Re: Is risk compensation threatening public health in the covid-19 pandemic?
Dear Editor
Face masks became mandatory on public transport on 15th June 2020 in England (young children and others who have difficulty are exempt) 1. Marteau et al. address concerns about risk compensation but do not consider that not wearing a mask correctly is a form of risk compensation.2
In the debate about mask usage, surprisingly little attention has been given to whether passengers wear them or wear them correctly, a critical factor. On 37 journeys In London on National Rail, London Overground, tube and buses between 20th July and 17th August, we observed 459 people; 82 (18%) were not wearing a mask properly, 9 (2%) were holding a mask and 74 (16%) were not wearing one at all. We excluded people who were obviously exempt.
Individuals who were not wearing masks properly were putting them under their nose, under their mouth, on their neck or taking the mask off to talk. We noted some people put masks on (or off) as they left the tube carriage, or removing them as they entered the bus after going past the bus driver. Signage promoting mask use is insufficient, especially on open air platforms. We could not fully assess fitness of mask e.g. masks that were too loose.
Either the public are not fully aware of how to wear a mask appropriately or they don’t believe they should be wearing them at all and/ or there is an element of risk compensation – in that even by wearing a mask some believe their risk to be substantially reduced so they don’t need to wear it properly or can remove it where convenient. We would suggest further targeted public health advice on how to wear a mask correctly 3.
Rapid Response:
Re: Is risk compensation threatening public health in the covid-19 pandemic?
Dear Editor
Face masks became mandatory on public transport on 15th June 2020 in England (young children and others who have difficulty are exempt) 1. Marteau et al. address concerns about risk compensation but do not consider that not wearing a mask correctly is a form of risk compensation.2
In the debate about mask usage, surprisingly little attention has been given to whether passengers wear them or wear them correctly, a critical factor. On 37 journeys In London on National Rail, London Overground, tube and buses between 20th July and 17th August, we observed 459 people; 82 (18%) were not wearing a mask properly, 9 (2%) were holding a mask and 74 (16%) were not wearing one at all. We excluded people who were obviously exempt.
Individuals who were not wearing masks properly were putting them under their nose, under their mouth, on their neck or taking the mask off to talk. We noted some people put masks on (or off) as they left the tube carriage, or removing them as they entered the bus after going past the bus driver. Signage promoting mask use is insufficient, especially on open air platforms. We could not fully assess fitness of mask e.g. masks that were too loose.
Either the public are not fully aware of how to wear a mask appropriately or they don’t believe they should be wearing them at all and/ or there is an element of risk compensation – in that even by wearing a mask some believe their risk to be substantially reduced so they don’t need to wear it properly or can remove it where convenient. We would suggest further targeted public health advice on how to wear a mask correctly 3.
1. The Health Protection (Coronavirus, Wearing of Face Coverings on Public Transport) (England) Regulations 2020 https://tfl.gov.uk/campaign/face-coverings. https://www.legislation.gov.uk/uksi/2020/592/contents/made
2 Mantzari Eleni, Rubin G James, Marteau Theresa M. Is risk compensation threatening public health in the covid-19 pandemic? BMJ 2020; 370:m2913
3 Coronavirus: A user's guide to wearing a face mask to the shops https://www.bbc.co.uk/news/uk-53395513
Competing interests: No competing interests