Abstract
Background: Face masks or coverings are effective at reducing airborne infection rates, yet pandemic mitigation measures, including wearing face coverings, have been suggested to contribute to reductions in quality of life and poorer mental health. Complaints of inconvenience, discomfort, and other issues have been repeatedly and loudly voiced by critics, and adherence in many nations is not strong enough to suppress viral spread. We wished to see whether wearing face coverings is associated with mental health and wellbeing. Methods: We analysed survey 1 and 2 of the CovidLife study, a sample of more than 18,000 individuals living in the UK. The study asked a variety of questions about participants’ psychological, economic, and social lives while living under the coronavirus disease 2019 (COVID-19) pandemic in 2020. We measured individuals’ adherence to following guidance on wearing face coverings, as well as several mental health outcomes: depression, anxiety, wellbeing, life satisfaction, and loneliness. Results: We found no association between lower adherence to face covering guidelines and poorer mental health. The opposite appears to be true. Even after controlling for behavioural, social, and psychological confounds, including measures of pre-pandemic mental health, individuals who wore face coverings “most of the time” or “always” had better mental health and wellbeing than those who did not. Individuals who wore masks only “some of the time” or “never” tended to be male, lower income, and already had COVID-19 or COVID-19-like symptoms. Conclusions: These results suggest that wearing face coverings more often does not negatively impact mental health. Wearing a face covering more often is actually linked to better mental health and wellbeing. Implications are discussed and we highlight the potential pathways for addressing a lack of face covering that this study reveals.
Highlights
Regulatory bodies and governments around the world recommend wearing face masks, termed ‘face coverings’ by the United Kingdom (UK) government, to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Klompas et al, 2020) because face coverings are an effective low-cost measure for reducing the spread of infectious aerosols and droplets (Fischer et al, 2020)
Individuals who wore masks only “some of the time” or “never” tended to be male, lower income, and already had COVID-19 or COVID-19-like symptoms. These results suggest that wearing face coverings more often does not negatively impact mental health
In Survey 1, participants were categorized as having a mental diagnosis relevant to anxiety or depression if they reported being diagnosed with any of the following: “Anxiety, nerves or generalised anxiety disorder”, “Depression”, “Mania, hypomania, bipolar or manic-depression”, “Panic attacks”, or “Social anxiety or social phobia”
Summary
Regulatory bodies and governments around the world recommend wearing face masks, termed ‘face coverings’ by the United Kingdom (UK) government, to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Klompas et al, 2020) because face coverings are an effective low-cost measure for reducing the spread of infectious aerosols and droplets (Fischer et al, 2020). Many of the most effective measures that reduce coronavirus transmission, such as distancing, have negative impacts on individual wellbeing and mental health at the population level (Qiu et al, 2020; Rossi et al, 2020). Wearing face coverings does not have obvious, direct links to negative experiences such as self-isolation or quarantine (Brooks et al, 2020), but might induce negative experiences through physical discomfort, communication difficulties, or stigmatisation (Czypionka et al, 2020) This been the topic of public and informal debates (Czypionka et al, 2020; Howard et al, 2020), which often do not take evidence into account. We measured individuals’ adherence to following guidance on wearing face coverings, as well as several mental health outcomes: depression, anxiety, wellbeing, life satisfaction, and loneliness. Even after controlling for behavioural, social, and psychological confounds, including measures of pre-pandemic mental health, individuals who wore face coverings “most of the time” or Invited Reviewers version 1
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