Preventing Illness: To Mask or Not to Mask

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Why don't people who are sick wear face masks?

I began thinking about this question over the weekend when faced with what I viewed as a real health hazard.

My wonderful husband surprised me with tickets to a comedy show on Saturday night.  He must have sensed that I was getting a bit stir crazy with last week's super cold weather that had been keeping me indoors.  I definitely needed an outing and a change in my surroundings. 

The show was lots of fun except there was one problem.  The person sitting right behind us coughed the entire time and to make it worse she did not cover her mouth. Being the gentleman that he is, my husband switched seats with me so he would be directly in the path of all those wonderful droplets filled with germs that this woman was spreading every time she coughed.  

If you are anything like me, I am extremely careful about trying not to get sick. There is of course good reason for this -- I have always gotten sick easily even before my Sjogren's diagnosis and like many others with autoimmune disease I am often on medicines like steroids that makes me immuno-compromised (and more likely to get sick).  I have also found that for me getting sick can cause a flare, and when I do get sick it can be really hard for me to get better. My friends and family know when they are sick that I do not want to see them and to stay far far away!

Back to my story… we contemplated leaving the comedy performance early, but we were having such a good time I didn't want to.  It was actually funny! My ad-hoc solution was to cover my mouth and nose with my winter scarf and keep my head down for most of the performance.  I was already sporting my movie star look with big dark sunglasses since my eyes have been very light sensitive recently, so they were at least somewhat protected.  I might have looked ridiculous, but I will go to great lengths to avoid getting sick.  

It was shocking to me how inconsiderate this person was.  As far as I am concerned, if you don't have the decency not to go out in public and contaminate other people, at least have the decency to cover your mouth.

This incident also reminded me of when my husband and I were in Asia a number of years ago and we saw people wearing face masks. We asked one of our friends in Hong Kong about this and were told that when people get a cold or the flu there, they often wear a mask to prevent spreading their illness to others. This is a very simple solution and it seems that it would at least help prevent the transmission of illness especially during flu season. I am not sure why people in the United States haven't adopted this practice more.  I suppose that it is because it is not culturally acceptable.  It is odd to me that it is not.

The next question that I have heard is why not just wear a mask in public if you are healthy to avoid getting sick?  Well, it appears that doesn't help nearly as much. While a mask might help somewhat, the evidence seems to be more robust that a mask is most effective when worn by the person who is sick.  According to a CDC flu advisory: "Facemasks help stop droplets from beings spread by the person wearing them. They also keep splashes or sprays from reaching the mouth and nose of the person wearing them. They are not designed to protect against breathing in the very small particle aerosols that may contain viruses."

So while wearing a mask might be better than nothing when around someone who is sick, the mask is most effective when worn by the person who is ill.  Of course vigorous hand washing, blocking sneezes and coughs with a tissue or your elbow, and staying home when you are sick are the best ways to avoid spreading viruses such as the flu.

Obviously sometimes when you are sick, it is impossible to stay home with the demands of work and daily life.  However, to go to a crowded theater when ill and coughing without taking any precautions to protect those around you is another story. I do hope that it becomes more culturally acceptable in the US to wear a mask when you are sick and need to be out in public.  Because if you wear one now, you will stick out enough that you will be the recipient of many stares. 

What do you think?  Would you wear a mask in public if you had a cold or the flu?