hearing the facts, which in turn leads to not following safe measures to prevent the thing they fear. It is a vicious, unhelpful cycle, which ultimately contributes to the problem.”

Another thing feeding into this denial is the conspiracy theories and other out-there ideas about the virus. “Wild ideas can get traction and get a following on social media,” says Dr. Seide. “There are voices out there questioning the data we are being presented with regarding the prevalence and severity of COVID-19; it has become something of a movement. There are people literally denying the virus, and there are people who are subconsciously in denial about the virus.”

A third reason people might be refusing to wear a mask is that they want control back. We were all ordered to stay in our homes for weeks, wear a mask if you went out for essential needs, and our whole life was interrupted and changed. Now in order to regain control, some people have gone to the extreme by not following any of the CDC guidelines, they don’t wear a mask and they don’t follow the social distancing rules. Dr. Seide says,  “Some are choosing to rebel against everything that has been forced on them for the past few months—including wearing masks. The mask has become the symbol of COVID-19, so it makes sense that some people reject it.”

The fourth reason some people refuse to wear a mask is they simply don’t want to be team players.

 “I do think some people have a sense of elitism, narcissist traits, or a better-than-others kind of self-image,” says Dr. DeSilva. “This is largely due to defense mechanisms also—born of fear and feeling cut off from others.”

While others see this issue only in terms of their comfort and safety. They don’t understand that wearing a mask not only can protect them but their family and community. These people don’t see the benefit of doing something for the greater good.

It is my hope that everyone who reads this will understand why wearing a mask is important and will choose to wear one. But I hope they will also understand why others might refuse to wear a mask because, for those who wear a face mask, anger and outrage are often expressed toward those not wearing a face mask and the last thing we need now is more anger toward each other.

Please let me hear from you, comment below.





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