Influenza Masks
A short history of a surprisingly controversial cloth
If one were to time travel to downtown San Francisco in January 1919, they would see a sight that has now become familiar; people on the streets wearing bits of gauze cloth masks across their face. This was because the world was still in the midst of the H1N1 Avian flu that first appeared the year before and infected one third of the human population worldwide. (Centers for Disease Control and Prevention, 2018) And, in 1919 as today in 2021, unfortunately, you might also see several people who refused to wear a mask.
Mask mandates, created to combat influenza, started in San Francisco on October 22, 1918. (University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library, 1918) The Board of Health proclaimed the mask was 99% effective against transmission of the virus (The Effect of Public Health Measures on the 1918 Influenza Pandemic in U.S. Cities, 2007) and soon after, mask avoidant “slackers” coalesced as the Anti-Mask League in January 1918. The group maintained a vague and incorrect argument that mandating masks wearing was unconstitutional, but mostly outraged about the perception their personal liberties were being infringed upon. And this was during a time, unlike today, that masks were not used as a symbol for a political statement as it has been in 2020 and 2021. In the 1918 pandemic, masks were associated with the war effort and wearing a mask was seen as patriotic duty and not identified with any specific political party.
History tells us that masks and vaccines work. In a mathematical simulation model published by the National Academy of Sciences in 2007 cities like San Francisco, St Louis and Kansas city who maintained prolonged and high adherence to influenza transmission control practices such as mask mandates, and avoiding crowded spaces, significantly reduced mortality in comparison to Baltimore and Philadelphia who delayed preventative measures and did not require control practices. (The Effect of Public Health Measures on the 1918 Influenza Pandemic in U.S. Cities, 2007, #7591). And the first vaccine ever developed to fight Variola, the virus that caused smallpox. This vaccine was so successful, Variola no longer exists in nature. (Amanna & Slifka, 2020) Yet, even with scientific evidence that proves masks and vaccines work to curb the spread of disease, some will still refuse to follow public health guidance. A recent study conducted by the National Institute of Neurological Disorders and Stroke, National Institutes of Health and University of California Riverside’s department of Psychology determined that non-compliance with public health directives have an association with a limitation of the working memory of some individuals: “Noncompliance behaviors partly reflect people’s concerns for the inherent costs of social distancing while discounting its public health benefits. We propose that this oversight may be associated with the limitation in one’s mental capacity to simultaneously retain multiple pieces of information in working memory (WM) for rational decision making that leads to social-distancing compliance.” (Xie & Campbell, 2020)
The last global pandemic to affect all members of the population of the world was 100 years ago, but the next global pandemic could happen at any time. The lesson of the pandemic of 2019–2020 is that despite advances in science and education, there will be a percentage of people who will not act in the best interest of others and will not set aside their individual personal preferences and comfort for the greater good of the whole of society. Knowing this, we would all benefit from having more targeted, consistent and easy to understand public health messaging that reinforces why compliance with health directives will benefit their immediate family members and themselves personally. We know from the past, we cannot change human behavior, but we can learn from it and design for it.
Bibliography
Amanna, I.J., & Slifka, M.K. (2020). Successful Vaccines. Current Topics in Microbiology and Immunology, 428, 1–30. Amanna, I. J., & Slifka, M. K. (2020). Successful Vaccines. Current topics in microbiology and immunology, 428, 1–30. https://doi.org/10.1007/82_2018_102
Centers for Disease Control and Prevention. (2018, March 21). History of 1918 Flu Pandemic. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm#:~:text=It%20was%20caused%20by%20an,military%20personnel%20in%20spring%201918.
The Effect of Public Health Measures on the 1918 Influenza Pandemic in U.S. Cities. (2007, May 1). Proceedings of the National Academy of Sciences of the United States of America, 104(18), 7588–7593. JSTR. https://www.jstor.org/stable/25427531
University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan. (n.d.). Influenza Archive. https://www.influenzaarchive.org/cities/city-sanfrancisco.html#endnote14
University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan. (n.d.). Influenza Archive. The Influenza Archive. https://www.influenzaarchive.org/cities/city-sanfrancisco.html#endnote14
University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library. (1918, October 22). Wear A Mask and Save Your Life! San Francisco Chronicle. https://quod.lib.umich.edu/f/flu/0620flu.0009.260/1/--wear-a-mask-and-save-your-life?view=image
Xie, W., & Campbell, S. (2020, July 28). Working memory capacity predicts individual differences in social-distancing compliance during the COVID-19 pandemic in the United States. Proceedings of the National Academy of Sciences, 117(30), 17667–17674. https://www.pnas.org/content/117/30/17667
