Prof. Gilles Pialoux: the imminent end of the mask outdoors, liberation or haste?

If there is an object, a symbol, which embodies the imbroglio, sometimes the madness, of this pandemic and which will stand the test of time as such, it is the mask. From the start of the health crisis, it was at the center of all controversies, invading medico-political blooper, from shortage to its uselessness, from its preventive effectiveness to its use deemed “liberticidal”. Mocked by some who wear it ostensibly under the chin. Quota for a time for caregivers. On the TV sets, the masked ones who were counted give way to the unmasked under the subjective pressure of the epidemic warming and the vaccine surge. And as the mask made sense, the philosophers got involved. Can we forget that Bernard Henri Levy, in the middle of the first wave, judged the object “contrary to this ethics of the face”? While others, less publicized, have wandered between the mask as a “new dialectic between what is shown and what is hidden” – even in a certain eroticization – and the mask “vector of solitude and absolute strangeness”. The mask has been all conversation for fifteen months. Until the very recent withdrawal of some 17 million FFP2 masks distributed to caregivers were thus recalled by Public Health France (SPF), “pending the assessment of the possible risk associated with the presence of graphene in these masks and as a precaution “. Heavy additive for conspirators of all stripes.

But the tide is turning. Leaving the shores of a combined prevention (mask + vaccine + screening + distancing), defended among others in this column, and supposed to respond to uncertainties as to vaccine efficacy in times of variants, and to the still uncertain correlation between vaccination and non-transmissibility, the mask is now in the hot seat. Its systematic wearing in public, yet the prevention measure most widely respected by the population (84% of French people say they wear it, according to the latest results of the CoviPrev survey conducted by SPF), is in the crosshairs of the ‘executive. The people, like their President, “are fed up with the mask”. Accentuating a little more in passing the gap which separates political decisions from scientific uncertainty.

Factors of concern

“The perspective in which we all live”, recently indicated Emmanuel Macron, “is that we can gradually remove it in open places. When we walk in the forest, when we walk in a city without bringing together common sense and what we know about the epidemic means that we must be able to fall. This will be done in a differentiated way in the territory “. In some places, like Arcachon, the Biarritz coast, or the city center of Bourges, it is already possible to do without it in the public space. These same municipalities counting on the municipal police officers to ensure the dressing of the face at the slightest regrouping. Until then one would almost feel a surge of common sense.

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Yet there are worrying factors. Starting by reading the recommendations of the American CDC (centers for disease control and prevention), according to which vaccination against COVID-19 exempts from wearing a mask outdoors, except in crowds. A measure to which is added, again in the United States, that vaccinated persons can visit indoors to other vaccinated persons without masks or distancing, as well as to unvaccinated persons “from a single household to low risk of Covid-19 “. They can even “no longer isolate themselves or be tested in the event of exposure to a case of asymptomatic Covid-19” (!).

Incentive for vaccination

The French, of which only 20% (as of June 6) have received two injections, could eventually experience such a “release” outside, under the leadership of the Vaccine Strategy Orientation Council (COSV). The High Council of Public Health should get involved. This libertarian COSV measure should be presented, among other things, as an incentive for vaccination which, let us remember, is experiencing a plateau in the United States as in France, among non-medical nursing staff as well as among those under 50 years of age. But is there a single study in the world that shows that citizens will be vaccinated to have the right to a life in the open air unmasked?

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Another element of concern: do we know what will be the impact of the total abandonment of the mask in public on its wearing in the private sphere, recognized as a high place of transmission? What will happen to the intermediate areas: from the wild straw hut to the popular glacier, from the end of school party to France’s victory in the European Football Cup? Will there be a “Fischer list” of public places considered to be “closed” spaces and according to what criteria? Last question, finally: once the mask is abandoned in the public space what social mark will be attached to those who will continue to wear it? Several diagnoses will then be offered vis-à-vis these masked deconfinement: 1) hypochondriac; 2) unvaccinated; 3) antivax; 4) return from India or South Africa; 5) under 18; or, of more concern, 6) immunocompromised person who failed to respond to three vaccine doses. A new form of discrimination may then emerge, as this health crisis has continued to produce.


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