ROCHESTER, Minn. — As one of the most personal interventions ever imposed in the name of public health, mandatory masking defies our expectations about people and rules.

Among the law-breaking marauders who marred nonviolent protests this summer with looting and destruction, adherence to local masking orders was widespread.

And it only takes a visit to an outstate convenience store, boating party or big box store to discover that otherwise law-abiding citizens have readily become scofflaws in the face of orders requiring masks when indoors or in-close contact outside.

This disconnect between the mandating of masks and how people follow rules is a conundrum, because studies like those found at the site masks4all.com show that if we are ever going to contain the spread of COVID-19, we will need 100% mask adherence in public places to reduce case counts and rebuild the trust of consumers.

For researchers at Mayo Clinic, that means trying to better understand what exactly masks mean to people -- what specifically causes those who reject masks to question their use. Armed with answers to those questions, health officials might then be able to craft the right messages, to address the real concerns, for the specific subset of the population that now rejects masks.

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"I think a lot of people think that it should be a personal choice and you can't make me," said Pamela Sinicrope of the Mayo Clinic Behavioral Health Research Program. "Other people have to figure how to get a mask, what kind of mask to get, how to wear it. And then there's this thing with masks that you're wearing a mask to protect other people, not yourself. That's kind of a complicated idea."

(Although new research from UC San Francisco shows that wearing a mask can reduce the wearer's severity of COVID-19 as well.)

Sinicrope is co-investigator for a large, anonymous survey now underway within Mayo to tease apart the willingness to wear masks in southeastern Minnesota. The survey examines the motivators and barriers to wearing masks, as well as any gender, ethnicity, age or other characteristics that predict mask discomfort -- including where people get their information about health and prevention.

Do you have a problem wearing a mask?

Thank you for voting!

  • Yes

    28%

  • No

    72%

The brief, multi-lingual survey, which is now being conducted online until the end of August, is open to all adults who live in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice, Steele, Wabasha, and Winona counties.

Among its many intriguing questions, the investigation teases apart if masks make people feel weak, threatening, or a target for police. It probes the very interesting question of whether wearing a mask when others do not makes a person feel embarrassed, or disrespected.

It asks about health and communication fears related to masking, and finally, it explores to what extent a person's views on masking relate to their sense of belonging in their communities. Sinicrope says they have had a huge participation so far, with 7,000 participants and counting.

"We want to be able to identify opportunities in our community to help adopt the behavior of wearing a mask. We want to figure out where the holes in our messages are, whether it's how to access masks, or to clean them, or whatever the issues are, so we can target those through intervention or an educational campaign."

She says one of the primary misunderstandings is that you can skip out on wearing a mask if you are not worried about getting COVID-19 -- much like some motorcyclists believe they can choose to go without a helmet if they are personally willing to risk their own injury.

"It's more like not driving drunk," she says of masking, something that protects everyone else. "Seat belts, lowering of the blood alcohol limit, not being able to smoke while at work, all these other major public health efforts started with people who were resistant when they were new."

"At first these things seem like really big asks," she adds, "but over time, people got more comfortable when they got used to them. I think the mask is like that. The problem is, with this one, we don't have a lot of time."

  • Minnesota Department of Health COVID-19 hotline: 651-201-3920.
  • COVID-19 discrimination hotline: 833-454-0148
  • Minnesota Department of Health COVID-19 website: Coronavirus Disease (COVID-19) website.