Flu: why hardly anyone wears a mask in France

Reading time: 6 min

Influenza can be transmitted mainly in two ways: postilions, coughs and sneezes that contain infected droplets that are likely to spread through the air; and by the hands, just touching those of an infected person who sneezed or coughed and did not wash them afterwards.

To avoid getting the flu, the National Institute of Prevention and Health Education (Inpes) recommends not coughing or sneezing in his hands, but in a handkerchief that will immediately be thrown in the trash. You should wash your hands immediately afterwards. No handkerchief nearby? Then cough in your elbow. These rules of good behavior observed, the wearing of the mask can it contribute effectively to fight against the transmission of the virus of the flu or any other respiratory infection?

Only for the sick

Virtually invisible in the streets, the metro, the open spaces, the mask is however part of the recommendations of the Inpes so as not to transmit the virus to his entourage. No need to wear a mask if you are not affected, it is only used to protect the patient's entourage air that exhales coughing or sneezing. "The surgical mask has no" filtering "property and therefore does not prevent the wearer from being potentially contaminated.explains Prof. Fabrice Carrat, flu specialist, epidemiologist at Inserm and head of the public health unit at the Saint-Antoine hospital in Paris.

"In France, it is never advisable to wear a mask to protect yourself from others. The mask is a screen but only from the point of view of the one who is sick. It makes it possible not to project the droplets in which are the viruses »Isabelle Balty, head of the biological risks division at the National Research and Safety Institute (INRS), is very satisfied.

Ministry of Health

The wearing of the mask is part of the "barrier measures" against the spread of the virus listed on the website of the Ministry of Health. But this is only a proposal made to the sick: "In community, even if the wearing of the surgical mask is difficult to achieve (low acceptability, insufficient wearing time …), it must however be proposed." It is however "Recommended in the health care setting, for staff or visitors in contact with a patient with a respiratory infection and for the patient, in the emergency department, in consultation and when he leaves his room", says the ministry.

Restrictive

The mask requires some knowledge of good practice to be truly effective. "Misuse of a mask can actually increase the risk of transmission rather than reducing it. If masks are to be used, this should be combined with other general measures to prevent the human-to-human transmission of influenza, training on the proper use of masks, and consideration of cultural values. and personal », warned the World Health Organization (WHO) in a note published on May 3, 2009 while the pandemic influenza A.

The Haute Autorité de Santé (HAS) details the rules for an effective mask wearing: "A surgical mask must cover the nose, mouth and chin permanently. It adjusts to the face with a nose clip and is held in place by ties or elastics pbading behind the ears. It should be discarded as soon as it is wet or soiled, in a trash bin if possible equipped with a lid and provided with a plastic bag. Then wash your hands with soap and water or disinfect them with a hydro-alcoholic solution.. If it is not wet before, the mask must be changed every four hours. Beyond that, it is no longer effective.

An effective gesture?

In its 2005 International Health Regulations, revised following the H1N1 pandemic, WHO states that "The benefits of wearing the mask have not been demonstrated but can be worn if desired". An absence of results confirmed by the epidemiologist Fabrice Carrat: "No study of my knowledge has shown that the surgical mask has an effectiveness on the reduction of the transmission".

For him, it is therefore perfectly normal that the authorities do not further encourage the wearing of the mask in case of infection. "The role of public authorities is to promote methods that have proven effective. This is not the case with masks », he comments. According to the epidemiologist, the first rule to be observed – and the most important – is to have excellent hand hygiene: "In terms of prevention, I think it's much more effective than wearing the surgical mask".

Nevertheless, for the HAS, the wearing of masks by professionals who work with a fragile public such as very young children or the elderly, remains a useful gesture. "In the event of an epidemic of respiratory infection or in the case of workers with a respiratory infection, the wearing of the mask helps to reduce the spread of epidemics, in particular the flu which threatens the most fragile people", notes the authority, which however did not develop a specific recommendation on the subject.

In addition to the lack of knowledge of good practices and its moderate efficiency, wearing the mask is often poorly perceived in French and Western culture. "Low acceptability", writes the Ministry of Health on its website. "In Europe or on the American continent, we do not see this practice with a good eye, on the contrary! The wearing of the mask in public places is the object of curiosity on the part of those who rub shoulders with it », observes Isabelle Balty. The mask, synonymous with illness, acts like a scarecrow.

Absent in France, ubiquitous in Japan

Yet it is a country where the mask is an institution: Japan. Karyn Nishimura-Poupée is a journalist for Agence France-Presse (AFP), based in the Japanese archipelago for almost twenty years. "The Japanese have been wearing masks for a little over a century. Initially, it was rather in factories to protect themselves from dust and other insanities but the use has spread over the decades in medical practices and hospitals, then in public places, trains and subways including ", she says.

Tokyo Metro | Maya-Anaïs Yataghène via Flickr

In Japan, masks are available in pharmacies, but also in supermarkets 24/24 and supermarkets. And if you put as much, it is not to protect yourself from pollution. "People with allergies to pollens carry the most. This is the main reason with the risk of contamination. The different pollens that circulate in the spring in Japanese cities are terrible. It is estimated that around 40% of people are affected by pollen reactions. For them, the wearing of the mask is an absolute necessity, without a mask, it is unbearable ", the journalist continues.

Karyn Nishimura-Poupée badures, the mask is not a fashion accessory in Japan, or only for a tiny part of the population. "The Japanese have no fear of feeling ridiculous by wearing a mask. On the contrary, they will feel more ashamed if they cough in transport without wearing it. ", says the author of the sociological essay The Japaneses.

Why is the wearing of the mask so democratized in Japan and totally absent from the French landscape? According to her, "The Japanese are more concerned about the risks to themselves and those around them. To wear a mask is to respect others and to protect oneself. It's a question of "living well together", politeness. It is also a question of basic hygiene, such as washing your hands or making gargles. We learn this in kindergarten.

While these Japanese and Japanese masked us, they themselves question the French habits. "In general, it is not uncommon for the Japanese to wonder about the hygiene of the French who take less baths than the Japanese, perfume on the other hand much more, disinfect the hands less with special liquids, fly into tissue tissues that end up being microbe tissue, etc. They wonder why the French do not protect themselves more against microbes and viruses, especially in areas of high promiscuity like the metro. Actually, I end up thinking like them. "