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How to react when you see someone not wearing a mask?

As the number of COVID-19 cases is rising all over thee world, we find ourselves once again having a societal reckoning over the need to wear protective mask.

It’s clear that the COVID-19 pandemic isn’t going anywhere anytime soon. So, why is there still a sizable segment of the U.S. population that either refuses to wear masks or treats the idea of practicing effective COVID-19 prevention methods as unnecessary?

For most of this year, public health experts have been strategizing about what might make more people in the United States accept mask wearing, from changes in government oversight to better media messaging.

Given how politicized wearing masks has become in this country, what happens if you’re wearing a mask and find yourself in a supermarket or store, standing next to someone who refuses to do the same?

Do you say something? Do you potentially engage in a public dispute? Do you move to a different location for your own safety?

It’s a complicated position to be in, experts say.

Anna Van Meter, PhD, an assistant professor at the Institute of Behavioral Science at Feinstein Institutes for Medical Research and an assistant professor at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in East Garden City, New York, said this is a difficult place for someone to find themselves.

If you’ve been adhering to all public health recommendations out of concerns for your own health and that of others, if you’ve been doing all you can to wear a mask, it can “feel threatening when other people aren’t wearing masks,” she said.

“There’s sort of two different types of negative emotions that can occur in those types of situations, and I think that particular feeling around that sort of threat can make people feel stressed. It can sort of elevate their ‘fight or flight response’ that can develop where conflict arises,” Van Meter said.

She said we’ve all seen the news reports about people getting into actual fights and physical altercations over mask wearing in public.

Oftentimes, it starts when someone with a mask approaches another who isn’t wearing one. Or it can happen when others mock or intimidate those who are wearing a mask.

“I think in those situations in public, it’s probably not productive to try to change other people’s mask-wearing behavior,” Van Meter said. “It’s also going to be easier to change our own behavior than to change somebody else’s behavior.”

She said that if you feel threatened or disrespected by another person in a public space, moving away from them might be the easiest short-term solution.

That being said, there’s a way to approach someone without escalating a potential conflict.

For instance, if you see someone wearing a mask under their nose, Van Meter said you could always approach the situation politely by going up to them and, in a helpful way, say something like, “Hey, I noticed your nose isn’t covered. You might not be aware it isn’t fully covering your face.”

“Trying to be helpful or offering a suggestion politely is a more positive response than getting confrontational about it,” she added.

“I think as a stranger who encounters someone in a public place, it’s probably hard to convey a different message to them, or to convince them on the spot that wearing masks is important,” Van Meter said.

“I think if you have someone in your life who doesn’t wear masks or thinks it isn’t important, in those cases you can work from your relationship with them or try to impact their behavior,” she said.

Van Meter said it’s often better to try to understand someone’s point of view rather than make assumptions about how they value others and define those behaviors as being “ignorant.”

If someone you know doesn’t wear a mask, you could ask them, “I see you don’t often wear a mask. I’m curious about that — why?”

Having a conversation, rather than a confrontation or an interrogation, could be a better way of reaching a loved one or friend.

Beyond this, Van Meter added that emphasizing the “social good” of wearing masks can be a good way to reach out to someone.

If someone isn’t concerned about the new coronavirus as others — perhaps they already had an infection months ago, or are in an age group where they feel less susceptible to significant health consequences — it could be helpful to say that wearing a mask is a way to protect those who are more vulnerable.

“You could say, ‘We never know who we will encounter when we go out. Could be an elderly person, or could be someone with a compromised immune system,’” Van Meter said.

Jerry M. Suls, PhD, MA, a health and social psychologist and professor at the Institute of Health Innovations & Outcomes Research at Feinstein Institutes for Medical Research, told Healthline that there are several reasons some people are resistant to the idea of protective masks.

For one, some people just find them uncomfortable. They’re supposed to be worn over the nose and mouth, which some people find difficult to make part of a normal, habitual routine.

Additionally, he said that until it becomes a clear habit, wearing a mask “demands you to engage with your vulnerability, and that’s a scary thing for people.”

“It also applies to the vulnerability of people around you as well. It requires you to signal that ‘I’m vulnerable to something that can harm me and harm people potentially close to me.’ That vulnerability is somewhat scary,” Suls said.

If you’re able to make mask wearing an almost automatic, rote behavior — go outside, put on a mask — then that sense of vulnerability, of overanalyzing the reasons behind wearing one, dissipates.

The third reason is cultural, Suls said.

“Certainly in the United States, it has taken on cultural and political overtones. Wearing [a mask] and not wearing one can indirectly convey political views about you to other people. It may signify — intentionally or not — what your worldview is,” Suls said.

As a result, something meant to just be a protective health device has acquired this politically charged meaning.

Suls stressed that the group of people who are actively against mask wearing, who seemingly take pride in disparaging the need to engage in public health behaviors that will protect others, are a minority.

“That being said, sometimes minorities can become very visible because they are a minority, because you notice them more,” he said. “Right now, in this country with these cultural and political overtones surrounding masks, it becomes difficult.”

“People routinely wear masks over their nose and mouth in various countries in Asia, particularly ones with high population density, so there are cultures where it doesn’t have that overtone that it certainly does now in the United States,” Suls said.

Of course, there’s no secret where the politicization of wearing masks comes from.

Early in the pandemic, President Donald Trump openly disparaged and mocked the protective health practice.

Eventually, in the midst of this year’s presidential election, Trump himself contracted the coronavirus.

Megan Ranney, MPH, FACEP, associate professor of emergency medicine at Rhode Island Hospital/Alpert Medical School of Brown University, and a director and assistant dean of the Brown Institute for Translational Sciences, told Healthline that, overall, mask wearing adherence is up now in the United States than it was earlier in the year.

That being said, it’s an ever-divisive issue.

Anecdotally, Ranney, a practicing emergency room physician, health policy researcher, and a founding partner of GetUsPPE.org, said she’s seen increased compliance of mask wearing in public spaces but less so in private settings.

“We see compliance in public places like grocery stores, schools, workplaces. Folks are more likely to be wearing them particularly in states with mask mandates. But then, even in states with supposed mask mandates, only 50 percent are wearing them when with folks outside of [their] household, with friends and family. There’s a tendency even among those who see the value of masks that, ‘Oh, this interaction doesn’t count,’” Ranney added.

She said there’s a strange disconnect between people sensing the need to wear masks in public spaces but then having a false sense of security and taking them off while at a backyard barbecue, Halloween party, or wedding.

“We train our kids to put a seat belt on whenever they go in the car. It’s second nature. We are not there when it comes to wearing masks,” Ranney said.

Ranney said there are a variety of public health strategies that could motivate a cultural, behavioral shift at large among the U.S. public.

She said you first have to make it “a norm.” That involves getting celebrities, politicians, and other public figures to wear masks when out in public — to make it a “performative, cool thing to do.”

Again, she cited the seat belt example as well as campaigns against smoking cigarettes that helped change the public’s perceptions around different health behaviors.

Ranney said another part involves “American ingenuity.” For instance, if you wear glasses, it isn’t very comfortable wearing a mask. It can fog up your glasses and feel uncomfortable.

“It involves engaging local makers to develop better masks, develop design of cloth masks that can be fashion statements, that can appeal to people, that don’t fog up when you put on a pair of glasses or sunglasses, to be comfortable,” she explained.

Separate from this, there needs to be more of a positive, public reinforcement of what the clear consequences are of wearing masks, how it keeps your family and community safe — as well as yourself.

“Unfortunately, a segment of the population is not going to do the right thing. That’s when policy comes in, but policy only works if it’s enforced,” she said.

Of course, there’s debate and confusion over how best to go about this.

As part of his COVID-19 response plan, President-elect Joe Biden has emphasized the need for a nationwide mask mandate. The problem is, that involves a lot of trust in the public, which varies widely state by state.

Going back to the seat belt comparison, having a police officer pull people over and deliver a fine has proven successful in getting people to take wearing seat belts more seriously. It also brings with it peril.

“I hesitate around the enforcement issue because we know that, statistically, Black and brown communities, which are already impacted disproportionately by the pandemic, are most targeted by these kinds of measures. You don’t want ‘being Black’ becoming a reason why people are being more [targeted] than others for not wearing masks,” Ranney stressed.

“These kinds of measures have to be done with great caution and cultural sensitivity,” she said.

Suls said that the best way to get people to change a behavior like this one is always “the million-dollar question” for behavioral science and public health.

He said it didn’t help that there was early confusion in the messaging delivered to the public.

Some mixed communications over who was and wasn’t supposed to wear masks in the early days of the pandemic muddied later efforts to encourage the need to adopt this behavior.

“I’m certainly hopeful. I do think it is going to improve over time if the messaging from top public health officials and private officials can become more homogeneous, more in the direction of promoting this as [a] way to avoid danger for oneself and others — that will make a difference,” Suls said.

“I think it’s important for people to see important figures wear masks. I think some important figures who get all our media attention and don’t wear masks serve as the wrong model for behavior, and I suspect that will become less indicative of a political stance over time,” he said.

Ranney said we need to move beyond this as a “liberal versus conservative issue.”

She said if current leaders in the Republican Party and conservative media came out in support of mask wearing, it would make a huge difference.

When asked whether the cat was out of the bag, whether it was too late to change minds, Ranney emphatically said “absolutely not.”

“We’re not asking people to dramatically shift their entire lifestyle. We’re just asking to wear a mask when out of the house and with people not in our direct households,” Ranney said.

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