“I couldn’t wear one – it would be too embarrassing.”
When I asked some friends about using face masks to prevent flu, they all laughed. And then they said that they would not wear them. “I am not sure they would really work.” “I don’t tend to get bad colds.” “People might think that I was a doctor – or a surgeon”, “I couldn’t wear one – it would be too embarrassing!”
I only asked four people so this is hardly a scientific study – but it set me thinking about face masks and ‘flu. And when thinking things through, a good place to start is with the evidence. In the case of respiratory infections, there is some evidence that “facemasks and facemasks plus hand hygiene may prevent infection in community settings, subject to early use and compliance.” 1
But there are barriers to people wearing face masks. Sim and colleagues have delved into these barriers in an insightful review of the use of facemasks to prevent respiratory infection. (2)
They found a range of barriers. Some people found masks uncomfortable; some forgot to wear them every day; some found them impractical – wondering how they would eat or drink when wearing masks.
Sometimes the masks didn’t fit or fell off; sometimes they became damp and uncomfortable; sometimes children didn’t like their parents wearing face masks.
Masks also didn’t seem to suit certain groups of patients – such as those with chronic lung disease or with rhinorrhoea. Or children.
Some people also found them embarrassing.
I suspect that this embarrassment would continue to be a barrier even if the other problems were overcome – that is, even if we had masks that were comfortable and a good fit and easy to put on and take off.
How can we overcome the embarrassment? A multi-pronged approach will be needed but the underlying strategy will need to be about convincing people that wearing a mask is not only socially acceptable but desirable. This will take time. To draw an analogy, it took a good number of years to convince people to wear a seatbelt. But today wearing a seatbelt is second nature to most people.
In the future it may be similar when it comes to wearing a face mask during a ‘flu outbreak.
1. MacIntyre CR, Chughtai AA. Facemasks for the prevention of infection
in healthcare and community settings. BMJ. 2015 Apr 9;350:h694.
2. Sim SW, Moey KS, Tan NC.The use of facemasks to prevent
respiratory infection: a literature review in the context of the Health Belief
Model. Singapore Med J. 2014 Mar;55(3):160-7.
This opinion piece was authored by BMJ Clinical Director, Dr Kieran Walsh. The purpose of this document is to educate and to inform. The content of this document does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner’s judgement, patient care or treatment. The views expressed by contributors are those of the author's. BMJ does not endorse any views or recommendations expressed in this document. Readers should also be aware that professionals in the field may have different opinions. Users of this document hereby agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.
The actors involved in global health are changing, and a multi-sectoral, cross-cutting approach is essential for tackling the priority issues.
We have extensive experience in bringing together thought leaders, policy makers, healthcare professionals and senior stakeholders from all sectors with an interest and mission for improving global health and global health security.Our programme of events collectively attracts more than 10,000 delegates annually from over 85 countries, including:
Mitali Wroczynski works closely with ministries of health, agriculture, and defence to influence policy decision-making, and develop new global health partnerships.
She pioneered BMJ’s clinical decision support training initiative that supports healthcare professionals working in low and middle-income countries to improve the detection, diagnosis, and management of infectious diseases and contributes to building health system resilience. Mitali has also played a key role in making risk communication a central issue for managing major infectious disease outbreaks, epidemics or pandemics, as part of the EU-funded programme, TELL ME.
Contact Mitali to find out how together we can address global health and global health securities priorities:
Head of Strategic Partnerships, Global Health & Global Health Security
Tel: +44 (0) 20 7383 6517
The Practical Approach to Care Kit (PACK) is a clinical decision support programme guides primary healthcare clinicians through the diagnosis and management process of more than 500 common symptoms and conditions, including:
This four pillar training programme improves primary health care in low and middle income countries. It works most effectively by partnering with governments, universities and NGOs to partner with us. Provide PACK to your clinicians working in remote areas today by contacting Dr. Tracy Eastman.
Dr Tracy Eastman, KTU Director of PACK Global Development and Delivery
Tel: +44 (0) 208 872 6323