Public health and government officials say that mask-wearing is an important part of helping to curb the spread of the novel coronavirus — but not everyone is listening.
Across the U.S., fights have erupted over stores’ mask policies, and some have even turned deadly. A security guard at a Flint, Mich., dollar store was fatally shot after telling a customer they needed to wear a mask inside the store.
In Toronto, a video of a woman refusing to wear a mask at St. Joseph’s Health Centre, per hospital policy, went viral after she posted footage of her arguing with health-care workers on social media. Video footage taken at a Mississauga, Ont., T&T Supermarket and uploaded on Tuesday shows an angry shopper refusing to wear a mask, per the store’s policy, and telling a store clerk that the benefit of masks is “a communist, socialist lie.”
The man is also heard yelling at a store employee, saying the virus is from China, and continues on a racist, anti-Asian rant telling the worker to “go back to where he came from.” The employee responds by telling the customer that he’s Canadian.
But why are masks, which help catch infectious respiratory droplets expelled by the wearer, so controversial during the pandemic? According to experts, there are several common reasons why.
Emotions are high
When people are in a heightened emotional state, their ability to think rationally can be affected.
“While some people view wearing of masks as altruistic and a joint effort to combat the virus, others view it as yet another way that their lives are being controlled by the government, and by the virus,” said Taslim Alani-Verjee, a Toronto-based clinical psychologist and founder of the Silm Centre for Mental Health.
“When anxiety is heightened, we tend to take more rigid stances and lose our flexibility, and, unfortunately, sometimes our ability to see things rationally.”
Many Canadians are not accustomed to wearing face masks in their daily lives, and doing so feels uncomfortable, “culturally strange” and even like an inconvenience, said Steven Taylor, a professor of psychiatry at the University of British Columbia.
Taylor, who is also the author of The Psychology of Pandemics, said these factors can contribute to a general disinterest in mask-wearing, as can the issues they pose when trying to communicate with others.
Jay Van Bavel, an associate professor of psychology at New York University, said North American societies often value individualism over collectivism, which means Canadians and Americans greatly value their individual freedoms. When it comes to masks, this means people may think of themselves and their own comfort over the collective good that comes from virus prevention measures.
“That’s a cultural characteristic of often western European and North American countries that differ, say, from Asian countries, especially East Asia, which are more collectivistic,” Van Bavel, who co-authored a recent paper on behaviour response to the COVID-19 pandemic, said.
“In individualistic cultures, you pride things like individual freedom of expression more. In collectivistic cultures, you tend to prioritize the benefit of the group. And so that might be one cultural factor that puts people at risk in Canada.”
Another reason that people don’t wear masks is because they underestimate the seriousness of the COVID-19 pandemic, experts said. Taylor said COVID-19 is like a “hidden pandemic” because many people have not witnessed first-hand the death or harm it can cause.
This plays into “optimism bias,” which is the idea that bad things are more likely to happen to other people than oneself. This mentality can play a role in how people assess risk, causing them to think they don’t need to take health precautions as seriously.
“Even if they might realize there’s a big risk for the population, they somehow think they’re exempt from it, that it doesn’t apply to them,” Van Bavel explained.
“They might think they’re smarter, more clever or healthier.”
Masks symbolize change
Our lives have changed since the outbreak of the novel coronavirus, and the pandemic has affected nearly every aspect of “normal” life. Masks are a physical symbol that things are different and we have to adapt from the way we previously lived.
Some people are better at adapting to change, Alani-Verjee said, while others have less cognitive flexibility. For those who struggle to adapt their perspectives to new information, refusing to accept masks can offer a slice of the “pre-COVID” days.
“If we stand firmly in our stance that we do not need to wear masks, it may help us hang on to that sense of normalcy for a little bit longer,” Alani-Verjee said.
“That, in a way, can help people cope with all of the change. Unfortunately, this stance does not allow us to see the situation for what it is. What we need is an acceptance of the reality of the situation.”
Messaging and misinformation
Consistent and clear public health messaging about health risks and prevention measures during the pandemic is key. When people get mixed messaging or don’t understand the rules, it can lead to confusion around what measures are necessary.
Early in the pandemic, government officials said the public did not need to wear face masks as health-care workers were a priority during fears over mask shortages. Now, as the pandemic has evolved and the public health messaging on masks has changed, it has led to some confusion, Taylor said.
Experts say masks can be helpful reducing the spread of COVID-19 alongside other health measures like handwashing, physical distancing, testing and contact tracing.
“Ideally, what we would have done back in January is be proactive and said, ‘OK, there could well be a point when infection becomes widespread in the community where it’s going to be wise for everyone to wear masks,'” he said.
“We know from history that non-adherence is going to be a problem, and we should anticipate that.”
Coronavirus misinformation is also spreading on social media, which can fuel the anti-mask fire. Graphics with inaccurate information on mask safety are popping up on Instagram, causing some people to believe that masks do more harm than good — despite evidence showing the contrary.
“Social networks can amplify the spread of behaviours that are both harmful and beneficial during an epidemic, and these effects may spread through the network to friends, friends’ friends and even friends’ friends’ friends,” Van Bavel and his co-author wrote in their paper on pandemic behaviours.
‘Violation’ of freedoms
Drastic — and sudden — change can take a toll on people’s emotional well-being and lead to a sense of loss of control. The idea that we are no longer able to move as freely or do activities as we like, as we could pre-pandemic, is upsetting to many.
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Mask policies or bylaws are another way some people feel like they’ve lost control over their lives.
“For those who are resistant to wearing masks, it is likely that they highly value their personal freedom, and their anxiety around the virus and the loss of freedom are playing a significant role,” Alani-Verjee said.
What’s more, when people are told or legally required to do something, they can rebel, Van Bavel said.
This was seen in Toronto when an anti-mask protest on public transit took place on Tuesday morning in response to the TTC mandating that riders wear masks while taking transit. A group of about 40 protesters boarded a subway car sans masks and talked through megaphones about “informed decision-making” and “freedom of choice.”
The City of Toronto also recently passed a bylaw that makes masks mandatory inside all businesses and indoor public spaces.
“When some people are forced to do something that they feel is against their will, they react against it,” Van Bavel said.
“As things are required, for example, wearing a mask in the subway, some people react against that; they react against authority. It’s just a way of asserting themselves and their autonomy.”
Normalize mask wear
In order for all (or most) people to wear masks, social norms have to adapt, experts said.
It’s not enough to have political leaders say, “wear a mask,” but lateral acceptance has to happen among society, Taylor said.
Van Bavel said local community leaders need to model behaviours to help normalize them. People who are greatly respected within spaces, like religious groups or community organizations, can help shape people’s acceptance of new health measures.
Workplace managers and business leaders play a role, too, he said.
“It’s really important that we model these (behaviours) throughout the organizations that we’re in and in sustainable ways so they take hold,” Van Bavel said. “Because once they become social norms, they become self-perpetuating, and people start automatically doing it. Almost like a new habit or a reflex.”
When people refuse to wear masks, shaming them for their behaviour is rarely effective, Alani-Verjee added. People do not react well to shame and often become even more defensive.
“Instead, by recognizing that so much of people’s decision-making around the issue of wearing masks is driven by anxiety and emotions, we can perhaps make an opportunity to understand people’s thinking and help them understand why wearing masks is the better option,” Alani-Verjee said.
Questions about COVID-19? Here are some things you need to know:
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.
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