Tag: face masks

Why People in Japan are Still Wearing Masks after COVID

Photo by J Castellon on Unsplash

When you think of Japan in the age of COVID, you might imagine a crowd of people wearing masks. But many of them are still wearing masks after the pandemic has ended. In an article published this month in the International Journal of Disaster Risk Reduction, a researcher from Osaka University analysed mask use before and after the government of Japan downgraded the legal status of COVID. Results showed that many people continue to wear masks for socio-psychological reasons – including reasons related to ‘relief’ and ‘norm’.

Of course, the obvious motivation for mask use is disease prevention. In the first half of 2020, masks were recommended worldwide because they help to prevent COVID transmission. Japan has since had one of the highest rates of mask usage throughout the pandemic.

However, on May 5, 2023, the World Health Organization declared the end of COVID as a global health emergency. Furthermore, on May 8, Japan downgraded the legal status of COVID to the same level as seasonal influenza.

Michio Murakami, the study’s author, notes, “The online survey shows that 59% of Japanese participants are still wearing masks, even after the downgrading of the legal status of COVID. That is only slightly down from 67%, which was before the downgrading.”

The surveys were conducted among people aged 20 to 69 in Japan. The first survey was performed in April 2023, before the policy changes, while the second was performed after the changes in June 2023. A total of 291 participants completed both surveys.

So what reasons, besides disease prevention, might lead people to continue wearing masks? “One common socio-psychological reason involves what we call ‘relief’. This means that wearing a mask can help relieve anxiety for many people,” explains Murakami. “There’s a second sociological reason, too: a ‘norm’. This refers to when people think they should wear a mask because they see others wearing masks,” he explains. People that have this trait are more likely to wear a mask when others around them are wearing masks, unsurprisingly.

Murakami was also able to document correlations between mask-usage motivations and actual mask usage. For instance, citing psychological reasons for mask use in April was correlated with actually wearing a mask later on in June. Furthermore, wearing a mask in April was associated with citing infection avoidance as a reason to wear masks in June.

“So many Japanese people prefer to wear masks,” notes Murakami. “This study helps us understand why people might do so, even in light of reduced infection risk.”

Source: Osaka University

Not Yet Time to Ditch Masks in Healthcare, Experts Argue

Photo by SJ Objio on Unsplash

A new commentary by infectious disease experts published in Annals of Internal Medicine says that, for patient safety, masking should continue in health care settings. This message, from authors at George Washington University School of Medicine and the National Institutes of Health (NIH), conflicts with a recent commentary from authors from 8 US institutions suggesting that the time for universal masking is over.

Masking has been a controversial mitigation strategy during the COVID pandemic because high-quality evidence of efficacy is lacking and because the topic has become highly politicised. Regardless, real-world experience demonstrates the effectiveness of mask-wearing in clinical settings where data shows that transmission from patient-to-staff and staff-to-patent, when both are masked, is uncommon. Since health care personnel report being driven to show up for work even when they are ill themselves, the argument in support of mask-wearing becomes even more compelling.

Those without symptoms may also transmit respiratory viruses, particularly SARS-CoV-2. While the Omicron strain has been milder, infection could still cause severe or life-threatening disease or prolonged illness if transmitted to at-risk patients, such as the elderly or immunocompromised. With the still-looming risks, now does not seem the time to take off masks in the health care setting. Instead, the authors advocate strongly for continued mask use for infection prevention.

Source: EurekAlert!

Face Masks for Kids Slow Aerosol Spread, Especially from Sneezing

Photo by Kelly Sikkema on Unsplash

In a new study published in Pediatric Investigation, researchers demonstrate that face masks reduce the release of exhaled particles when used by school-aged children, helping to slow the spread of various respiratory viruses. While there was little difference between no protection and masking in exhaled particles from breathing, sneezing saw a significant reduction in the number of particles produced.

Respiratory viruses, including SARS-CoV-2, are transmitted via respiratory droplets and aerosols generated by all activities that involve exhalation, including tidal breathing, speaking, singing, coughing, and sneezing. Droplets, large particles subject to gravitational forces, are rapidly deposited from air and form fomites on surfaces. Aerosols, fine solid or liquid particles which remain suspended in the air, can travel long distances (> 6m) and reach high concentrations in poorly-ventilated areas. The relative contribution of the various modes of infection (direct contact, indirect contact via fomite, large droplet, or aerosol) for various respiratory viruses is difficult to determine, but survival of infectious viruses has been demonstrated in aerosols.

For the study, 23 healthy children were asked to perform activities that ranged in intensity (breathe quietly, speak, sing, cough, and sneeze) while wearing no mask, a cloth mask, or a surgical mask.

The production of exhaled particles that were 5μm or smaller, which is the dominant mode of transmission of many respiratory viruses, increased with coughing and sneezing. Face masks, especially surgical face masks, effectively reduced the release of these and other sized particles.

“Understanding the factors that affect respiratory particle emission can guide public health measures to prevent the spread of respiratory infections, which are a leading cause of death and hospitalisation among young children worldwide,” said corresponding author Peter P. Moschovis, MD, MPH, of Massachusetts General Hospital and Harvard Medical School.

Source: Wiley

After COVID, Experts Advise Against Universal Masking in Healthcare

While masking was a critical preventative measure to protect healthcare workers, patients and visitors during the COVID pandemic, infectious disease researchers argue against masking, saying that that as the pandemic dies down, the routine use of masking should be reconsidered. Previous policies over healthcare masking use against SARS-CoV-2 transmission were formulated against a background which assumed no population immunity and no countermeasures.

In editorial published in Annals of Internal Medicine, the authors argue for the discontinuation of universal COVID masking in healthcare settings as infection rates and mortality have fallen and access to testing and therapeutics is widespread, as is immunity. Universal masking is therefore no longer of benefit and its own drawbacks, such as facial irritation and hindering communication, are more of a hinderance.

In addition to difficulties faced by speakers of different languages as well as the hard of hearing, masks have a number of detrimental effects for communication. “The increase in listening effort required when masks are used in clinical encounters is associated with increased cognitive load for patients and clinicians,” the authors wrote. In addition to making clinicians’ jobs harder, they also impact the all-important clinician–patient relationship, as face masks “obscure facial expression; contribute to feelings of isolation; and negatively impact human connection, trust, and perception of empathy.”

Healthcare workers should instead adopt an approach for SARS-CoV-2 similar to that of any other endemic respiratory disease. Drawing on the experience of the COVID pandemic, they suggest a more flexible, responsive approach to masking policies. In response to future epidemics or localised outbreaks “may justify more widespread or targeted masking policies, respectively, as part of a bundled response. High-quality epidemiologic data with frequent updates and regular reevaluation are needed to inform scale-up or scale-down decisions.”

Natural Facial Asymmetry Affects Mask Fit

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In research published in Physics of Fluids, researchers used computer modelling investigate mask fit and found that face shape, especially natural facial asymmetry, influences the most ideal fit. The findings suggested that double masking with improperly fitted masks may not greatly improve mask efficiency and produces a false sense of security.

Using more layers results in a less porous face covering, leading to more flow forced out the sides, top, and bottom of masks with a less secure fit. Double layers increase filtering efficiency only with good mask fit, however they could also lead to difficulties in breathing.

The researchers modelled a moderate cough jet from a mouth of an adult male wearing a cloth mask over the nose and mouth with elastic bands wrapped around the ears. They calculated the maximum volume flow rates through the front of mask and peripheral gaps at different material porosity levels.

To create a more realistic 3D face shape and size, the researchers used head scan data for 100 adult male and 100 adult female heads.

Their model showed how the slight asymmetry typical in all facial structures can affect proper mask fitting. For example, a mask can have a tighter fit on the left side of the face than on the right side.

“Facial asymmetry is almost imperceivable to the eye but is made obvious by the cough flow through the mask,” explained co-author Tomas Solano, from Florida State University. “For this particular case, the only unfiltered leakage observed is through the top. However, for different face shapes, leakage through the bottom and sides of the mask is also possible.”

Producing individually customised ‘designer masks’ is not practical at large scales. Still, better masks can be designed for different populations by revealing general differences between male and female or child versus elderly facial structures and the associated air flow through masks.

Source: American Institute of Physics

Men in Medical Face Masks Rated as More Attractive

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Besides COVID prevention, there is an upside to wearing the ubiquitous face masks worn in many countries: they increase attractiveness, at least in men. 

A study published in Cognitive Research: Principles and Implications measured how different types of face masks changed the attractiveness of 40 male faces.

However, the researchers discovered the type of covering matters – blue medical masks were found to increase facial attractiveness more than other types of masks.

Dr. Michael Lewis, an expert in the psychology of faces, said: “Research carried out before the pandemic found medical face masks reduce attractiveness – so we wanted to test whether this had changed since face coverings became ubiquitous and understand whether the type of mask had any effect.

“Our study suggests faces are considered most attractive when covered by medical face masks. This may be because we’re used to healthcare workers wearing blue masks and now we associate these with people in caring or medical professions. At a time when we feel vulnerable, we may find the wearing of medical masks reassuring and so feel more positive towards the wearer.

“We also found faces are considered significantly more attractive when covered by cloth masks than when not covered. Some of this effect may be a result of being able to hide undesirable features in the lower part of the face—but this effect was present for both less attractive and more attractive people.”

In the study, 43 female participants were asked to rate the attractiveness of images of male faces without a mask; wearing a cloth mask; a blue medical face mask and holding a plain black book covering the area a face mask would hide. The research took place seven months after face masks became mandatory in the UK.

“The results run counter to the pre-pandemic research where it was thought masks made people think about disease and the person should be avoided,” commented Dr Lewis.

“The current research shows the pandemic has changed our psychology in how we perceive the wearers of masks. When we see someone wearing a mask we no longer think ‘that person has a disease, I need to stay away’.

“This relates to evolutionary psychology and why we select the partners we do. Disease and evidence of disease can play a big role in mate selection – previously any cues to disease would be a big turn off. Now we can observe a shift in our psychology such that face masks are no longer acting as a contamination cue.”

Next steps are to see if the reverse holds true for women’s attractiveness to men.

Source: Cardiff University