Meaning behind the mask; why the face mask is promoted in Asia but shunned in the West

Back in December 2019, I visited my sister at her workplace at a small elementary school in Bangkok. That day, the “red flag” had been raised in front of the school, indicating an unhealthy concentration of PM 2.5 in the air. Young students – no older than ten or 11 – streamed into the school.

As they congregated on the field for morning prayers, we were confronted with a surreal sight: orderly lines of children, dressed in dark pants and crisp white shirts, their little faces covered in surgical masks of all kinds and colors. Some wore gas masks, the kind with two protruding filters. There was something shocking about those masks in particular – a mocking facsimile of a gas mask, made of plastic, painted in childlike yellow and blue.

It was one of the most dystopian things I had ever seen.

After the prayers finished, a small child wearing a pink, bear-patterned surgical mask ran up to my sister. “Teacher,” she whispered loudly into my sister’s ear, “Why isn’t your sister wearing a mask?”

This was before the coronavirus outbreak, back when the concentration of PM 2.5 was still our biggest threat. Yet, for some reason, I felt ashamed.

The politics of the mask

Now the face mask is worn for more than one reason, it permeates all socio-economic divides in Thailand and much of Asia. The mask has stirred emotion and evoked political commentary.

To some, the mask has become the dividing line between competent and incompetent governments, with images of the Singaporean military packing free masks for its citizens going viral, while the Thai government’s inability to provide masks to the public has ignited frustration among the public.

More overtly, it has become the focal point for racist incidents in Canada, France, and the United States, highlighting deeply fractured cultural lines between East and West.

The mask, more than any other object, is the symbol of 2020. But it is a multifaceted one – of provocation, deception, protection, responsibility. 

If you try to look for the history of surgical mask usage in Asia, Google will point you in the direction of this Quartz article. It went viral in 2014, and ever since, the narrative shaped by journalist Jeff Yang has influenced subsequent accounts of the face mask’s rise: from Dazed Digital to South China Morning Post to the Wikipedia page for “Surgical Mask.”

The story told by Yang is a simple one: the surgical mask came into widespread use in Japan during the 1918 influenza, also known as the Spanish flu, which had an estimated death toll of 50 million and became known as one of the deadliest pandemics in human history. However, mask-wearing went from an episodic to a year-round phenomenon after the 1950s, when Japan’s rapid post-World War II industrialisation gave rise to intense air pollution. As South Korea and then China went through their own experiences of industrialisation, the use of face masks became so common as to filter through to K-Pop and Chinese high fashion. Then, mask-wearing spread to Southeast Asia when pollution rose to toxic levels.

The key question is, if the 1918 influenza was the genesis of mask wearing, why has mask wearing not been adopted as popular custom in the West?

In the 1918 influenza epidemic, the death toll was much higher in Western Europe and the United States than it was in Japan. Face masks were worn throughout Europe and the US by medics, public authorities and the general public. In San Francisco and San Diego, it was mandatory to wear a face mask. Then, as now, the efficacy of masks in preventing the spread of disease was questioned, but doing so was still the norm.

Yet, after the pandemic, the use of surgical face masks among the general public disappeared in the West, only to emerge episodically in moments of intense air pollution, like London’s Great Smog of 1952.

To explain the divergence, Yang invokes culture – specifically, the influence of Taoism and the health precepts of Traditional Chinese Medicine in East Asia that underly the popularity of face masks in Japan, South Korea and China.

‘Qi’, a central concept in Chinese cosmology, is related to ‘air’ or ‘atmosphere’, so masks are necessary to prevent exposure to noxious wind or ‘feng’ that can weaken the body’s Qi.

It is certainly one interpretation.

But the emergence of the mask in Asia and its corresponding lack of emergence in the West more likely points to the combination of trajectories of economic development, Asian notions of collective responsibility indebted to SARS, and Western liberal notions of proper citizenship.

Uneven and combined development

Rapid industrialization, the kind demanded of modern capitalist production, has always produced enormous amounts of pollution. England, home of the industrial revolution, was also home to the world’s first pollution crisis. London was hidden under a noxious ‘smog’ for the first half of the twentieth century, so much so that it was suggested as a screen for enemy bombers during World War II.

At the time, the health effects of toxic air quality were ignored, and there were few preventative measures put in place by the government – let alone measures taken by the general public.

1918 constituted the tipping point in ‘mask-wearing’ culture: developments in contagion theory meant members of the public were strongly advised to wear masks for the first time – transforming masks into a symbol of protection and defence.

Though Asian countries did not modernise and industrialise as quickly as their western counterparts, the situation changed rapidly towards the end of the twentieth century. China declared its first pollution red alert in 2015. Other countries in the region were not far behind.

For societies that industrialised later, air pollution was a known danger, and the general public was able to draw on established technologies of protection like the mask in response. By then, as predicted by what economists call the “environmental Kuznets curve,” pollution levels in most Western nations had decreased dramatically, so masks never came into widespread usage.

How masks came to Thailand

However, from East Asia, the surgical mask did not make a graceful leap over to Southeast Asia through some unknown process of cultural assimilation.

Rather, it was the SARS crisis that institutionalised mask usage – and elevated it into a symbol of collective and personal responsibility.

In a 2003 journal article, two medical professionals from the UK Health Protection Agency traveled from Manchester through Paris to Chiang Mai for a conference in Chiang Mai, and noted two things:

First, there was no mention of SARS in the British or French airports. Yet, when they landed in Bangkok airport, all staff – from custom officials, to police, to cleaners – were wearing masks.

By that time, around 40 people had died from the disease, with the outbreak hitting its peak in Hong Kong and just beginning to spread to mainland China. The limited Western response highlights SARS as a uniquely Asian trauma. Journalist Ian Young, who was reporting on Hong Kong at the time, writes, “For a generation of Hongkongers, SARS had a psychological impact akin to the events of 9/11 … Reality seemed upended. No horror impossible.”

Second, face masks were heavily promoted by the government – at the time, Thais had less cultural experience with the face mask than the Japanese, so masks were popularised by celebrities, distributed in parliament and to officials and reporters. Yet, the masks used were not those recommended by the World Health Organization, nor were they used consistently. Moreover, at the time there was not a single case of SARS in Thailand.

In the words of the two medics, “The mask became a highly visible symbol of individual and collective determination to achieve control even though its value in community settings is questionable.”

Regardless of the actual threat level, or their actual efficacy, wearing the mask was a public duty – signaling solidarity with a threatened community, and awareness that the nation was facing a potential public health crisis.

“It is this perception of the importance of personal and collective responsibility by members of the public that the mask symbolizes best.”

Why the West won’t embrace the mask

In the same period SARS was spreading across Asia, France passed a law banning the Muslim veil in schools.

The “West” – an unstable category that we define here as the broad swathe of Western European nations indebted to histories of Christianity and the Enlightenment – has long held an aversion to facial coverings in the public sphere.

The French and Dutch ban on facial covering has now expanded beyond veils to any masks worn in public spaces. Interestingly, the punishment for violating the ban in France is citizenship education. The mask provokes an anxiety of the “other” and is clearly linked to belonging and exclusion in Europe, its conspicuous absence symbolic of an idiosyncratic, Christianised notion of “appropriate” public behavior.

Part of this is related to notions of “rational” liberal thought that emerged from the Enlightenment. Jurgen Habermas, a renowned German philosopher, writes of a utopian “public sphere” in which ‘rational deliberation’, ‘transparency’ and ‘sincerity’ help mankind achieve radical, deliberative democracy.

In the idealised public sphere, the mask is a communicative barrier – interfering with the potential of achieving a universalised realm of consent and dialogue. The mask marks out your lack of participation in this “Western” public sphere, a traitor to the rational liberal state.

Masks as symbol

By tracing the history of the surgical mask – its widespread use in Asia and the lack thereof in the West – we can better understand the “racism” stoked by the mask as it is used by Asians in Western society today.

At its heart, the reaction provoked is not just simple xenophobia but speaks to deeper cultural cleavages around notions of civic duty.

The mask is a visible symbol of the differences in what constitutes being a “good” citizen in modern society. While in Thailand, the mask came to be the symbol of personal responsibility in a moment of collective trauma, in the West the mask is a symbol of anxiety, an obstruction to public democratic deliberation.

Yet, symbolism is never pre-determined nor static – objects are what people do with them. The coronavirus epidemic is taking place in an age of unprecedented transnational contact, and never before has there been so much cross-cultural dialogue on the meaning of the mask. It is in this process that we learn new kinds of empathy, and in a moment where the world hangs on a precipice of doom, this is more important than ever.


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