Air, Masks, and Individualism

Mandatory mask-wearing finally—and inexorably—went into full force, and from November 13 it came to be backed by fines. By coincidence, that day was also the day a new book was published, one I participated in as a co-author, on the history of medicine and the environment, along with one of my research papers. In that book, published in Europe, the closing sentence of my paper on the relationship between hygiene and medicine in 19th-century Britain oddly resonates with the bitterness I now feel as I look at a Korean society where the kind of policy described above is implemented as if it were nothing. Loosely paraphrased, that final sentence translates as follows.

Today, reductionism has become the dominant perspective in medicine and other scientific fields, and natural breezes and fresh air are no longer values we consider important for health, but merely secondary things and inconvenient environmental conditions. Hand-washing and regular checkups are always emphasized by doctors, but the basic philosophy of traditional hygiene for health appears to have been forgotten both in the everyday lives of many ordinary people and in today’s monopolized medical market.

Of course, the passage above may not resonate much with those unfamiliar with the classical Western concept of hygiene. At the core of this classical concept was the idea of increasing the immune capacity inherent in the human body—which cannot be separated from nature—through individuals’ management of their own lives and surroundings. For example, even up to the mid-19th century, when holistic medical theories still flourished to some extent, one of the most essential hygienic regimens prescribed by European doctors to their patients was walking in the fresh air outdoors.

The historical background behind the prevalence of this traditional notion of hygiene throughout Europe in the 18th and 19th centuries lay in Romanticism and naturalism. The Europe of that time, which regarded strolling quietly through the woods as an essential part of life, is clearly evident not only in literature and art but also in the history of medical philosophy. Even now in Britain, the way most ordinary people lift their spirits with their families is by going out into nature. Even if not camping, in virtually any town in Britain there are countless places within an hour’s reach where one can walk freely through forested natural surroundings.

Now, living amid Seoul’s fine-dust-filled air, I miss the cold, dry, refreshing air that Scots used to call “crisp air” when I was studying abroad. But people become far too easily accustomed to the air of the place where they live. After returning to Seoul, the urban landscape I could not help but face was that of office workers commuting in their own cars through acrid air. The roads were absurdly wide, like airport runways, and pedestrians, of all things, seemed to matter to no one in this automobile kingdom called Seoul. I do not even ask for Europe, that pedestrian paradise where it is common to see people jaywalking without much hesitation. Even compared with Tokyo, Japan, where people observe traffic signals much as we do, waiting times at pedestrian lights in Seoul are nearly twice as long, and Korean roads and intersections are bleak places where cars refuse to slow down even when pedestrians are plainly visible.

In practice, people in Korea live cut off from the air outside their cars and outside their windows. Naturally, they have no room to care about the mere existence of street pedestrians, much less the air those pedestrians breathe. Fine dust has worsened year after year, yet the number of cars and the width of roads keep growing, and the urban environment continues moving in a direction in which it cannot possibly become healthy, while people go on staring only at their blood sugar levels and calorie intake. Korea’s increasingly populist political reality also makes it hard to expect the political leadership needed to resolve this situation. I wonder whether those who support higher taxes on the wealthy and call for social justice would in fact support raising the fuel taxes, road taxes, or automobile taxes on the cars they themselves drive. The green paint spread across the rooftops of Seoul’s many villa buildings ironically reflects all too vividly the anti-natural way of life of Seoul residents, who are steadily drifting farther away from actual greenery.

Seen from this perspective, the policy of mandatory mask-wearing in the name of the coronavirus gives me much to think about. In particular, the guidance repeated over speakers everywhere on the streets and every time one boards the subway this year—stressing that one must wear a mask covering “the mouth and nose completely”—makes me furrow my brow deeply every time I hear it. If one searches Google for the keyword “compulsory mask wearing,” among the items on the first page is an article contributed last month to the Times of India by an emeritus professor of public health at the Australian National University

(https://timesofindia.indiatimes.com/blogs/toi-edit-page/compulsory-worry-to-wear-or-not-to-wear-masks-that-is-the-life-and-death-question

). It contains many sharply critical points that stand in contrast to Korea’s disease-control guidelines, which have taken on an ever more collectivist character. Fundamentally, and quite obviously, it points out that policies mandating mask-wearing remain a controversial subject in public health, and it presents as evidence the fact that most actual infections occurred in cases where people spent a certain amount of time indoors with an infected person, whether or not they were wearing masks. In other words, it says that rather than relying on masks, opening windows and ventilating the air around oneself may be more effective. It also notes, as many other papers do, that the benefit of wearing masks lies not so much in protecting the wearer himself from infection (except in very high-risk groups), but generally in preventing droplets from reaching a nearby person when one speaks or coughs.

It especially points out that covering the nose with a mask can actually have the effect of trapping the virus for a long time in the narrow space between the nose and the mask, rather than preventing it—a conclusion that follows naturally from common sense. I, too, remember that during my internship in the past, whenever I entered an operating room, I diligently followed the strict instructions for wearing a mask and the manual requiring immediate disposal as soon as I left the operating room. But for ordinary people to wear masks every day, indeed almost every hour, while believing that the masks they wear will somehow play an antibacterial role in their breathing is a belief detached from reality.

To begin with, the very purpose of covering even the nose with a mask—as if aiming for sterile respiration—is in fact close to a superstitious belief. Unless the masks worn by ordinary people are connected to oxygen tanks like an astronaut’s helmet, the oxygen they inhale must ultimately depend on the outside air beyond the mask. The pressure exerted by the muscles of the human nose during inhalation naturally becomes greater when wearing a mask, and the bodily energy required for this correspondingly increases; at the same time, one must also consider the unpredictable long-term changes in the body brought about by such stress. In other words, the effect of mask-wearing in preventing infection among mask wearers, based on the simplistic logic that it will lower the concentration of virus inhaled through the nose from the surrounding air, cannot be used as a basis for mandatory guidelines unless it is verified according to standards of medical rationality that include broader variables.

That is to say, I can accept that covering the mouth with a mask in crowded, enclosed places may be an effective public health measure, but the significance of wearing a mask should remain, at most, a matter of consideration for others, and it cannot be forced upon people for the preventive-medical purpose of protecting the wearer as an individual from infection. I am not asking for the luxury of Romanticism or naturalism. I am merely pointing out that living all day in a mask imposes a strain on health, as it is like continually breathing the air inside an unventilated sealed box—that is, air increasingly filled over time with all manner of waste matter discharged from the body.

“Social distancing” is loudly proclaimed, but in Korean society—where people were never particularly considerate of others when coughing to begin with, where there is little awareness of the concept of personal space, and where even the basic etiquette of waiting at a distance when standing in line or paying for things is absent—a policy of masks covering even the nose is, to borrow an analogy from dentistry, as foolish as brushing one’s teeth without using floss or an interdental brush, then gargling a few times with mouthwash and deciding that oral hygiene has now been achieved because one feels refreshed.

This is related, from the outset, to society’s indifference in Korea to the very air that citizens breathe and live in. In other words, the right to enjoy blue skies and clean air does not even enter the picture compared with the collective responsibility of society as a whole to prepare for coronavirus infection. But if the goal of protecting the immunocompromised were truly so important in such pure terms, then why did this government show no sign of taking responsibility for the dozens of individuals who died after receiving influenza vaccinations? Like those who died of COVID-19, they too would presumably have been people whose immune systems had some problem.

At a time when all of society is effectively declaring war on microorganisms for the sake of the immunocompromised—and fighting by pouring antibacterial disinfectants over every reachable surface—how are we to understand this double standard? Are they saying that because those deaths followed a voluntary choice to be vaccinated, it is a matter of personal responsibility? Then why, when I say that I too will fight the virus in my own way so long as I do not harm others—in other words, that I will cover my mouth with a mask but cannot cover my nose—do they refuse to recognize that position and instead seek to impose fines? Is this hypocrisy, or is it illogic?

Every policy has an intended purpose, but it also entails attendant costs. These costs include not only visible economic costs, but also social costs that cannot easily be quantified and into which individuals’ values inevitably enter. Many policies under governments oriented toward collectivist values often tend to ignore the latter aspect far too much. To be clear, I too agree that there is a need to cover the mouth with a mask, but a policy that obligatorily requires covering the nose with a mask also has ample room, even from the standpoint of constitutional principles, to seriously infringe on individuals’ right to health. How are we to accept a government that appears to have not the slightest interest in making the air I breathe cleaner, yet without rational grounds interferes with and obstructs even the fundamental right of an individual to inhale air through the nose? Why is Korean society silent about this? And how am I supposed to view such a society? Does everyone simply think that since even countries like France do it, we too should shut up and follow along?

Bae Min, history teacher at Soongeui Girls’ High School

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Original title: 공기와 마스크 그리고 개인주의

Author: Bae-min

Date: 2020-11-19

Source: https://www.cfe.org/bbs/bbsDetail.php?cid=free_opinion&pn=13&idx=23247