The Face Mask at the Intersection of Preventive Science, Domestic Politics, and International Diplomacy: A Historical Perspective.

Abstract

Background: The face mask has been used to protect against airborne diseases throughout history. We conducted a historical review of the literature on the origin of the face mask, the scientific evidence of its benefits, and its implications for domestic and international politics. Material and Methods: We performed a comprehensive search for peer- and nonpeer- reviewed literature published between 1905 and 2020. Results: Face mask wearing in hospital settings to prevent disease transmission from health care workers to their patients originates with the first use of the mask in surgery in 1897 by German surgeon Johann von Mikulicz. During the first half of the 20th century, various scientific investigators focused on determining the most effective type of medical mask. The role of the face mask in the general population as a preventive intervention during public health emergencies is supported by historical reports spanning from the European Bubonic Plague in 1619, to the Great Manchurian Plague of 1910-1911, the influenza pandemic of 1918, and the current coronavirus disease in 2019 (COVID-19) pandemic. Although the face mask has helped against airborne disease transmission, its benefits during pandemics have been filtered through the prism of political leanings and geopolitical interests. Conclusions: Our review suggests that while face mask alone cannot stop pandemics, in conjunction with other nonpharmacologic interventions it can be useful in mitigating them. When cooperation rather than division becomes the norm in the global response to pandemics, the face mask can then unite rather than divide us.