Wednesday , October 5 2022

Flu: because almost nobody uses a mask in France


Influenza can be transmitted mainly in two ways: postilions, coughs and sneezing that contain infected droplets that are likely to spread through the air; and by the hands, just touching an infected person who sneezes or tosses and does not wash it afterwards.

To prevent flu, the National Institute for Health Prevention and Education (Inpes) recommends not coughing or sneezing in your hands, but in a tissue that will be released immediately to the trash. You should wash your hands immediately afterwards. Is there no scarf nearby? Then he coughs on his elbow. Are these rules of good behavior observed, the wear of the mask can effectively contribute to fight against the transmission of the flu virus or any other respiratory infection?

Only for the sick

Practically invisible in the streets, the subway, the open spaces, the mask is part of the recommendations of the Inpes not to transmit the virus to its surroundings. You do not have to wear a mask if it is not affected, it is only used to protect the patient's follow-up air from coughing or sneezing. "The surgical mask does not have" filtering "properties and, therefore, does not prevent the consumer from being potentially contaminated.explains Prof. Fabrice Carrat, influenza specialist, Inserm epidemiologist and head of the public health unit at the Saint-Antoine hospital in Paris.

"In France, it is never advisable to wear a mask to protect yourself from others. The mask is a screen, but only from the patient's point of view. It's possible not to project the drops in which the viruses are."Isabelle Balty, chief of the biological risk division of the National Institute for Research and Security (INRS), is very pleased.

Ministry of Health

The wear of the mask is part of the "barrier measures" against the spread of the virus that appears on the website of the Ministry of Health. But this is just a proposal made to the sick: "In the community, even if the wear of the surgical mask is difficult to achieve (low acceptability, insufficient working time …), however, it should be proposed." It is nevertheless "Recommended in the health setting, for the personnel or visitors in contact with a patient with respiratory and patient infection, in the emergency department, in consultation and when he leaves his room", says the ministry.


The mask requires some knowledge of good practices to be truly effective. "Misuse of a mask may increase the risk of transmission instead of reducing it. If masks are used, they should be combined with other general measures to prevent the transmission of influenza between humans and humans , training on the proper use of masks and the consideration of cultural values ​​and personal », warned the World Health Organization (WHO) in a note published on May 3, 2009 while the influenza pandemic A.

The High Authority of Health (HAS) details the rules for an effective mask that carries: "A surgical mask must permanently cover the nose, mouth and chin. It adjusts to the face with a nose clamp and stays in place with neckties or elastic that pass through the ears. They should have to discard as soon as it is wet or soft, in a garbage, if possible, equipped with a lid and with a plastic bag. Then rinse your hands with soap and water or disinfect with a solution hydroalcoholic. If it is not wet before, the mask must be changed every four hours. Beyond that, it is no longer effective.

An effective gesture?

In its International Health Regulations 2005, reviewed after the H1N1 pandemic, WHO declares that "The benefits of wearing the mask have not been shown, but you can use it if you wish". An absence of results confirmed by the epidemiologist Fabrice Carrat: "No study of my knowledge has shown that the surgical mask has an effect on the reduction of the transmission."

For him, therefore, it is perfectly normal for authorities to not further encourage the use of the mask in case of infection. "The role of public authorities is to promote methods that have proved to be effective. This is not the case with masks", comment According to the epidemiologist, the first rule to be observed, and most importantly, is to have excellent hand hygiene: "With regard to prevention, I think it is much more effective than wearing the surgical mask".

"In Europe or the American continent, we do not see this practice with good eyes, on the contrary."

Isabelle Balty, responsible for the biological risk section of the INRS

However, the use of masks for professionals who work with a fragile audience, such as young children or the elderly, is still a useful gesture for use. "In the case of an epidemic of respiratory infection or, in the case of workers with respiratory infection, the wear of the mask helps to reduce the spread of epidemics, in particular the flu that threatens people more fragile ", points out the authority, which, however, did not develop a specific recommendation on the subject.

In addition to the lack of knowledge about good practices and their moderate effectiveness, the use of the mask often looks bad in French and Western culture. "Low acceptability", write the Ministry of Health on its website. "In Europe or on the American continent, we do not see this practice with good eyes, on the contrary! The wear of the mask in public places is the object of curiosity on the part of those who rub it with her", observes Isabelle Balty. The mask, synonymous with illness, acts like a scarecrow.

Absent in France, omnipresent in Japan

However, it is a country where the mask is an institution: Japan. Karyn Nishimura-Poupée is a journalist for Agence France-Presse (AFP), based in the Japanese archipelago for almost twenty years. "The Japanese wear masks for just over a century. Initially, it was rather that factories were protected from dust and other shortages, but the use has spread over the decades in Medical and hospital practices, then in public places, trains and subways that include "she says.

Tokyo subway | Maya-Anaïs Yataghène through Flickr

In Japan, there are masks available in pharmacies, but also in supermarkets 24/24 and supermarkets. And if you put so much, it's not to protect you from contamination. "People with pollen allergies take full advantage. This is the main reason for the risk of contamination. The different pollens circulating in the spring in Japanese cities are terrible. About 40% of people are affected by pollen reactions. For them, the wear of the mask is an absolute necessity, without a mask, it is unbearable ", continues the journalist.

Karyn Nishimura-Poupée says the mask is not a fashion accessory in Japan, or just for a small part of the population. "The Japanese are not afraid of feeling ridiculous wearing a mask. On the contrary, they will feel more embarrassed if they throw in the transport without using it.", says the author of the sociological essay The japanese.

Why is the wear of the mask so democratized in Japan and completely absent from the French landscape? According to her, "The Japanese are more concerned about the risks for themselves and those who surround them. Using a mask is to respect others and protect themselves. It's about" living together ", courtesy. It is also a matter of" Basic hygiene, such as washing your hands or gargling. Let's learn this in the garden of children.

While these Japanese and Japanese masked us, they themselves questioned the French habits. "In general, it's not surprising that the Japanese ask about the hygiene of the French who bring less baths than the Japanese, perfume, on the other hand, much more, disinfect their hands less with special liquids, fly to tissues that They end up being microbial tissue, etc. They ask why the French do not protect themselves against microbes and viruses, especially in areas of high promiscuity such as the metro. Actually, I just think about them. "

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