Masks have been with us for a very long time: in religion, theater, war, medicine, industry.
Throughout history, masks have served to disguise, cloak, or alter identity, whether in the special circumstances of ritual and theater, the perpetuation of crimes or the veiling of women. Their purpose varied, to conceal, to beautify, to make symbolic, to entertain. From Halloween costumes, Mardi-gras to sports, and Friday the 13th, masks are everywhere and are already part of American culture and behavior. Medical masks, however, have one purpose, are meant not to hide but to protect.
“Bad air “, germ theory and the need for masks
Plagues have been part of the human condition with population growth. As soon as humans gathered in large numbers, there was contagion and disease. Various plagues struck Europe from the 1300s to the late 1600s and were called the “Black Death”. The last major epidemic, called The Great Plague, lasted from 1665 to 1666, and was the last epidemic of the bubonic plague to occur in England. The Bubonic plague is a disease of rodents, especially black rats. It is passed between them by bites from their fleas. Naturally, there was the suspicion that death was being carried by air and so people began covering their faces as a protective measure.
In the 1600s. plague doctors adopt a costume that includes a leather headdress with a long, pointed beak filled with perfumes and aromatics that masked bad odors from the dead and dying that were believed to combat contagion carried by bad air.
200 years later, we have the scientific backing for germ theory, the theory that certain diseases are caused by the invasion of the body by microorganisms, organisms too small to be seen except through a microscope. In the 1850’s French chemist and microbiologist, Louis Pasteur showed that fermentation and putrefaction are caused by organisms in the air. In the 1860s English surgeon, Joseph Lister revolutionized surgical practice by utilizing carbolic acid (phenol) to exclude atmospheric germs. In the 1880s, German physician Robert Koch identified the organisms that cause tuberculosis and cholera. And yet, despite this knowledge, surgical masks were not adopted in medicine until about 20 years later.
Protective masks were not even commonly used in surgery until the late 1890s
In 1905, Chicago physician Alice Hamilton publishes an article in the Journal of the American Medical Association the first study advocating the use of masks during surgery as they are rare at the turn of the century.
In 1910, an epidemic of pneumonic plague strikes Manchuria. Appointed by the Chinese court to head anti-plague efforts, the Penang-born, Cambridge-educated physician Wu Lien-Teh (Wu Liande) argues that the disease is transmitted through airborne contact. To prevent its spread, he develops masks to be worn by medical personnel and the general public.
In 1918, facemask-wearing became a necessity when a massive pandemic of influenza killed between 20 and 40 million people around the world—more than died in World War I. There were outbreaks of the disease on every inhabited continent, leading to the deaths of a full 5% of the population. Covering the face with scarves, veils, and masks became a prevalent (if ineffective) means of warding off the disease in many parts of the world until the epidemic finally faded at the end of 1919.
Environmental factors have also caused us to cover our faces
Naturally occurring events such as volcanoes, fires, and other hazards have made humans protect themselves from the air. But the 20th century introduced man-made calamities such as chemical and biological warfare and environmental harm. As we weaponized the concept of “bad air”, spurring the rise of gas masks in warfare and industrial capacities. The French army was the first to employ tear gas in World War I, in 1914.
Both sides began using chemical weapons on a larger scale with about ninety thousand fatalities from a total of 1.3 million casualties caused by gas attacks. Gas was unlike most other weapons of the period because it was possible to develop countermeasures, such as gas masks. Ultimately, the use of these types of weapons was so horrific that international agreements were developed to ban their use.
Following World War II, there was an industrial boom in the 1950s and 60s, and choking air pollution, particularly in London, leads Britons to adopt “smog masks.”
As economic interests went global and manufacturing, particularly with the emission of toxic and noxious chemicals was delegated to poorer nations, so did smog masks. Appearing in India, China, and other developing countries. Rising ambient levels of carbon dioxide took mask-wearing from seasonal affectation to year-round habit. Today, Japanese consumers buy $230 million in surgical masks a year, and neighboring countries facing chronic pollution issues—most notably China and Korea—have also adopted the practice.
More recently, wearing masks in public has become normal in East Asian countries as a result of the 2002 SARS outbreak and the 2006 bird flu panic. Today we have better masks than their beaked predecessors. Better materials and better science. N95 respirators and surgical masks are worn by medical professionals treating people infected with the coronavirus.
The respirators protect the wearer from inhaling the aerosolized/airborne virus. Surgical facemasks are less effective, providing only what the CDC describes as “barrier protection” from droplets and “respiratory particles.” As such, their primary recommended use isn’t for people hoping to avoid catching COVID-19, but for those who already have it to prevent infecting others when they cough or sneeze since surgical masks have been shown to decrease transmission rates the CDC recommends everyone mask up.
The new normal
Masks are even becoming an element of personal style: Yang J. reports for Quartz magazine that in Japan, surgical masks bearing chic designs or the images of cute licensed characters can be purchased in every corner drugstore. Studies have found that among many young Japanese, masks have evolved into social firewalls; perfectly healthy teens now wear them, along with audio headsets, to signal a lack of desire to communicate with those around them. This is particularly true for young women seeking to avoid harassment on public transit, who also appreciate the relative anonymity the masks provide.
And so with the rise of the Corona Virus Pandemic of 2020, masks are not just for superheroes or professional workers. Average people are now being required to wear masks in public as they continue to engage in their daily activities. The environment has changed as well, and what was once a “100-year storm” has become a frequent occurrence. Will the same be true for pandemics? Will shutdowns be something that will become a periodic occurrence as the planet struggles with health challenges from the food supply, overpopulation, and microbial threats?
This project has been really interesting for me. I find it fascinating as this question to see how mask-wearing will evolve in society. Already, as we begin to start planning to reopen the economy and try to “normalize: life during the pandemic, we see many new laws go into effect requiring mask. What becomes acceptable and normal.
Thanks for your support and as always, stay in touch and stay safe,
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Resources & References
Types of masks. Contributors to Wikimedia projects. (2020, April 16). Mask – Wikipedia. Retrieved from https://en.wikipedia.org/w/index.php?title=Mask&oldid=951372930
Masks in Fashion. (2020, April 29). LoveToKnow Corp. Retrieved from https://fashion-history.lovetoknow.com/fashion-accessories/masks-fashion
AFRICAN MASKS – over 15 interesting and key facts. (2018, June 12). Retrieved from https://interesting-africa-facts.com/African-Art/African-Masks-Information.html
Postrel, V. (2020). Pandemics Come and Go But Medical Masks Are Eternal. Bloomberg.com. Retrieved from https://www.bloomberg.com/opinion/articles/2020-04-10/medical-face-masks-an-illustrated-history
Museum of London | Free museum in London. (2020, April 30). Retrieved from https://collections.museumoflondon.org.uk/online/event/35.html
Contributors to Wikimedia projects. (2020, April 27). Second plague pandemic – Wikipedia. Retrieved from https://en.wikipedia.org/w/index.php?title=Second_plague_pandemic&oldid=953434168
Surgery: Doctors pay attention to the new “germ theory”. (2020, April 30). Retrieved from https://news.stanford.edu/news/2008/february13/med-surgery-021307.html
Germ theory | Definition, Development, & Facts. (2020, April 30). Retrieved from https://www.britannica.com/science/germ-theory
Yang, J. (2020). A quick history of why Asians wear surgical masks in public. Quartz. Retrieved from https://qz.com/299003/a-quick-history-of-why-asians-wear-surgical-masks-in-public