The Politics and Etiquette of Face Masks in the Age of COVID-19

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During the spring of 2020, the COVID-19 pandemic brought the world to its knees. The global economy came to a screeching halt as countries around the globe enacted draconian lockdowns and restricted people’s movement in a bid to stop the spread of the newest novel coronavirus. Nations have each taken slightly different approaches to combating the virus mitigating it’s spread. While there is still a long road ahead, states are now in varying stages of reintegrating their citizens into society, while nations that were infected later in the cycle remain in total lockdown. 

The Show Must Go On

Doctors and scientists around the world are still learning about the virus and how it spreads. As more data becomes available, governments are introducing different rules and requirements about how to protect their citizens from infection whilst transitioning back into the rhythms of daily life. The delicate task of salvaging a nation’s economy and its citizens' mental health, while also preventing overwhelming hospital admissions, further loss of life, the dreaded second wave and severe economic downturn is a rather precarious process. Multiple organisations are currently working to develop a vaccine. While there’s been amazing progress in a short period, it will be quite some time before a vaccine is successfully developed, tested, manufactured, and distributed worldwide. In the meantime, people must adjust their daily habits to function in a world with COVID-19. 

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What is COVID-19?

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COVID-19 is the most recently discovered virus within the family of coronaviruses. The full name for COVID-19, an infectious virus, is SARS-CoV-2. Coronavirus is a blanket term used to describe an array of viruses that make humans or animals ill and experience flu-like symptoms and respiratory issues. Different breeds of infectious coronaviruses have existed for centuries. Some of the more recent strains before COVID-19 include the 2002/2003 outbreak of SARS-CoV (SARS) and 2012 MERS-CoV (MERS) virus. Typically, these types of viruses mutate within animal populations, but in rare cases, a virus is transmitted from animal to human.  

COVID-19 was unknown until a breakout in Wuhan, China in December 2019. It has since spread across nearly the entire planet. The World Health Organisation (WHO) declared COVID-19 a global pandemic on 11 March 2020, and months later, many countries are still struggling to contain the virus.  

Each coronavirus has a slightly different composition and lifespan but what SARS, MERS and COVID-19 all have in common is the virus was strong enough to jump from animal to human and then reproduce, allowing the human to human transmission. The exact origins of COVID-19 are unknown and are a highly debated topic. Many believe it originated in a “wet market” in Wuhan, China. Wet Markets are open-air markets most commonly found in Asia. Many wet markets are similar to farmers markets in the West that sell fresh produce, seafood and sundries. However, there are also wet markets and wildlife markets that sell wild animals such as snakes, beavers and rabbits. Live animals are sometimes slaughtered on-site at these markets, creating an environment that may be susceptible to animal-to-human transmission of a virus. 

Discovering the origin of COVID-19 will be instrumental in developing an effective vaccination, but in the meantime, most nations are focused on containing the spread of the virus and protecting their citizens. COVID-19 has now infected nearly 7 million people across the world and has caused just under 400,000 deaths as of mid-June 2020. The exact beginnings of COVID-19 may forever remain a mystery, but six months in and millions of infections later, we can certainly conclude COVID-19 is highly contagious. 

How is COVID-19 Spread? 

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So far, evidence shows that COVID-19 is mainly spread through respiratory droplets emitted by sneezing, coughing and talking as well as touching surfaces contaminated by infectious droplets. The most common route of transmission appears to be via droplets that can remain in the air for as long as 8-14 minutes after they are emitted. The virus dies at various rates on surfaces like door handles, fabric and countertops, although it is still transmittable via surface contact as well. 

If someone infected with COVID-19 sneezes or coughs, the airborne droplets may infect another nearby person by entering their nose or mouth. Once comfortably ensconced inside a new person, the virus may then reproduce and infect him or her. If a droplet lands on a surface, for example, a handrail, the virus may be transmitted if someone touches that contaminated surface and then touches their mouth or nose before washing their hands. The hygienic practice of frequently washing your hands with soap and water will kill any virus that may be on your hands. The virus doesn’t infect you via your hands but when your infected hands then touch your face. Many don’t realise, but on average, people touch their faces 16 times per hour. If exposed to the virus, this subconscious habit can increase the risk of transmission. 

The droplets are rather small and are not always visible to the naked eye. Everyone emits these droplets every day, even if we’re not sneezing or coughing, but simply speaking. That’s why being in close proximity with people in a jam-packed subway car, or even chatting with a colleague in your office, can easily spread the virus. These viral droplets are one of the reasons some church choirs became superspreader clusters as choirs typically stand in a few rows shoulder to shoulder while singing and, therefore, emitting tiny droplets.

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Before social distancing measures were required across most parts of the world, COVID-19 was spreading at a breakneck pace throughout multiple countries. Densely populated areas such as New York City were hard-hit, and hospitals were almost immediately inundated with hundreds of patients. The steep infection rate then left many nations and cities with no choice but to require their citizens to shelter in place in order to decrease the reproduction rate of infection. This extreme measure has successfully slowed new infections in many areas, but for obvious reasons is not a sustainable long-term solution. 

Protection and Prevention from COVID-19

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Baring a vaccine breakthrough, the next best techniques to slow the spread of COVID-19 are social distancing, protection and practising good hygiene.

Each government has its own recommendations, but below are some generally accepted best practices: 

  • Wash Your Hands with soap and water for at least 30 seconds. Be sure to wash your wrists and under your nails, too. 
  • Use of Hand Sanitiser early and often if soap and a sink with running water are not immediately available. It’s critical that you clean your hands regularly if you’re outside your home because you touch your face throughout the day without realising. Don’t touch any part of your face before cleaning your hands first.
  • Keep Your Distance - stay at least two metres (six feet) away from anyone who isn’t part of your household while outside your home.
  • Tame the Spray - This rule always applies in times of both pandemics and peace. Without fail, always cover your mouth and nose when you cough. Ideally, use a tissue, but if you don’t have one, you should sneeze like a vampire by coughing into your sleeve.
  • Cover Your Face - wear a face covering that covers your nose and mouth if you’re in an area where it’s hard to keep a distance from other people such as public transportation.
  • Leaders Who Dismiss Face Masks and Deaths due to COVID-19: Correlation or Coincidence? 
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The use of face masks by everyday civilians to hamper the spread of COVID-19 is a controversial and debated topic. In the earlier days of the pandemic, as coronavirus was starting to creep westward, yet many countries were largely ignoring the issue, some governments along with the renowned Centers for Disease Control disregarded the idea of wearing a face mask to stop the spread of this unknown virus. In their defence, this can be partly attributed to an effort to make medical masks available for essential workers who were woefully short on personal protective equipment (PPE) during the peak of the pandemic. On 29 February 2020, the US Surgeon General publicly tweeted that “they [masks] are not effective in preventing the general public from catching coronavirus.” UK Prime Minister Boris Johnson waffled and largely avoided addressing face masks until half-heartedly admitting on 30 April 2020 that face coverings may be “useful.” United States President Donald Trump flat out refused to wear a face mask until he visited a food plant in Michigan on 22 May and was photographed wearing one with a decorative presidential seal. Fast-forward to June 2020, neither the US nor the UK is faring particularly in the battle against COVID-19. As of 8 June 2020, the UK’s Office of National Statistics recorded over 50,000 deaths due to COVID-19. In terms of absolute death count by country, the UK (population 66.65 million) is only surpassed by the US (population approximately 328 million) who recorded a total of 113,984 deaths on this same day. By deaths per one million of the population, the UK ranks second-worst in the world at 610.58 deaths per million. The US is not far behind at ninth-worst with 338.82 deaths per million. 

Higher than average death rates, and leaders who initially dismissed face masks, are not mutually exclusive as there are multiple factors that must be considered. That said, it’s hard to ignore the continental European nations who were quicker to adopt mitigation practices (including wearing masks) have fared better in terms of COVID-19 death rates. Germany (population 82.93 million), for example, currently has a considerably lower death rate of 105.25 per million. 

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Stopping the Spread of COVID-19 and Starting Life Again 

In nations or areas where infection rates are now on a consistent downward trend, governments are focusing on the next phase. This scenario poses the complicated question of how to restart a society (and the economy), whilst keeping the rate of infection very low if not non-existent. Mitigation and management are the only options until a vaccine becomes available. 

In Europe, each country has taken a slightly different approach to managing the outbreak, but most are in general agreement that physical distancing, hygiene habits and more recently wearing face masks or face coverings in specific settings are key to keeping the population safe. 

The Psychology of Face Masks 

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Face masks are commonplace in many parts of Asia - pandemic or not. It’s not unusual to see someone wearing a mask, whether they’re on their daily commute or out shopping. Whereas in western countries face masks were typically only used in specific circumstances, such as a doctor doing surgery, or construction professionals working in an area with a potentially harmful substance like asbestos. Other than the odd biker in Central London, face masks were not often seen in Europe until the outbreak of COVID-19. 

We’re entering a new paradigm, and adaptation is key across all facets of life whether it’s how we conduct business, or what we wear each day to keep society protected. Understandably, this is quite an adjustment. Most communication amongst humans is non-verbal, and reading facial expressions is part of our daily discourse with others. It’s harder to gauge someone when most of their face is covered by a mask. Also, the idea of needing to wear a face mask while doing something as innocent and mundane as picking up groceries, almost feels like a sign of defeat. It’s hard to reconcile that existing in today’s world has become so dangerous, that there’s no choice but to utilise these extreme and unsightly precautions. 

Face Masks are Part of Our New “Normal”

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It’s critical we accept and embrace our new daily rituals and safety precautions, as this will help move the world forward with COVID-19. Nations that once ignored the idea of their general public wearing face masks have since changed their tune.

On 9 April 2020, United States First Lady, Melania Trump, tackled what her husband, apparently, could not bear, and released a public safety video announcement, encouraging Americans to wear non-medical face coverings while out in public.

On the other side of the pond, beginning on 15 June 2020, commuters must wear a face covering on public transport in England. There are a few exceptions, such as young children under the age of two and people with breathing difficulties.

The UK’s approach to containing the coronavirus has been confusing from the start. Many have complained that guidance has been unclear, and leadership has U-turned more times than we can count at this point. Walking around Central London for the past month, you would hardly realise there was a pandemic aside from the closed up shops and restaurants. People are seemingly quite relaxed (or, perhaps, ignoring the reality) about the virus and have continued to flout the government’s social distancing rules. For weeks, people flocked to local parks in large groups with only a small percentage of the population wearing any sort of face covering. The new rule requiring face coverings on public transport feels about 90 days too late for England but will hopefully prove to be part of an effective mitigation process as the nation continues to lift lockdown measures and open non-essential stores on 15 June 2020. 

Wearing a mask is not a guarantee that you won’t infect others if you have COVID-19, or prevent catching the virus if you’re in close proximity to someone who has it, but face masks do provide some degree of prevention and protection. Face masks are not a replacement for social distancing, and it’s important to remain vigilant about following local guidance for the health and safety of yourself and those around you. 

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When and Where to Mask

Face masks are proving to be most useful in cramped public spaces where social distancing is nearly impossible. For example, a small corner shop, a local pharmacy, or a crowded bus full of commuters during a rush hour. In parts of Europe where non-essential retail has now opened many stores, require shoppers to wear a mask while in the store. In Austria, wearing a mask whilst buying food and other basics became mandatory in early April 2020. This tactic has proved to be successful, and Austria plans on relaxing mask requirements in mid-June. 

Mask Etiquette

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Debrett’s, the UK’s household authority on manners preface their handbook with some sage advice:

“Etiquette is about understanding and mastering a set of clear and pragmatic guidelines that have evolved to make everyone feel welcome and valued. Manners make everyday life easier, removing anxiety and minimising social difficulties or awkwardness.” 

Debrett’s words of wisdom have never been more relevant as society begins to re-socialise. The guidelines have changed and age-old customs, such as a handshake, are no longer allowed, but the concept remains the same. For the health, safety, and respect of those around us, it’s critical that we accept and embrace COVID-19 norms as we navigate the second half of 2020, even if this means wearing something as awkwardly unfamiliar as a face mask. Emily Post, a US-based manners maven, has published a useful summary on COVID-19 manners

Cloth Face Masks

Many fashion designers, artisans and DIY-ers, have started making and selling reusable face masks to wear day to day. A cloth facemask doesn’t offer the same level of protection as a respirator mask, but, nonetheless, is now required in many public places and offers some degree of prevention and protection. One of the advantages of a cloth facemask is you can make or buy multiple reusable masks that are machine washable and, therefore, easy to sanitise and reuse - just pop the mask in the washing machine with your laundry, wash with detergent and allow the mask to fully dry. Alternatively, you can also hand wash the mask in a bleach solution. 

A reusable facemask is also an eco-friendly solution. Sadly, many discarded, and not to mention potentially infected single-use facemasks and surgical masks are now littered across many city streets. France has gone as far as to fine those who are found littering their masks with 135 EUR.

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Make Your Own Face Covering 

There’s no excuse to not wear a face covering because they can be made from common household items. Most required items are likely already lying around most homes. You can fashion a face covering from an old sock and hair ties or rubber bands. The CDC has created instructions on how to make a no-sew face covering using only rubber bands or hair ties and some pieces of button fabric.

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It’s important that a homemade face mask meets the following criteria:

  • Fit - the face mask should be fitted around your face but still feel comfortable.
  • Breathable protection - a mask should include multiple layers of fabric but should also be breathable. 
  • Security - the mask is secured with either ear loops or tied around the back of your head.
  • Coverage - the mask should cover your nose and mouth.
  • Washable - the mask should be able to be washed either in the washing machine or by hand without compromising or changing the shape or performance of the mask.
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Face Mask Fashion

There are now many face coverings available to purchase as well. There’s no reason why you can’t stay chic whilst staying safe. Take a few style cues from socialite Olivia Palermo who has been photographed wearing a silk scarf over her face while walking her dog in Brooklyn, New York. 

Style icon and heiress, Aerin Lauder, recently posted a selfie on Instagram modeling her cheerful pink floral print face mask. 

Be Prepared

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Since face coverings are now required to be worn while on public transport or shopping in many parts of the world, it’s advisable to always be prepared. 

Once you have either purchased or made your face coverings, it’s prudent to always take one with you as you head out the door. Even if you only plan on going somewhere a face covering is not required, what if your plans change and you decide to pick up some groceries or take the bus home? Keep at least one face mask in each of your purses or jacket pockets just in case. Another key item to keep on-hand is pocket-size hand sanitiser or antibacterial hand wipes. 

Preparedness is safe and courteous to both yourself and those around you. It’s your duty as a citizen to uphold the constructs of society and follow the rules designed to protect the population.

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We’re in This Together

Everyone has felt the frustration of 2020, this has been a challenging year. We must remember that the entire world is in this fight together, and unification, empathy, and safety are key in thriving in our new world.

Verified by a Healthcare Professional

Anastasiia Myronenko

Anastasiia Myronenko

Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.