Asians in Japan, China, and Hong Kong who lived through SARS in 2003 developed a habit of wearing surgical masks in public to combat the spread of the contagious respiratory diseases.
During the current Covid-19 outbreak, governments and health experts in East Asian countries all advocated mask wearing as essential to slow the spread of the virus. On the other hand, the World Health Organization and the US have until recently discouraged the use of face masks by the general public.
For months since the outbreak, the US Surgeon General and the Centers for Disease Control (CDC) urged seemingly healthy people not to wear masks, claiming that masks offer no protection to the general public and should be reserved for front line medical workers.
Between March 30 and April 3, however, the CDC and the White House revised their original guidelines on mask use: the CDC now recommends people wear reusable cloth masks while in public even when they are not showing any symptoms. This new recommendation seeks to address the concern that asymptomatic carriers are responsible for widespread community contagion, while taking into account the critical shortage of medical-grade masks for front line health workers.
While infectious disease researchers in Hong Kong urge the public to wear three-layer surgical masks for their proven filtration efficacy, the US government is recommending only homemade cloth ones, largely to prevent aggravating the current shortage of personal protective equipment (PPE) for front line medical staff.
The effectiveness of cloth masks, however, has not been scientifically proven. One study has even shown that healthcare workers wearing cloth masks are more likely to be infected than those with surgical masks.
Racist harassment of Asian people has become commonplace in the US and the UK since the outbreak. The website Stop AAPI (Asian American and Pacific Islander) Hate received over 650 reports of racial discrimination against Asians within its first eight days. Some of this harassment has entailed physical violence. A San Francisco woman was spat on last week as she walked to the gym. An Asian family was stabbed while grocery shopping in what police alleged to be a coronavirus-related hate crime. An Asian woman wearing a face mask was punched and kicked on the New York subway.
Public mask wearing is a highly visible feature of a person’s presence in this pandemic-ridden world. Because of cultural differences in mask use and the fear of vile racist attacks, for Asians in the US, the dilemma between whether to wear a mask in public, and what kind of masks to wear is particularly difficult.
For Asian diasporas, donning a face mask in public could heighten their risk of being violently attacked. In other words, while mask wearing is helpful in safeguarding the health of the community during a pandemic, in a racist culture, it intensifies the threat of violence against racialised communities. While different in kind from the coronavirus, these attacks, and the xenophobia underlying them, are also a threat to public health.
Owing to different cultural practices and beliefs in the efficacy of public mask use, many Asians diasporas have acquired surgical masks and N95s prior to the current shortage. Now that Hong Kong no longer experiences a public shortage of masks, Hongkongers have been shipping them in droves to their loved ones abroad.
As a result of US President Donald Trump administration’s incompetence in securing sufficient PPE for front line medical workers, the American public has been told to wear only cloth masks, and donate any protective supplies they may have, even a single N95, to hospitals.
While the dire need for PPE is caused largely by the Trump’s repeated mishandling of the pandemic and what medical historian Debora Levine called “the technological imperative in US health care” that prioritises high-tech and high-cost interventions over low-tech.
But necessary equipment like face masks, Asians and Asian Americans who own medical-grade masks are now put in a difficult position to negotiate an ethical conundrum in which there are no absolutely right answers. The US has recommended the public to rely on cloth masks goes against what experts and governments in East Asia have advised.
While the Chinese government and Hong Kong health experts agree that N95s should be reserved for front line medical workers, based on their experience battling SARS, they recommend single-use surgical masks for low-risk individuals in the general public, even when they are not showing any symptoms.
When experts and governments across the globe disagree on best public health practices, individuals are forced to navigate tensions between cultures that affect how scientific evidence is interpreted and translated into everyday practices.
Before the current mask shortage in the US, Hongkongers have long criticised European and American expats as endangering themselves and others by refusing to wear proper masks.
Asians and Asian Americans who own a small amount of surgical or N95 masks – either purchased prior to the current shortage, or received in the mail from their loved ones abroad -deliberate with each other if they should donate them to hospitals, or wear them in more crowded public spaces to protect themselves and their immediate community.
Some worry they would be criticised if they don medical-grade masks in public because they may be accused of stealing from healthcare workers. Others, citing the success of the South Korean and Taiwanese governments in securing surgical masks for the public, argue that individuals should not be tasked with bearing an ethical and public-health burden caused by the US government’s failure to prepare for the pandemic and supply chain mismanagement.
Asian diasporas and Asian Americans are embroiled in an environment that has repeatedly put them in harm’s way. They were targeted by the Trump administration, first ridiculed for their mask use, and now being asked to donate masks to help solve a systemic failure.
Hongkongers, similarly, have suffered during this pandemic from political failures: the suppression of whistle-blowers by the Chinese Communist Party, and the incompetence of the Hong Kong government in controlling the spread of the virus. Both groups have, in their own ways and respective locales, been practising mutual aid and devising grassroots tactics to protect their own communities.
Rather than arguing who has done the “right” thing when so much remains unknown about the virus and what the most effective public health policies are, we should harness this moment of crisis to cultivate solidarity. The world shares common struggles against systemic failures in the global medical supply chain and government responses to pandemics with Hongkongers, Asians diasporas and Asian Americans.
At the individual level, regardless of our locations, we are all in this together. Instead of wrestling over what the absolutely right course of action is, we should also allow ourselves to feel at ease with the decisions we make for our health and the health of our community based on the limited resources and scientific information available to us right now.