Health & Wellbeing

No evidence wearing face masks creates a false sense of security

No evidence wearing face masks...
An evidence review concludes there is no data to suggest wearing a face mask reduces a person's other hygiene behaviors such as hand-washing or social distancing
An evidence review concludes there is no data to suggest wearing a face mask reduces a person's other hygiene behaviors such as hand-washing or social distancing
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An evidence review concludes there is no data to suggest wearing a face mask reduces a person's other hygiene behaviors such as hand-washing or social distancing
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An evidence review concludes there is no data to suggest wearing a face mask reduces a person's other hygiene behaviors such as hand-washing or social distancing

A newly published review, by a trio of researchers from the University of Cambridge and King’s College London, has concluded there is no evidence to suggest wearing a face mask leads to lower levels of compliance with other hygiene measures such as social distancing and hand washing.

Face masks have arguably become the most divisive issue in this ongoing COVID-19 pandemic. Despite more than 100 countries bringing in some kind of mandatory mask wearing policy there is still vociferous debate on the topic.

One of the fundamental concerns often raised over broad compulsory mask orders is that they can instill a false sense of security in the wearer. This hypothetically could lead to individuals feeling over-protected and subsequently they may wash their hands less or become less vigilant in social distancing practices.

Even the World Health Organization’s current COVID-19 advice warns mask wearing can result in a, “false sense of security, leading to potentially less adherence to well recognized preventive measures such as physical distancing and hand hygiene.”

While there seems to be an intuitive appeal to the idea that a face mask can lead to relaxation in other important protective behaviors, is there any actual scientific evidence this is true? According to a systematic review of the current research, the answer is no, there isn’t any evidence to show one precautionary behavior reduces adherence to other related behaviors.

The new study begins by investigating the foundations of a common psychological theory called risk compensation. This is the idea that people tend to increase risky behaviors relative to safety measures that are imposed. For example, making bicycle helmets compulsory could be considered counter-productive if people intrinsically respond by subsequently cycling at higher speeds.

From a public health perspective, risk compensation is certainly something to consider when mandating new safety measures. However, the new study examines the history of several major public health interventions (including compulsory bicycle and ski helmets, HIV prevention measures, and HPV vaccinations) and finds evidence lacking to suggest any of these cases resulted in compensating behavior that led to worse outcomes.

“In each case, the benefit to the population tremendously outweighed the additional and very modest risk compensation that occurred in some individuals,” says the University of Exeter’s David Strain , who did not work on this new study. “Indeed, in alpine skiing and snowboarding, wearing a helmet was generally associated with risk reduction oriented-behavior, suggesting safety devices are both compatible with and perhaps encourage safety-oriented behavior, reducing head injuries more than can be accounted for by the helmet alone.”

Looking more closely at the research conducted on the impact of mask-wearing in relation to respiratory virus transmission, 22 systematic reviews were analyzed and none showed evidence that wearing a face mask reduced a person’s frequency of hand-washing. In fact, the researchers note two particular experimental studies found self-reported rates of hand-washing were higher in mask-wearing groups.

No prior research exists looking at mask-wearing in relation to social distancing behaviors. However, the researchers do reference three observational, albeit currently unpublished and not yet peer-reviewed, studies finding people tend to move away from others wearing face masks. This of course does not offer evidence to suggest people wearing masks will socially distance less, but it does affirm a lack of evidence showing how mask-wearing could result in people physically coming closer together.

“We do not rule out the possibility that for some people, engaging in one behavior can influence other behaviors in ways that might attenuate their beneficial effects,” the trio of researchers write in the study. “But based on the evidence we review here, any attenuation is unlikely to be sufficient to counter, or even reverse, these beneficial effects and lead to a worse outcome for a population.”

In the end, the new study goes so far as to claim the concept of risk compensation is a greater threat to public health. This long-held idea is not backed up by any evidence yet it seems to constantly appear as a justification for pushing back on public health and safety interventions. In this case, it has underpinned an argument, based on no evidence, suggesting mask-wearing could do more harm than good by making individuals relax other preventative behaviors.

The trio of researchers conclude their analysis by citing a 2016 commentary piece from McGill University epidemiologist Barry Pless, who adamantly says pushing the risk compensation theory is akin to flogging a dead horse.

“We would add that this dead horse now needs burying to try to prevent the continued threat it poses through slowing the adoption of effective public health interventions,” the new study concludes.

The new study was published in the journal BMJ.

Source: University of Cambridge

7 comments
Brian M
Strange conclusion - just the opposite of observations you see by simply observing people in shops.
Many shops have now removed one way aisle system, distance markings and number allowed in at one time etc. People are getting closer, That is a change in risk taking behaviour.

Have to admit I didn't like having to wear a mask - but do feel a lot safer, but that's the whole political point to get people out shopping, and using facilities. I.e. A change in behaviour which is more risky that staying more isolated.

Other previous studies over many years, from wearing seat belts to even wearing gloves while driving does increase the feeling of safety and increases risk taking. The question is not if it increase risk but if the reduced risk is more favourable than the risk of a changed behaviour.

Worzel
The mass wearing of face masks is a joke!
The LARGEST virus particle ever measured was 3/10,000ths of 1mm in diameter.
The pores of a surgical mask are 80-500 microns, so hundreds or even thousands of virus particles could pass through one pore of a mask, simultaneously. It's a bit like expecting an open window, to stop flies and bugs getting into your house.
It's a political scam, nothing more.
paul314
I think that at a certain level of inconvenience safety measures serve as a reminder as well as just protection. When I'm wearing a mask, I am constantly aware that we're in a pandemic, and that I should maintain other precautions.

But it does sound as if in some places business have gotten lazy. Around here, all the distancing markers and signs are still there, and it makes a difference.
Signguy
Worzel: well said; surgeons wear masks to prevent them from contaminating the person being worked on, anything wlse is just plain FEAR; False Evidence Appearing Real.
Bruce H. Anderson
This is not surprising. Those who wear masks of their own volition have concern regarding the virus and would most likely be hand washing and social distancing as well. Those who wear masks begrudgingly might still consider hand washing and social distancing as reasonable precautions.
ljaques
My observations match Brian's. In one day at the market, I saw: 1) several people stick their dirty fingers inside the mack and pull it up over their nose. 2) Several with the mask down under their chin. (chin cups) 3) man took his mask off and fold it, then put it in his pocket. 4) man take his mask off and roll it up, dirty side to inside, then put it in his pocket. 5) lady take her mask off and set it on her dashboard clean-side up. This is in a small town of 30k people, too. EGAD!
fen
My observations are the opposite, social distancing is going out the window now in shops around here that have said masks must be worn. Also coughing etiquette also goes out the window, with them using the mask to hold in their coughs when coughing into elbow is better. There is also a lot of mask touching going on then touching products, without masks people seemed to be careful of everything they touched, ofter using hand gel several times walking around the shop, now they seem to do it just getting back into the car.