I See You – The Answer to The Mask Mandate Controversy
Author: Maurice A. Ramirez, DO, PhD
As the United States and other nations see surges of influenza and COVID-19 on top of record RSV hospitalization rates, fear of holiday and post-holiday infection spikes have precipitated mask advisories and mask mandates in a rapidly growing number of school systems, municipalities, and states. As with prior mask mandates, the most current mask mandates and advisories are already met with resistance and misinformation. These behavioral health factors impact acceptance of and compliance with mask initiatives and solutions to improve mask use by the general public.
Large systematic reviews and analyses of the peer-reviewed scientific literature regarding the effectiveness of masks for preventing airborne illnesses are clear and definitive. Masks reduce the rate of airborne disease among mask-wearers compared to non-wearers. This is true whether you look at the whole of the scientific literature dating back decades or just at the science since the beginning of the COVID-19 pandemic. Masks prevent disease spread, minimize spikes in infections and save lives. After three years of COVID-19-inspired public health messaging, most people know that N95 masks offer better protection than plain surgical masks. The public also knows that cloth masks provide acceptable levels of protection for otherwise healthy people who are not in a healthcare or first responder role.
So, if masks are scientifically proven effective, and the general public is at least aware of this scientific fact, why is there so much resistance to wearing masks, mask advisories, and mask mandates? The answer is not about mask effectiveness, but rather it is about communication and empathy.
The human face has 42 muscles that provide non-verbal signals to other humans and animals. Most of these facial muscles are below the cheekbone and therefore covered by masks. While humans, regardless of culture, have complex verbal languages, science has proven that the language of faces is quite simple. The human face communicates messages in six groups: happiness, sadness, fear, anger, surprise, and disgust. This facial language is independent of culture, race, socioeconomic group, or education, making it almost universal. From infancy, humans study and learn faces and facial nonverbal communication. Interpersonal connection, and empathy, are almost exclusively communicated through the lower face. The lack of facial communication is a universal danger signal. Cover the lower half of the face, and most people lose the ability to interpret nonverbal cues and intention.
While only 30% to 40% of human speech can be accurately lip read, over 70% of normal-hearing people consciously or unconsciously improve their understanding of spoken communications with some degree of lip reading. Face coverings like masks increase miscommunications for these people, and the problem is worse for those with any degree of hearing impairment. In addition to losing nonverbal facial signals, many people have difficulty recognizing someone wearing face coverings. It is no wonder mask-wearing, and mask mandates trigger such strong emotional responses.
During the COVID-19 mask mandates of 2020 and early 2021, many people tried to relieve the angst, upset, and anger with innovative solutions. Masks with photorealistic images of the wearer’s face were popular but ultimately failed to solve the issue of interrupted nonverbal communication. Masks with clear windows flooded the market. Major corporations, including Ford Motor Co., attempted to design a clear N95 respirator with an anti-fog coating. The reasons that Ford scrapped the product have never been publicized. In addition to fogging, another challenge inherent to transparent masks is ensuring breathing resistance is not excessive. One example of a successful fog-resistant see-thru mask is the Optrel P.Air Clear N95 respirator. Approved by NIOSH in May 2022, this see-thru mask provides the protection needed by healthcare workers, first responders, law enforcement, teachers, frontline workers, food service, and the general public with no increased breathing resistance compared to non-see-thru N95 masks. The fog-resistant window allows for unimpeded nonverbal communication and facilitates lip reading for both hearing-normal and hearing-impaired individuals.
Mask advisories and mask mandates are inevitable when respiratory illnesses surge seasonally. Masks are a scientifically proven public health good that prevents infection, protects the vulnerable, and saves lives. See-thru masks are a social good that improves nonverbal and verbal communication, promotes empathy, and facilitates public health. The best solution to mask resistance is a personal see-thru mask policy indoors and in public.
About the Authors
Maurice A. Ramirez, D.O., Ph.D. is the recipient of the Lifetime Achievement Award in Disaster Medicine and the Co-Founder of the High Alert Institute, a 501c3 not-for-profit educational public charity dedicated to providing disaster readiness education and resources to unserved and underserved communities, industries and charitable organizations in an All Hazards, One Health/One Nature, One Framework paradigm. Learn more about the High Alert Institute at www.HighAlertInstitute.org
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Disasters are defined as situations in which needs exceed or overwhelm available resources. Some disasters affect an entire community, while other disasters impact individuals and families. Crises of physical or psychological health can be very personal disasters.
The therapeutic value of pets during illness, trauma, and recovery is well established. And Koi fish may be well suited for people who are not able to provide verbal pet commands or physically care for pets like dogs and cats. Koi ponds are also a source of beauty and peace, providing an ideal setting for quiet reflection or meditation.
We are working to partner with pond installers and aquatic pet rescues/shelters to offer free or reduced-cost ponds with rehomed Koi fish to people seeking this type of pet therapy.
Disasters disrupt life and impact our sense of personal, family, and community safety. Survivors and responders alike often are not aware of the emotional, psychological or spiritual challenges that they may face from disaster onset through recovery. With two decades of experience training responders and communities to prepare for the behavioral health aspects of disasters, we will continue to provide education and a curated list of resources to groups or individuals.
Non-medical factors that impact overall health are termed Social Determinants of Health or SDoH. Noise pollution, poor air quality, and poor water quality are three environmental factors known to have a strong link to overall health. And the same environmental factors that impact humans impact their pets and other animals in their care. We continue to assist in advocacy, education, and technology development to mitigate the impact of SDoH on humans and animals alike.
Our efforts in shelter and rescue are the main focus of our environmental stewardship, reducing the environmental impact of non-native aquatic animals being dumped into public waterways. The High Alert Institute also assists innovators with the design, development, and evaluation of green and renewable energy technologies. Reducing the carbon footprint associated with disaster preparedness, response, and recovery furthers our continued mission to mitigate risk and improve resilience.
We partner with public and private organizations, sharing resources and fostering partnerships to improve disaster preparedness, response, and recovery, and mitigation.
The High Alert Institute team has over a century of combined research experience in medical, nursing, behavioral health, and disaster sciences. Our team provides support to researchers and technology developers through comprehensive literature searches and reviews, as well as failure mode database searches and adjudicated reviews.
When disaster strikes, most aquatic pet owners have limited options to secure the safety of their pets. Sheltering in place may not be possible if there is no power to provide aeration and “pet-friendly” shelters do not include ponds or aquariums. Our goal is to provide an option for aquatic pet owners in need of rescue and shelter for their finned friends.
Our goal is to share our two decades of disaster readiness experience with animal welfare organizations, shelters, caretakers, and pet owners, as they implement contingency plans for natural and manmade disasters.