The Reality of (the general public wearing) Face Masks

First up, an introduction to face masks!

There are a huge variety of face masks, most of which are designed to protect the wearer or those around them from becoming infected with some type of contagious pathogen, with exceptions such as those designed for fashion or non-medical non-health related purposes.

Firstly let’s talk about the two main types of face mask; the surgical mask, and the N95 respirator. The difference between these two masks can be easily understood and remembered by comparing them to scarves and umbrellas.

A scarf keeps you warm by trapping your body heat close to your body - it keeps the warm air around your body from escaping. The warm air around your body is analogous to the contagious particles that you might spread around when you cough. This is the primary purpose of a surgical mask. It keeps the sick wearer from spreading their germs around.

An umbrella, on the other hand, prevents the rain from affecting you, the user of the umbrella. The rain is analogous to a nearby contagious person coughing or spreading germs in the air around. This is the purpose of an N95 respirator. It keeps the healthy wearer from becoming sick.

Note that there is an exception with regard to medical workers, who often wear surgical masks to protect themselves from splash of large droplets of blood or other bodily fluids, as is common in their profession. Additionally, medical workers, even whilst not currently known to be sick themselves, do wear this type of mask to help eliminate any possibility that they are sick and may infect their patients.

A bit more detail on the purposes of these masks. Skip the next two paragraphs if you're not super interested in this.

One of the most common types of mask is the surgical mask, which is used by doctors and nurses all over the world. This type of mask is specifically designed for two dual purposes. 1) to protect OTHER PEOPLE from becoming infected by the potentially contagious mask wearer. This has two common applications - First, they are worn by doctors and nurses when performing medical procedures, such as operations, to prevent the vulnerable patient (possibly with an incision or other wound) from being infected by the doctor or nurse, and second to be worn by a symptomatic patient known to be contagious to protect the doctors and nurses from infection when the patient coughs/sneezes or otherwise expels large droplets from their mouth & nose. Keep in mind that aerosolised or smaller particles will escape this type of mask. And 2) for doctors and nurses to wear, to give an extra layer of protection to them from any large droplets that do escape the patient’s orifices.

When worn by doctors and nurses in high risk settings in other words (when in contact with a symptomatic and contagious patient) this mask may be worn in conjunction with an N95 respirator mask, which is the primary source of protection for the doctor or nurse, as it protects from aerosolised and very small particles. As opposed to the large droplets that the surgical mask protects against.  The surgical mask will be worn over the top of the respirator as an added layer of protection, and also to protect the respirator from large droplet splash. After contact with the patient, or after a situation that is likely to have caused the surgical mask to become infected, the surgical mask will then be discarded and replaced with a fresh one.


This is a medical setting, in which doctors and nurses are trained in how to handle masks, how often to replace them, important hand-washing techniques and procedures, etc. These people are at work. Doing their jobs. Utilising the knowledge and skills they have learned during their extensive education, training, and careers.

In layman's terms, this means:

1. Wearing multiple masks throughout the day - changing them regularly, particularly after high-risk encounters.
2. Avoiding touching the mask at all when in use - adjusting it once when it is put on, and then leaving it alone until it is removed and replaced.
3. If the mask is touched, the hands are washed before touching anything else, particularly a patient
4. Fitting the mask tightly against the face in such a way as to prevent air escaping the sides as much as possible. 

Now let’s take a look at the reality of the general public wearing masks.

Firstly, let’s note that when a member of the general public wears a mask, they are often doing so whilst they conduct themselves throughout their usual day. This could be at work, at home, in between the two, at the shops, at a restaurant, when meeting with friends, or all of those one after the other. The vast majority of those people will wear a single mask for that single day, and will take the mask on and off as they please, touch and adjust the mask for comfort or other reasons, and will likely not be washing their hands after every time they touch or adjust it.

I personally live in Japan, and Japan, as you likely know, is a country in which a huge portion of the population, dare I say, literally 100%, wear masks regularly, or have worn a mask at some point in their lives. Contrast this with Australia (where I am from), and probably many other western countries (such as America, and the UK), the vast majority of people almost never wear masks, and many would have never worn one in their lives.

As a result of their widespread use in Japan, they are generally used as more of an accessory, than a medical item. I know this from observation, as well as speaking to people about their mask wearing habits, and finding out that they include, but are not limited to, wearing masks to help ease symptoms of hay fever and other allergies, as part of the uniform for customer service staff, women wearing masks to hide their un-made-up faces from other people - I’ve even heard mothers tell their adult daughters that they should wear a mask when they go out without makeup to protect OTHER PEOPLE from the horror of their un-made-up face. Yes, you read that right. And yes, of course, they’re also worn when sick as a courtesy to other people - it sends the message “I’m considerate of you and the possibility that I might get you sick”.

As a result of the mask being an accessory, as opposed to a piece of personal protective equipment, many people in Japan will not take a single precaution when handling the mask. They constantly touch and adjust them throughout the day, they put them on, take them off, put them half on, so their noses are sticking out... move them around... put them in their pockets, in their bags, and the list goes on.

One phenomenon that I have witnessed in Japan, even during the current outbreak, is people wearing masks on the streets and when walking around shopping malls and other places, and then, the moment they sit down at a restaurant or cafe table, they remove the mask, and proceed to eat/drink/whatever, and talk to whoever they are sitting with. Think about this for a moment. You wear a mask whilst you’re walking around in public, not talking to anyone, not facing anyone directly, with almost zero chance of catching anything from anyone, with the rare of exception of an airborne virus, against which your flimsy surgical mask provides no protection anyway, but then the second you sit opposite another human being and proceed to talk to each other slash spit all over each other, because, let’s be real here for a moment, when you talk to someone, your saliva is going all over them, including their face, hands, clothes, whatever food they’r eating or drink they're happily sipping. You know those times you notice that someone’s spit has landed on your face or on the table between you? Those are just the droplets large enough for you to feel or see. Think about all the tiny ones floating between you that you’re inhaling or that are spraying the area around you.

This just all seems backwards to me. Wearing a mask when you’re in a relatively safe environment, such as walking around the streets or shopping malls, but then taking off the mask when you enter a high risk environment, such as socialising and eating in a restaurant. Granted, it is actually impossible to eat or drink whilst wearing a mask, but this just reinforces my point about it being less than ideal for the general public to wear masks in non-medical settings.

At the end of the day, I think there is an argument for the general public to wear masks en-masse. I think there would be a type of herd immunity effect, as we see with vaccination, if 99% of the population was wearing face masks when out in public. However, it is important that the public also does not treat those masks as accessories, and understands that they are pieces of medical equipment, that must be used in conjunction with regular hand washing and care taken when handling the masks.