Is the UK getting the maximum benefit from face masks?
By: Yui-Wah Lee
Tags: Masks4all, UK, UK Politics, Covid 19, Coronavirus

On the brink of a second national lockdown in the UK, I think we should re-examine all the tools that can help us fight covid19. This article focuses on one such tool — face masks.

On YouGov, you can find a survey result titled “Personal measures taken to avoid COVID-19”. One of the questions is on mask-wearing. The chart is interactive and you can compare countries/territories of your choosing. If you select only the UK and Hong Kong, you would see a chart like that in Figure 1.

Figure 1: An YouGov survey showing seemingly similar levels of face masking in the UK and Hong Kong, but this chart is misleading

At the same time, the UK and Hong Kong are having very different outcomes in their covid-19 handling. The daily new cases in the UK are exceeding ten thousand for many days (as of today the 16th of October, 2020), while those in Hong Kong are mostly in single or lower double digits. The population size of the UK is about nine times that of Hong Kong. So Hong Kong has been doing at least two orders of magnitude better than the UK.

Now, if people look at the chart in Figure 1 and the covid-19 outcomes, they may draw this conclusion:

See! Both places are heavily masked (by late September both are more than 76% masked), yet covid-19 is spreading more severely in the UK than in Hong Kong. This chart demonstrates that face masking is not effective in fighting covid-19.

This conclusion is wrong, however. And that is good news for the UK — for the fight going forward (more on this later).

I live in the UK, but I grew up in Hong Kong. With these backgrounds, I can attest that the concepts of mask-wearing are very different in the two places.

In Hong Kong, mask-wearing means the following:

People always wear a mask in any settings outside of their home. These include offices (Figure 2a), schools (Figure 2b), any official settings (for example, government press conferences and Legislative Council meetings — the equivalent of British Parliament meetings) (Figure 2c), as well as any outdoor settings (Figure 2d). Every day, they start wearing their mask the moment they leave their home, and they would avoid touching it during the day. They would not take the mask off except for drinking and eating. They understand that the outer surface of a face mask is potentially contaminated. So if for some reason they do have to touch their masks, they would wash or sanitise their hands immediately after that. If they need to take off the mask for a prolonged time (for example, during meal time), to prevent the outer surface of the face masks from contaminating their pockets, they would use a “mask holder” to fully enclose the contaminated surfaces of the masks. Alternatively, some restaurants would give their patrons a (single-use) paper envelop for keeping the face masks. Only upon returning to their home would they take off their face masks.

Figure 2 — How Hong Kong people are masked up 100% throughout the day. From the upper left: (a) in an office; (b) in a school; (c) in a government press conference; (d) in an outdoor setting. Source of images (all screen captures from Hong Kong TV): (a) Viu TV; (b) Now TV; (c) Apple Daily; (d) Now TV.

In the UK, people think they are already using face masks, but I have observed quite a few caveats.

People wear a mask only when they are required to (e.g. in a supermarket). And they would take it off immediately when they are not (e.g. upon walking out of a supermarket). As they frequently put off and then on their face masks, people touch the outside of their face masks often and may have contaminated their hands. Politicians (and MPs) often do not wear face masks, even in a closed space such as the Parliament or in a press conference (Figure 3). By not wearing face masks in public, the British political leaders fuel the unwarranted scepticism towards face masks. This makes the British people even more reluctant to wear face masks (see also a critique here). Office workers typically do not wear face masks in their offices. Students do not wear masks in the classrooms (Sometimes they are even prohibited from doing so). They also do not wear masks in the hallways.

Figure 3: No one wears a face mask in the British Parliament. Source of image: A screen capture from Sky News

Why is it important to point out the difference? Well, this is a message of hope.

Forget about the mistakes that we have made in the past. The above observation highlights that in the UK we still have a powerful tool yet to be fully exploited.

Face masks are cheap, and they do not cause economic hardship. Many countries and territories have shown that they could use face masks to curb covid-19 (see two interactive charts here and here). Going forward, the UK can achieve the same with face masks — we just need to use them correctly.