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People wearing face masks walk past decorations of a department store in Paris on Dec. 24, 2020.

STEPHANE DE SAKUTIN/AFP/Getty Images

Vivian Song is a Toronto expat and journalist who has been living in Paris for the past 10 years. She has written for The New York Times, BBC, CNN and Vice among others.

Since late August, masks have been mandatory in public, outdoor spaces in Paris. The city streets are filled with half-covered, semi-anonymous faces, serving as an omnipresent reminder that we are living under threat of a deadly virus.

In quick time, grabbing a mask before heading out the door has become as normal as remembering our house keys before leaving home: a part of our daily routine. No longer is it an eccentric quirk exclusive to Asian countries, where masks were commonplace well before the appearance of COVID-19.

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In China, Japan, Hong Kong and South Korea, it’s long been a simple common courtesy when sick to wear a mask as a means to protect others from your cold or flu. During days of peak air pollution and fine dust, it’s also common to don a mask to serve as a barrier against harmful particulate matter.

What if, even after the worst of the pandemic is behind us, face masks continue to be used as a tool in managing public health during the regular flu season, which the World Health Organization says kills as many as 650,000 people a year?

What if, even after most of the vaccines have been administered, the Western world sets aside its former snobbery against Asia’s widespread mask usage, and adopts the practice in its public health strategy for mitigating the adverse effects of air pollution, which causes the premature deaths of about 4.2 million people in smog-choked cities every year?

What if we stopped politicizing the face covering, which has been maligned as a muzzle and a violation of civil liberties, and normalize the mask as simply an effective barrier to keep our harmful germs in, and deadly particle pollution out?

Just as aggressive public health campaigns have taught us – or rather, reminded us – about how to properly wash our hands and the importance of sneezing and coughing in our elbows during the pandemic, well thought-out public education and messaging could help destigmatize the face mask once the worst of the outbreak is over.

Given the mask’s widespread adoption, why not ask citizens to voluntarily don one when ill with the cold and flu and out in public spaces? Or when they’re around the immunocompromised and the elderly, who are at greatest risk of dying from flu-related complications? Why not encourage people to exercise a bit of civic responsibility and protect others with this small gesture?

It’s estimated that in Canada, regular influenza causes about 12,200 hospitalizations and 3,500 deaths every year. A 2018 preparedness and planning document published by Health Canada affirms that “masks worn by ill individuals may protect uninfected individuals from virus transmission.” The scientific findings were based on studies conducted during and after the 2009 H1N1 outbreak in Canada, also known as the swine flu. Combined with good hand hygiene, the two-pronged approach helped reduce influenza transmission within households and among university students in residence, reads the report.

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As part of the document’s respiratory etiquette guideline, which outlines measures that can minimize the dispersion of the influenza virus, authors also recommended that those who exhibit symptoms of an “influenza-like illness” and must leave the house wear a mask.

From where I sit in France, I find it perplexing that masks have not been made mandatory outdoors in densely populated cities such as Toronto, where physical distancing has been shown to be often impossible.

Meanwhile, in 2019, the Paris region experienced 17 days of peak air pollution that exceeded WHO-recommended thresholds. Though the best defence against exposure to such dangerous levels is to stay indoors, refrain from strenuous outdoor activity and limit travel by car, there’s the commute to work, school drop-offs and pick-ups, and other assorted errands that need to be done. In other words, unlike a global health pandemic, it’s less likely that the world will come to a screeching halt owing to poor air quality.

A study out of the University of British Columbia, and published in the European Respiratory Journal this past June, recommends wearing N95 masks for those times of “unavoidable exposure to ambient air pollution exceeding recommended levels.”

Admittedly, the recommendation comes with a host of caveats. Manufacturers’ instructions must be followed closely as factors such as facial hair, facial structure and movement can dramatically reduce masks’ efficacy. Face masks can also provide a false sense of security. But researchers cite four small studies showing that the use of close-fitting N95 masks could mitigate the negative health effects of ambient air pollution on the respiratory and cardiovascular systems.

“With technical improvements (e.g., using nanofiber technologies, metal-organic coatings and anti-microbial features, and the use of 3D-printing for better fitting personal facemasks), facemasks may provide better filtration and comfort,” the authors note.

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It might be a tall order asking people to regard the mask as more than just a bitter, symbolic reminder of these extraordinary times. But before we swear it off for good with the arrival of vaccines, maybe we should consider keeping the mask in our public health toolbox to protect ourselves and our loved ones in the future.

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