Fashion statement: The polarising nature of the face mask

Attempts to introduce mass-masking may be hampered by a lack of established social expectations. Photo / Getty Images

Varying attitudes towards mask-wearing say less about our phobias and more about our trust in authorities – or lack thereof.

Freud is credited with having said, "Sometimes a cigar is just a cigar". But he is also, incorrectly, supposed to have said, "Time spent with cats is never wasted", when his verified position on felines was, "I, as is well known, do not like cats".

So, when is a face mask not a face mask? On the surface of it, a face mask is going to not be a face mask only if you've mistaken it for something else. I don't think that this is what one Twitter wag meant when they said, "Ripping off your mask when you get back in the car is the new taking off your bra when you get home". Thanks @maggiescott231.

Around the world, the uptake of advice given by authorities trying to contain the coronavirus pandemic has varied markedly. Although most people have been compliant when it comes to regular hand-washing, social distancing and staying in "bubbles", it's mask-wearing that seems to polarise the most.

In the United States, the issue has become depressingly symbolic of the growing divide between supporters of the Democratic and Republican parties, in which people signal their affiliation by wearing or not wearing a mask. As Freud didn't say, sometimes a mask is just a badge of which political gang you belong to. We're so lucky here, right?

Yes, in so many things, but that's not to say the little smile-coverers are entirely uncontroversial – as seen during the election campaign when Billy Te Kahika Jnr, then co-leader of Advance New Zealand, refused to wear his mask over his nose on a flight from Wellington to Dunedin. Even under Covid-19 alert level 1, masks are recommended on public transport, and at alert level 2 – such as when Te Kahika pulled his stunt – if a flight attendant tells you to pull your mask up over your nose, you are legally required to do so.

A survey of 1000 New Zealanders by researchers at Otago and Massey universities is the first to delve behind the issues affecting mask-wearing adherence here. In a paper published in the Journal of Primary Health Care, they say attempts to introduce mass-masking may be hampered by a lack of established social expectations, as well as previous negative and confusing public messaging.

Perhaps surprisingly, the survey found that the cost of masks and embarrassment about what others would think of them were least likely to deter New Zealanders from donning them.

The main barrier was beliefs about their efficacy – prompting the academics to recommend better messaging from authorities to explain the effectiveness of masks and to "socialise" their wearing.

"A sense of responsibility for others, including for vulnerable populations, can be a key driver in people undertaking protective action," the paper says.

The New Zealand survey adds to a veritable explosive sneeze of international research since the pandemic began on the effectiveness of efforts to contain it.

Resistance to mask-wearing in countries such as Austria, the UK, the US and Australia has been driven by conflicting messages about mask effectiveness, anxiety and stigmatisation concerns, confusion about different types of masks and supply issues.

The World Health Organisation's initial advice that healthy people would be "wasting a mask" if they wore one didn't help. In Switzerland, many people maintain they don't wear a mask because they either feel healthy or have already contracted Covid-19 and recovered.

But the variation in usage rates is not explained solely by differences in policy and is more likely due to cultural factors, researchers say.

In the UK and Denmark, mask-wearing has been found to be more predominant among those who are more anxious, such as those with existing health problems, and who trust health authorities' recommendations.

These are "rational" predictors.But in Slovakia, greater conspiracy belief and poorer scientific reasoning both predict "non-standard" anti-Covid behaviour – for example, someone's declaration that they drink "at least 52% alcohol as a disinfectant".

In the Netherlands, Covid anxiety is greatest among people who worry about their health and that of their loved ones, but also among regular media (and social media) users. Stay away from Twitter, folks.