It would be simplistic to state that the stigmatization of mask-wearing in the West, and the corresponding lag in Westerners adopting the practice, are responsible for the struggles to contain the coronavirus. The science on the efficacy of face masks just isn’t there. But these factors do illustrate a number of the challenges—the failure to take the threat of pandemics seriously and prepare accordingly, the lack of social solidarity during public-health emergencies, the absence of comprehensive government containment strategies—that proved disastrous as the virus moved westward.
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“In the West, I think we need to overcome—I wouldn’t call it a fear of the mask, but [the] stigma with a mask,” Christos Lynteris, a medical anthropologist at the University of St Andrews, in Scotland, told me. “I’ve heard people say, ‘I was carrying a mask in the airplane but I was too ashamed to wear it.’ Where does this shame come from? Is it because people will think you are a wimp? Because people will think you are ill?”
That shame simply doesn’t exist in East Asia. China has had an ethic of wearing masks during public-health emergencies since the outbreak of the pneumonic plague in 1910, and Japan has a long tradition of doing so as well. In other East Asian countries, the public practice was first forged in 2003 as SARS, another lethal coronavirus, spread from China, pummeled the health systems of neighboring countries, and left a terrifying, indelible impression of the damage that viral respiratory diseases can inflict.
Judy Yuen-man Siu, a medical anthropologist at Hong Kong Polytechnic University, told me by email that mask-wearing went from being uncommon in Hong Kong before SARS to being widely adopted afterward—as an important component of containing a viral outbreak, and as a civic duty and a signal of “support to health-care providers.” Today in Hong Kong, “if you do not use a face mask in public areas, you will be stigmatized and discriminated against, not just because people would [be] afraid of you as a potential virus-spreader, but [also because] it can mean you have low civic responsibility,” she wrote. Siu noted that face-mask usage has been thoroughly “socialized” in the semiautonomous Chinese region, by public-health officials who stressed the need for it in the throes of the SARS crisis as well as by schoolteachers. Governments “can create culture,” she observed, just as the Trump administration has during the coronavirus crisis by advising Americans not to wear masks unless they are sick.
Lynteris said that ever since SARS, Westerners have associated mask-wearing with China and East Asia more broadly. He attributed the resulting stigma in the West in part to xenophobia and the idea of “China being the origin of infectious diseases and Chinese people spreading them.”