Tackling COVID-19: The Behavioural Consequences of Face Mask Policies

Post by Flora Moujaes 

What's the science?

Wearing face masks to curb local outbreaks of COVID-19 or reduce transmission in future waves of the pandemic has already become a contentious issue worldwide. For example, in the US in May 2020 an employee was shot after telling a customer her daughter was required to wear a face mask, while in France a bus driver was stabbed to death after asking three passengers to wear face masks. Despite its potential to generate conflict, wearing face masks is currently believed to be the most effective way to stop the transition of COVID-19. In addition, as mask wearing protects others from contracting the virus, but does not protect the wearers themselves as much, a high level of compliance is needed for the method to be effective. It is therefore imperative to explore the behavioural and social consequences of different types of mask wearing policies. This week in PNAS, Betsch and colleagues explored the social and behavioural consequences as well as compliance levels of voluntary vs. mandatory mask policies.

How did they do it?

To assess the behavioural consequences of mandatory vs. voluntary mask policies, the researchers first gathered data from 7000 German participants using an online weekly cross-sectional survey. They found that after mask wearing became mandatory in public shops and on transport in Germany in April 2020, mask wearing increased steeply from 30% to 80% over a two-week period. They also found that people who wore masks were much more likely to wash their hands, avoid handshakes, and keep their physical distance. This implies that mandatory mask wearing policies are (1) effective and (2) that individuals wearing masks exhibit other protective behaviours more often. 

In order to explore the social and behavioural consequences of mandatory and voluntary mask policies, the researchers then conducted an experiment in which 925 participants were asked to imagine that they were in the fruit section of their local supermarket with one other person. They were randomly assigned to a scenario involving either a mandatory or voluntary mask policy where the other person was either wearing a face mask or not wearing a face mask.   

What did they find?

Perception of Mask Wearers: Overall, regardless of whether the mask-wearing policy was mandatory or voluntary, others wearing masks were perceived as more prosocial. People who reported wearing a mask frequently themselves in everyday life perceived greater warmth toward others who also wore masks compared to those who didn’t. Mask wearing was therefore perceived as a social contract, as those who complied with it socially ‘rewarded’ each other but ‘punished’ others who did not wear a mask. Finally, both those who were low risk and high risk for contracting COVID-19 reported feeling more at risk when the other person did not wear a mask.

Voluntary vs. Mandatory Mask-Wearing Policies: Fewer people were likely to wear a mask themselves when the mask-wearing policy was voluntary (77% compliance under a voluntary policy vs. 96% under a mandatory policy). The mandatory mask policy was judged fairer than the voluntary policy, especially by participants belonging to a risk group. In addition, the voluntary mask policy resulted in stigmatization, as others wearing a mask were judged as belonging to a risk group, though they were not judged as more likely to be infected with COVID-19.

What's the impact?

Understanding the social and behavioural consequences of mask-wearing policies is important (1) to ensure high compliance for effectiveness  (2) to avoid it becoming a socially contentious issue. Overall, this study suggests that mandatory mask-wearing policies are necessary in order to ensure a sufficient number of people to wear masks. Furthermore, this study suggests that mandatory policies are preferable as voluntary policies may increase the amount of stigmatization associated with mask wearing, and increase the potential for polarization within society. This study also highlights the importance of communicating to the public not only the benefits of mask wearing (e.g. risk reduction, mutual protection, positive social signaling), but also the benefits of mandatory policies (e.g. fairness, less stigmatization, and higher effectiveness).

Betsch et al. Social and behavioral consequences of mask policies during the COVID-19 pandemic. PNAS (2020). Access the original scientific publication here.