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I led treatment of the first confirmed COVID-19 case in the US. We need universal mask wearing — here's how we can get everyone to wear one.

Sep 10, 2020, 19:22 IST
Business Insider
David Cliff/NurPhoto via Getty Images
  • Dr. Amy Compton-Phillips is the chief clinical officer of Providence St. Joseph Health, a health system with 51 hospitals in the western US.
  • Wearing masks helps stop the spread of the coronavirus — and we need to make mask-wearing universal.
  • It's important for role models and influencers to showcase themselves wearing masks.
  • But the ubiquity of something is also persuasive, meaning that anyone be an influencer by wearing a mask.
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Wearing a seat belt feels natural today. We buckle up without a thought and US seat belt usage is over 90%. In 2017 alone, seat belts saved nearly 15,000 lives in the United States.

We can save tens of thousands of lives if we slow infection from COVID-19 while we wait for treatments and vaccines — if wearing protective face masks becomes as routine as wearing seat belts. Hundreds of thousands more will avoid getting sick. The medical community knows masks help prevent transmission of germs and that wearing masks is one of the very best ways to curb the pandemic.

Amy Compton-Phillips.Courtesy of Amy Compton-Phillips

When the outbreak began to spread, the first thing hospitals did was reach for a protective mask. Providence had the first diagnosed Covid patient in the US and we had to figure out how to protect caregivers and patients — fast.

We require everyone entering our facilities to wear a mask. It hasn't been a hard sell to caregivers used to masking during surgery and to prevent spread of diseases like influenza; wearing masks has been the medical standard for more than 100 years. And science confirms that COVID-19 is transmitted through droplets formed when people talk, cough, sing, or sneeze — all stopped by masks.

So why is wearing a mask to protect each other from getting sick such a hard sell among certain populations in the US?

Countries in which people routinely wear masks to safeguard against spreading colds and the flu have kept COVID-19 infections very low, even though their population density is high. For example, total cases per million residents is just 501 in Japan and 346 in South Korea, compared to 17,420 in the United States. Japan and South Korea also used aggressive contact tracing, personal distancing, and safety measures.

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Creating a cultural norm of universal masking requires a multi-pronged approach, just as the campaign for seat belt usage did. That includes advertising, leveraging influencers, leading by example, regulation, and continuous improvement of masks. These are all underway, but need to be accelerated and amplified.

Often role models pave the way for adoption of new habits and accepted social practices.

New York State has created an ad campaign with the Ad Council to promote mask usage. The eight, 30-second ads have been given free air time and are running nationwide. This campaign includes prominent celebrities like Robert De Niro and Jamie Foxx. In one, actor Morgan Freeman says: "When you wear a mask, you have my respect. Because your mask doesn't protect you, it protects me. I wear my mask to protect you. Be New York tough. Mask up, America."

Providence also is doing everything it can to influence the way people think about masks — to make them "cool" and deliver the message that masks protect the people we love. We launched our #MyMaskIs social media campaign system wide on July 25 and have since been joined by the American Medical Association's #Maskup initiative.

Medical staff, television actors, athletes, social media stars, and "regular people" alike have been posting photos and videos showing people happily going about their daily business while wearing masks. They demonstrate that masks are not only effective, but can be beautiful or bear positive messages.

In these videos and messages, my fellow physicians describe how masks help stop the spread of COVID-19, while others explain why they wear masks. To some, wearing masks is an act of patriotism, to help keep Americans healthy and get the economy moving; for others, it's an act of mutual community protection and caring. Some are high-risk individuals, others do it out of love for friends and family. The Catholic Health Association has launched a #LoveThyNeighbor social media campaign.

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As human beings, we take cues from people around us.

If almost everybody is wearing a mask, some people who currently resist them will mask up, too. In this respect, anyone can be an influencer. Be the one who creates the change you want to see: let's make masks so ubiquitous that everyone feels comfortable wearing them and, perhaps, uncomfortable if they don't.

Mask producers can help too, by developing masks that are more effective. We now know very thin masks, like single-layer gaiters, don't help. They may even break up droplets, making them more easily aerosolized. Fashion-oriented companies can make masks that not only are most effective, but also beautiful and comfortable.

Masks can be both functional and fashionable accessories, like sunglasses and hats. And mask manufacturers might also take a lesson from Nils Bohlin who, in 1959, invented the three-point seat belt that transformed automobile safety. He said, "It was just a matter of finding a solution that was simple, effective, and could be put on conveniently with one hand."

As long-time mask wearers, we physicians can assure the public that they will get used to masks – they will become second nature. The benefit to everyone is well worth that initial awkwardness. If everyone wears a mask consistently, we can all go back to work, school, and normal life much sooner. And if our culture gets used to wearing masks, we might even wear them when we feel ill from a cold or the flu, helping prevent even more illness and death.

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