The masked identity

Dr. P. Ravi Shankar
IMU Centre for Education
International Medical University
Kuala Lumpur, Malaysia

At the beginning of 2020, as coronavirus disease (COVID-19) spread globally, well-fitting masks were shown to significantly reduce transmission of the virus. Once mostly used by those who wanted to hide their identity for malicious purposes, masks have become an essential part of one’s personal attire in many countries. I find it ironic that once the use of face masks was discouraged and now their use is strongly encouraged and mandated in many countries.

Some countries in East Asia were already using masks during the SARS epidemic and started using them quickly during the current one. In other places masks were previously used outdoors as a protection against air pollution and poor air quality. I am struck by the stark differences in the acceptance and use of face masks globally.

In Malaysia, where I am based, masks are generally widely used both outdoors and indoors. Public compliance is nearly universal though occasional problems are seen with the masks covering the chin rather than the mouth and nose. Lifts, stations, entrances, ATMs, and buses are cleaned rigorously, and the standard operating procedure (SOP) is mostly followed. There are no major protests and nearly everyone agrees these are for the common good.

I regularly watch the news, and I notice that citizens in many western democracies have a more guarded and negative attitude toward face masks. From my interactions with different people, I have learned that mask wearing is also not widely and properly practised in India and in many other South Asian countries. In the West, individual freedom is dominant, and masks may be regarded by some as subverting one’s fundamental rights. In more collectivistic cultures the use of masks is common, and protecting society as a whole takes precedence. In Southeast Asia, the public is generally respectful of authority and the reporting of protests elsewhere has not had a significant impact on public acceptance of mask wearing and other measures to reduce the spread of COVID.

Before 2020 I rarely used a face mask. With increasing cases in February and March last year and the increasingly dire media reports, I carried a set of masks with me while traveling but only used them on a few occasions. At that time, I never expected we would still be wearing masks in December 2021. A mask has become a routine part of my attire and is rarely forgotten. I am fine with a mask most of the time, though wearing one for long periods makes me itch, and I must scratch my face. The ear bands cause pain in my ear lobes after wearing a mask for a long time, and I find it difficult to use a face mask with reading glasses as the air exhaled moves upwards fogging the glasses.
In Malaysia, masks are sold in a variety of places. These can range from chemists, supermarkets, small shops inside malls, and even corner shops. Masks are now very much in demand with widespread acceptance (resignation?) of their use. The health ministry in Malaysia started recommending double masking with a surgical mask inside and cloth one over it early this year as cases were rising. Masks are uncomfortable in hot and humid tropical climates and cause sweat to accumulate underneath.

Many also wear face shields as an added measure of protection. I found wearing this device more claustrophobic when I wore one to fly during the pandemic. A few do wear them, and I am stuck by the resilience and adaptability of humans. We have quickly adapted to face masks and face shields. But we are up against a relentless foe and the latest virus variant Omicron informs us that this will be a long and bloody fight, a fight in which face masks and shields are critical but may not be enough; we may need technology also.

I work at the Center for Education at the International Medical University (IMU) in Kuala where I am involved in faculty development, student evaluations, and educational sessions for both postgraduates and undergraduates. Over the last two years, the university has invested heavily in online systems, and most tasks including teaching can be done online.

Last year our university installed face recognition cameras which also record forehead temperature. I find it remarkable that artificial intelligence can recognize you even if you are wearing a mask. I still struggle to recognize people through their masks. Cameras are now widely used to scan body temperature in a variety of places including big malls, a few offices, train stations and bus stations. There is also a contact tracing app which requires you to scan the quick response (QR) code before you enter. Use of the app is mandatory. Recent updates also enable you to manually check out of a place. I remain committed to the fight against COVID but am also concerned about the security of the information we are providing, and this has also been mentioned by authors in several publications.

We had to learn to adapt quickly to a life where most things are done online, and I strive to be empathic and caring towards learners during online sessions. Currently, I go to the university for a certain number of hours weekly. Clinical teaching-learning and assessment are now being done face-to-face. I also go to the university canteen daily for my meals. For a long time, dining in was not allowed and only takeaway was possible. I must admit face-to-face meetings cause fear and anxiety though we do enjoy the chance to interact physically with our colleagues and friends after a long time. That fear was easing, but now with the omicron variant it may be returning. I do enjoy the chance to have a hot meal in the canteen and other eating places, but I am also aware that when remove our masks to eat in public we become vulnerable.

At the end of 2021 the pandemic continues to wreak havoc, and in northern countries cold weather and spending time indoors have brought about a spike. Asian countries have begun reopening though the Omicron variant is causing concern.

What will the future bring? Can we return to an unmasked future? Or will masks become an established part of our apparel? The emergence of the Omicron variant complicates the picture and reduces my optimism that we can return to an unmasked identity!

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