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Covid-19: Biden calls for science, vaccines, and masks

BMJ 2021; 372 doi: (Published 18 January 2021) Cite this as: BMJ 2021;372:n150

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Changes of thinking about wearing masks in Kazakhstan throughout the COVID-19 pandemic

Dear Editor

 The BMJ article entitled “Covid-19: Biden calls for science, vaccines, and masks” by Janice Hopkins Tanne [1] states that President Joe Biden of the USA listed the 'importance of science', an 'extensive supply of vaccines', and 'wearing masks' as three key measures to mitigate COVID-19. Our experience with mask-wearing in Kazakhstan may be instructive regarding how resistance to this crucial measure can change with time.

 During the COVID-19 pandemic, quarantine restrictions and strict sanitary requirements have been introduced, but over time, the number of violations of these restrictions, such as violations of the mask regime, has increased [2]. There are many scientifically proven reasons why masks should be worn. That is, people can be positive for COVID-19 without knowing it and, if not wearing a mask, can unwittingly infect others. Masks slow the transmission of infection by those who have not yet developed symptoms, significantly reduce the number of saliva droplets that spread in the air, and prevent such droplets from entering the body. The probability of infection is greatly reduced.

 A long quarantine leads to an increase in feelings of anxiety, and people begin to question the need for the quarantine. During the first wave of the pandemic, groups of radical opponents of the mask regime appeared in many countries, including Kazakhstan and Russia. The second global wave of the pandemic has caused a new surge in coronavirus denial and in violations of quarantine measures, and there is a segment of the population who choose not to wear masks. Initially, it was believed that such people simply did not agree with the opinions of WHO specialists or local doctors regarding the effectiveness of masks. But it turned out that this is not the key factor in their reluctance to wear masks. The primary factor was the so-called ‘identity factor’, which was accompanied by ‘reactive resistance’. Reactive resistance results in a complex of behavioral reactions with the goal of ‘self-defense’ against restrictions of a person’s freedoms [3]. Reactionary resistance is highly dependent on the structure of society and the traditions within it: in more collectivist societies, people may be more likely to accept things like wearing masks. This explains why the wearing of masks is calmly accepted in Asian countries. The pandemic has been best controlled in countries with a high level of citizen discipline, such as Japan.

 Over the course of the pandemic, the attitude toward wearing masks in Kazakhstan has gradually become similar to that in Japan. In the future, it is possible that people throughout the world will come to better understand the need to wear masks, as has occurred in Kazakhstan.

Nailya Chaizhunusova (1) , Ken Inoue (2), Nursultan Seksenbayev (1), Nargul Ospanova (1), Timur Moldagaliyev (1), Yersin T. Zhunussov (1)

(1) Semey Medical University, 103 Abay Street, Semey 071400, Kazakhstan
(2) Kochi University, 2-5-1 Akebono-cho, Kochi-shi, Kochi 780-8520, Japan

1. Tanne JH. Covid-19: Biden calls for science, vaccines, and masks. BMJ 372: n150, 2021
2. WHO. Accessed 23 Feb 2021
3. Taylor S, Asmundson GJG. Negative attitudes about facemasks during the COVID-19 pandemic: The dual importance of perceived ineffectiveness and psychological reactance. PLoS One; 16: e0246317, 2021

Competing interests: No competing interests

04 March 2021
Nailya Chaizhunusova
Professor and Doctor
Ken Inoue, Nursultan Seksenbayev, Nargul Ospanova, Timur Moldagaliyev, Yersin T. Zhunussov
Semey Medical University, Kazakhstan
103 Abay Street, Semey 071400, Kazakhstan