Why do you often see people from East Asia wearing surgical masks?

It’s not uncommon to spot people wearing surgical masks at airports nowadays.

Within the past decade it has become progressively more common to spot east Asians wearing surgical masks in public. In western countries the use of surgical masks by health professionals are primarily intended to safeguard their patients. In contrast, the use of masks by people from east Asian countries are intended to safeguard the wearers against environmental germs. The question in the mind of many is why we see this widespread phenomenon among this subset of peoples?

Some of us may vividly recall the worldwide panic in 1997 caused by the so-called “highly pathogenic avian influenza (HPAI)” or Avian H5N1, and the mask-wearing phenomena appears to have stemmed from this pandemic. That virus was originally detected in Hong Kong. Then came along SARS, and now, all the media headlines are consumed by the novel coronavirus.  The common denominating attribute of these three viral pandemics is that they began in China. Do you think that the latter facts are sufficient to explain the widespread use of masks by the east Asian population? Or was the use of the facial mask a common trend in east Asia, and we only learned about it after 1997?

The cover of February edition of The Economist magazine quite nicely and humorously depicts the contents of this blog

So, here is our weekly challenge question:

The use of surgical masks in public settings is very common among the east Asian population. Which of the following reasons most closely explains this widespread phenomenon?

A.     Higher genetic predisposition for airborne diseases

B.     Higher rates of zoonotic (animal to human) diseases

C.     Higher number of people living per square miles

D.     Mandatory governmental requirements for wearing surgical masks

E.      Widespread beliefs in Taoism principles

F.      Societal predisposition for anonymity to avoid governmental persecutions

G.     Masking facial expressions to facilitate socializing with others

H.     It is a fashionable trend in Japan and China

Dr. E


Also known as "Dr. Testbuster", Dr. Eftekar (Dr. E) is the founder, head coach and lead lecturer of the medical board training programs at Northwestern Medical Review. A unique attribute of Dr. E is his well-rounded academic background that, in addition to the science of medicine, extends over several other disciplines such as physiology of aging and longevity, philosophy of science and medicine, and integrated kinesiology.

1 Comment


  • Dr. E

    Problem is finally solved! The sudden explosion of COVID-19 pandemic in March 2020 led to rapid eruption of information about the entire coronavirus family, including MERS-CoV, and SARS-CoV. Likewise, COVID, MERS, and SARS are also believed to be endemic to bats but spreading to camels (MERS) and civet cats (SARS), before adapting to the humans. The viciousness of these viruses, and the fact that SARS and COVID-19 both originated in China, supports another hypothesis for the popularity of masks among Chinese people. Now, I strongly believe that the Chinese people, as a result of SARS epidemic that erupted in 2003, must have been ordered by their government to use face-masks. To help you understand better, mandatory use of masks plus social isolation are the top two prophylactic measures for reducing the rate of spread of contagious infections among populations. As a result, since 2003 the Chinese population have become accustomed to the use of the masks. It is noteworthy to mention that most people believe that if they use the masks, they are safeguarded against the virus, which is only slightly true. The main purpose of using masks in public settings is to safeguard others from getting the virus. If the use of masks becomes mandatory by government, then the people themselves will gradually act as watchdogs for enforcing their use. As such, those who don’t use them would be looked upon as being irresponsible, antisocial, or even risking the health of their fellow citizens. I trust that if within the next few weeks, the use of masks becomes mandated by the US government, for years to come we will see Americans wearing them in crowded environments.

    April 1, 2020

    Dr. E Reply

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