Everything seems to be a part of the ‘culture wars’ these days.
Wearing face-coverings in public used to be the preserve of large cities in East Asia, where a recent history of disease outbreaks and cultures which encourage small personal actions to protect the population as a whole has led to face masks becoming a common sight on city streets and public transport. The COVID-19 pandemic has caused face masks to become an increasingly common sight in European and American cities, in-line with World Health Organisation recommendations that wearing face masks in public is an important measure to stop the spread of the virus as countries and economies begin to reopen.
However, as an increasing number of local and national governments have started to mandate the wearing of face coverings in public spaces , videos and stories of people loudly refusing to wear masks started spreading across social media and the news cycle. Reasons given range from a lack of understanding of the risk the virus poses or the efficacy of masks, feeling that it violates their personal freedoms or emasculates them, to a series of truly bizarre excuses given by Florida residents at a hearing before a vote on whether to make masks mandatory.
This isn’t an exclusively American problem. British political commentators have claimed that the requirement to wear face masks in England from July 24 is a “sinister encroachment of the state”; that masks make life “so unpleasant” that people will stop going out if threatened with a £100 fine; or even erroneously claiming that they developed a cold sore after wearing a mask. Many of these arguments have come from people with libertarian or “small-government” political leanings, rejecting any attempt to enforce behavioural changes onto citizens. Thus masks have become yet another battle in our modern culture war.
However none of this is new.
The Spanish Flu (H1N1) pandemic of 1918 is arguably the first pandemic of modern times, with devastating consequences. The mass movement of troops during the final months of the First World War accelerated the spread of the highly contagious disease across the planet until in infected a third of the world’s population and killed 50 million people.
The measures implemented to deal with the outbreak read as if they were implemented in 2020. In the United Kingdom – although there was no central directive ordering them to do so – churches, dance halls and theatres closed, and some people wore face masks as they went about their lives.
In the United States, containment measures varied widely across states and cities. In St Louis MO, after the virus began to spread in the local population, Health Commissioner Dr Max Starkloff responded quickly by closing schools, picture houses and public pools and banning all public gatherings. This swift response, enacted within two days of the first cases showing up on October 5th, resulted in keeping the number of people who died from the virus to 700. Contrast this with Philadelphia, one of the largest in the United States, refused to cancel a “Liberty Loan” parade despite the virus spreading through the population. 200,000 people attended the parade. 2,600 people had died of the virus by the end of the week, and 16,000 died over the next six months.
Wearing face masks in public was also a measure encouraged to control the virus. The Red Cross distributed masks took out newspaper adverts accusing those who resisted wearing masks of being “dangerous slackers”. In a time of high patriotic sentiment at the end of the Great War, wearing a mask was touted as a “patriotic duty for every American citizen”. But the humble face mask became a focus of opposition to anti-pandemic measures over a hundred years ago as it has in 2020. Some refused to wear them because they felt there was limited evidence for their efficacy; others found them inconvenient, cutting holes in the fabric so they could smoke or breathe more easily; and others rejected the imposition upon their behaviour and liberty.
Although incidents of resistance to mask-wearing occurred across the country, the San Francisco “Anti-Mask League” turned this sentiment into a political movement which campaigned the city to overturn their requirement to wear a mask in public.
From the October 25 1918, everyone in San Francisco had to wear a face covering in public or in a group of two or more people else face a $5 fine and possible imprisonment. Although initial compliance was reported at 80%, the city’s policies resulted in jails becoming overcrowded. 110 people were arrested on October 27 for ignoring the ordinance, with another 50 being arrested the next day. While some people who violated the ordinance were simply forgetful, others were openly resistant to requirement to cover their faces, accusing it of being “unconstitutional”. Tensions ran so high that three people were shot after a health inspector attempted to force a man to wear a mask.
San Francisco began relaxing their lockdown measures of November 16, reopening theatres and sporting arenas but still requiring patrons to wear masks. It wasn’t until the 21st that the requirement to wear masks was lifted. The San Francisco Chronicle reported the widespread jubilation as people threw off their masks and the sidewalks were left “strewn with the relics of a tortuous month”, as if the virus had disappeared. Unfortunately, these celebrations were premature and short-lived, and a second deadly spike of the disease forced the Board of Supervisors to reinstate the compulsory mask-wearing ordinance on January 17 1919.
The new ordinance faced wider organised opposition, with the Anti-Mask League forming on January 21 to protest the new rules. With numerous influential San-Franciscans among their ranks, including a member of the Board of Supervisors, several physicians and the first woman to vote in the city, word of the “Sanitary Spartans” as they were dubbed by the press began to spread across the country.
A gathering on January 25 of 4,500 people, organised by the Anti-Mask League in order to gather signatures for a petition demanding the end of compulsory mask-wearing drew further attention to their complaints. Many arguments they deployed against the ordinance sound very familiar: complaining that masks were “burdonsome” and an “infringement of our personal liberty”. Although Mayor James Rudolf stood his ground and resisted the demands of the vocal Anti-Mask League, the ordinance was once again lifted on February 1 after the San Francisco Board of Health declared that transmission had decreased to a safe level.
Were masks effective in controlling the spread of Spanish flu? It seems unlikely. The masks distributed by the Red Cross were made from a porous gauze material which is less effective at preventing the dispersal of infectious droplets from coughing and sneezing than the triple-layered protection currently recommended by the World Health Organisation. Germ theory was still a relatively new concept and one which was little understood by the general public without a scientific education. Viruses were an even newer concept, with the first virus having been discovered in 1898 and the influenza virus a decade away from discovery. However, there is a strong scientific basis for wearing masks as one of a variety of measures to contain the virus as we return to our places of work and education.
Fundamentally, wearing a mask is an altruistic act: it involves the individual putting themselves in slight discomfort in order to prevent themselves from transmitting a disease they may not even know they are carrying. Like vaccination, it requires almost all of the population to participate in order to protect a small number of people who are unable to do so because of breathing difficulties or disabilities. The parallels between the objections of the Anti-Mask League of 1919 and and the anti-maskers of 2020 highlight that some people are unable to comprehend that their refusal to wear a mask will have consequences that extend beyond their own health.
In the highly individualistic cultures of the United States and United Kingdom, this lack of will see themselves as but a small part of a larger community and to understand that the actions of the one can have dire consequences for the many may be one of the biggest challenges for containing this pandemic as we move towards future waves and beyond into the ‘new normal’.