Whether or not you are prepared to call it a crisis, the NHS is undoubtedly on its knees. In addition to existing backlogs, a “twindemic” of surging flu and increasing Covid cases means that demand for medical attention is outstripping supply.
So when Susan Hopkins, chief medical adviser at the UK Health Security Agency (UKHSA), made the rather modest suggestion that people should wear masks or stay home if they are poorly, you might have thought it would be uncontroversial.
Not so.
The Daily Mail covered two-thirds of its front page with the screaming headline “Let’s not return to face mask madness”. The Tory MP Philip Davies raged: “The control freak socialists at UKHSA are never going to change.” What is it about masks that evokes such fury for rightwing media and politicians?
No one exactly likes wearing masks. They are uncomfortable. They fog up your glasses. They can irritate your skin. They can impede communication by muffling sound and obscuring cues as to how people are feeling. However, fears that this might lead to stunted development and impaired mental health have proved to be unfounded – for instance, masks impede our ability to read emotions no more than wearing sunglasses. Overall, any minor negative impacts of masks are more than offset by their positive effects in limiting disease, keeping children in schools and keeping schools open. As the Office for Science and Society at Canada’s McGill University puts it: “Have the fears about children wearing masks materialised? The studies we have so far – and a hefty dose of common sense and low plausibility – say ‘no’.”
So if fear of masks has no basis in science, where does it come from? The answer is politics – and more specifically a populist politics rooted in the claim that an unaccountable elite is seeking to control and exploit ordinary people. From this perspective, the pandemic is either a hoax or a pretext for elites to extend their control. Vaccines, for instance, are designed to regulate the fertility of the masses or (in more far-fetched versions) an excuse to inject microchips into a subjugated population.
My colleague Yasemin Ulusahin, whose doctoral research addresses the role of populism in the Covid response, shows how the UK coronasceptic movement represents itself as fighting for the freedom of the 99% against the elite 1%, and that supposed fight is encapsulated in opposition to face coverings. To quote from one leaflet by the White Rose group: “Masks are dehumanising and a symbol of suppression and control.” In this worldview, masks are muzzles and opposed as such.
In other countries, such views have moved from the fringe to the centre of politics – notably the US, where the then President Trump repeatedly expressed scepticism about masks. He invoked the issue of liberty, retweeting a message that described masks as “silence, slavery and social death”. And he promoted the political polarisation of mask wearing by endorsing the view that people who wear them may be making a statement against him personally.
For a long time, conservative opposition to masks seemed a uniquely US phenomenon, bound up with the country’s specific history of equating state intervention with tyranny. Certainly the UK initially resisted such political polarisation. Through 2020 and 2021, Labour and Conservative voters were largely in lockstep in their support for Covid measures, including mask mandates. However, since the removal of measures in early 2022, and the stress on “freedom”, “personal responsibility” and “living with Covid”, things have changed somewhat. A YouGov poll from March last year showed that Tory voters favoured “we need to learn to live with it and get back to normal” over “we need to do more to vaccinate, wear masks and test”, by 73% to 22%. For Labour voters, the figures were 48% and 41%.
If the root of opposition to masks lies in populist distrust of the “elite”, then the long-term response has to be to address that alienation and to change the distant, forbidding and exclusionary nature of our institutions. That is an essential project, but in the short term – especially in regard to the government – that horse has well and truly bolted.
An alternative approach, then, as with vaccines, is to take a community engagement approach to promoting masks. That means reframing mask wearing as a community issue: less about individuals exercising personal responsibility; more about a collective exercising social responsibility, looking after each other, making sure we all come through this well (which was key to high rates of adherence early in the pandemic).
A further dimension of the engagement approach is to take a position of trust and respect for your audience. It means starting from the assumption that people themselves have goodwill and want to do the right thing.
It is far more effective to think about the barriers that stop people from adhering to the extent that they would wish. Throughout the pandemic – and now, in the midst of the cost of living crisis – people haven’t been able to afford to stay home and to self-isolate. Now many can’t afford masks. So provide masks to people free of charge. Send a pack, with clear information about why and how to use them, to every household. Joe Biden did it. In Bangladesh, free masks proved highly effective. Supporting people is always more effective than hectoring them.
In these various ways, we can reframe the mask issue as something we do for each other rather than something that is done to us. Mask wearing thereby stops being an issue of autonomy and becomes an assertion of agency. That is the way to take the wind out of populist sails. It is also a means of regaining a sense of proportion. As Ari Horanvar (who grew up in post-revolutionary Iran) notes: “I still find myself watching for signs of the slippery slope of tyranny. Even before the pandemic, we had plenty of injustices to challenge: infringement on the rights of people of color, women and workers … These are things worth fighting against. Shopping at Trader Joe’s with a mask is not.”
Stephen Reicher is a professor of psychology at the University of St Andrews
