A masked commuter in a packed subway train. Photo: AFP

A culture of wearing masks is still prevalent throughout Asia as people refuse to drop their guard, even though the region has emerged better than Europe and North America in the global novel coronavirus plague, whose epicenter has long shifted away to the West.

A sense of security has been much needed for Asians amid the viral outbreak and having some thin layers of gauze or fabric over their mouths and noses can be psychologically reassuring as they walk in teeming streets – apart from the apparent benefit of keeping out bacteria, droplets and aerosols.

However, US President Donald Trump has openly shunned the latest advisory about general mask use from the Centers for Disease Control and Prevention, and the recalcitrance by politicians and a large cross-section of the population in America and Europe against mask-wearing has been there from the moment the virus reared its ugly head.

Numerous “mask holdouts” are still unwilling to cover their faces as Covid-19 tears through countries on both sides of the Atlantic.

Many say the resistance to basic measures such as donning marks and social distancing has helped incubate the respiratory disease in the US and Europe, at least at the onset of the crisis.

Yet by comparison, Asians’ common predilection for masks had strained supplies and depleted stocks on the continent, the moment the highly infectious pathogen cropped up in the central Chinese city of Wuhan and crept across borders.

It has been hard to spot anyone without a mask in Hong Kong since the outbreak of Covid-19 across Asia. Photo: AFP

In late January, Taiwan’s lemming-like scramble for masks exacerbated a supply crunch to a point that the island’s hospitals were hard-pressed to procure enough batches to fortify themselves for the looming pandemic, as individuals and price gougers hoarded masks for speculation.

Taiwan’s CDC soon made it clear that its experts regarded masks as “unnecessary” for the public and Vice-President Chen Chien-jen, an epidemiologist, also chimed in against the panic-buying. Still, the never-ending lines outside pharmacies forced the government to introduce a rationing mechanism.

Taipei-based journalist James Baron argued in an op-ed that appeared in the Taipei Times that recent studies, including “opportunistic data” collated in Hong Kong during the SARS outbreak of 2002 to 2003, indicated that the population-wide use of masks could have some impact on reducing transmission, but the evidence remained “flimsy at best,” as there was almost zero support within medical and scientific circles for the use of masks in the general population as a means to stay protected.

But he admitted that the Taiwanese were “culturally predisposed to mask use,” as the fear of a viral pestilence played on their minds.

Baron cited the 1918 influenza in the US, when hundreds of troopers at a military camp were allocated masks but still came down with the fatal Spanish flu, as a historical antithesis of the perceived efficacy of mask-wearing.

Research published in the Australian and New Zealand Journal of Surgery on the 1968 Hong Kong Flu also suggested that gauze masks had less than 30% efficiency in blocking particles of less than 5 micrometers in diameter.

US Surgeon General Jerome Adams also tweeted in late February “STOP BUYING MASKS!” The anesthesiologist and veteran with the US Public Health Service Commissioned Corps argued that masks were not effective in preventing the general public from catching coronavirus, but would be much needed for those tending the sick.

Yet the reoccurring debate over if a mask should be worn during the ongoing Covid-19 contagion has been tilting towards the Asian perspective, after Western health authorities issued clear protection guidelines on how to mask your faces.

Following the US CDC, Canada’s Chief Public Health Officer Theresa Tam was the latest official to have elevated the significance of mask-wearing in her latest recommendations. She said the benefits of masks were borne out by the lower rates of infection and faster containment of outbreaks across Asia.

Previously, maintaining personal hygiene like washing hands and social distancing were the more stressed points.

More commuters are wearing masks in New York City, the epicenter of the Covid-19 pandemic in the US. Photo: Handout
A banner in virus-hit Italy urges people to wear a mask. Photo: AFP

CNN also quoted Adrien Burch, an expert in microbiology at the University of California, Berkeley, as saying that “despite hearing that face masks ‘don’t work,’ you probably haven’t seen any strong evidence to support that claim. That’s because it doesn’t exist … In fact, there is evidence of the exact opposite: that masks help prevent viral infections like the current pandemic.”

He also added that one study of community transmission in Beijing in 2003 had revealed “a 70% reduction in the risk of catching SARS” if one wore a mask.

Other health experts say that like the ubiquitous mask rules in Asia where governments in Hong Kong, South Korea and Japan are reportedly mulling legislation to deter violators, similar efforts to beseech people to mask their faces may soon come in the West, now that masks are not hard to come by with supplies stabilizing, but the tally of infections continuing to soar.

The emerging wave of asymptomatic infections across Asia which will soon hit the US is now the rationale for the USCDC’s about-face when it comes to masks: coronavirus can be spread when people are not showing symptoms and having everyone covering their faces – as has been the norm in Hong Kong and other parts of Asia since January – will help put a lid on transmission.

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