People who choose to wear a face mask are not likely to wash their hands less as a result, a new study has found.
The study, published in the journal BMJ Analysis and conducted by researchers at Cambridge University and King’s College London, suggests people do not garner a false sense of security by wearing face masks, and continue to engage in other protective measures like hand-washing amid respiratory virus outbreaks.
The researchers investigated 22 systematic reviews — which explored the impact of wearing masks on the spread of respiratory viruses other than COVID-19, to determine whether people engage in “risk compensation.”
The paper explains risk compensation by saying people have a “target level of risk they are comfortable with and they adjust their behaviour to maintain that risk level.”
The concept suggests people will offset a perceived gain in safety with an increase in risky behaviour elsewhere.
However, researchers said six of the studies found that wearing face masks did not have an adverse effect on hand hygiene.
“Wearing masks did not reduce the frequency of hand washing or hand sanitising in any of the six studies,” the researchers wrote.
In fact, two of the studies concluded that the rate of hand-washing was higher in groups who wore face coverings.
As a result, the researchers said that the idea that face masks will lead to risk compensation should be “laid to rest.”
Colin Furness, an infection control epidemiologist and assistant professor at the University of Toronto, said “cognitive dissonance” can explain why most of the people in the studies who wore masks also reported practicing good hand hygiene.
The theory of cognitive dissonance suggests when a person has two or more contradictory beliefs or values, it can cause psychological distress.
Furness said that means if people are doing one thing that they deem to be important — like wearing a mask or practicing physical distancing — they will likely do other “congruent” things.
“If you’re washing your hands, because you’ve got the right attitude and you’re wearing a mask because you’ve just got the right attitude, then those other behaviours will be concordant,” Furness explained.
“And that’s really what the study was saying.”
However, Furness said that there will always be some people who don’t share that attitude and who won’t comply with the public health measures.
Others, he said, may comply with some but not all of the suggestions from health authorities.
However, Furness said the research suggests there was a higher level of people who were committed to the public health measures than those who were non-compliant.
While the studies the researchers investigated were not COVID-19-related, Dr. Timothy Sly, an epidemiologist and professor emeritus at Ryerson University’s School of Public Health, said he doesn’t expect there is a large amount of risk compensation happening during the novel coronavirus pandemic, either.
“I don’t think you’re going to see a massive decision made — ‘well, you know, I’ll give up there and I’ll start doing that’ as a general daily function,’” he said.
“I don’t think you’re going to see that, at least in Canada.”
Sly said while there are likely some people who are following none, or just a few of the public health guidelines, he expects the majority of people understand that employing multiple protective measures — like washing their hands and wearing a mask — is their best chance not to contract COVID-19.
But Furness said there may be some people who were committed to the protective measures at the beginning of the pandemic who are now experiencing COVID-19 fatigue.
“These are people who really were like-minded, but the wind is out of the sails and compliance starts to fall off,” he said.
According to Furness, this is to be expected because health-related behaviours are “really hard to change,” especially for long periods of time.
Once the initial fear of the pandemic wears off, Furness said it becomes more difficult to get the public to comply with these behaviors.
What public health officials should do now, he said, is point to examples in other jurisdictions where these protective measures have proven to be successful.
“Things are starting to emerge,” he explained. “There are winners and losers — there are winning strategies and losing strategies.
“When you equip people with more than just a message, but a real insight into, ‘oh, this works because we know it’s worked elsewhere,’ and ‘this is dangerous because we know other people’s experience’ people can internalize that.”
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