The Lone Ranger in Covid Town

'Human kind cannot bear very much reality'

The Four Quartets, T.S.Elliot

It's been around five years since the Covid-19 pandemic started. Sometimes, I hear people refer to our current time as 'post-Covid'. I don't agree with that. 

As far as I can tell from the scientific papers and data, we are still in a pandemic. And so I still hold Covid-19 mitigations: I mask with FFP3 respirators, I carry a small air purifier, I don't eat in restaurants, and generally I tend to avoid busy indoor places if I can help it. I also use a nose spray and a mouthwash that appear to reduce viral load. Covid-19 is caused by the SARS-CoV-2 virus; it is a highly contagious, airborne virus, that can be suspended for hours in the air like smoke. Handwashing, although a good thing to do for a variety of reasons, is not the most relevant precaution as some suggest. Obviously I vaccinate against Covid-19 whenever possible, but as far as I know the vaccine on its own does not yet protect you from getting Covid-19 or from Long Covid (although it seems to reduce the severity of the acute disease), so the strategy needs to be 'vaccine plus'; the vaccine only as part of a suite of measures. 

Because most people around me seem to consider Covid-19 a thing of the past, I am usually a lone masker everywhere I go. As a Psychologist, how do I explain that? And how can I live that way? 

Being 'Covid-cautious'

The answer is: with great difficulty. I don't enjoy wearing respirators. I really struggle with being the only masker and carrying a very small but annoyingly noisy air purifier, it's simply excruciating at staff meetings. I feel like I have a facial disfigurement. I miss talking to my colleagues and to students without wearing a mask. I miss going to restaurants and coffee shops with friends and family.  

But at the same time, I don't want to be infected by Covid-19, and increase my chances of developing Long Covid, diabetes, heart disease, stroke, dementia and so on. With every additional Covid-19 infection, even if it seems mild, the probability of getting Long Covid is increased, even for those with no prior illnesses. Some consider Covid-19 like a cold or the flu, but this is misleading and minimising. It looks like Covid-19 is a devastating vascular, multisystem, inflammatory disease and can cause serious organ damage even when it is asymptomatic. Some scientists have made comparisons at a viral level with HIV in the 80s, when there was not yet effective anti-virals. (Talking about cold and flu, I must say I have enjoyed not being ill for the last five years; I used to be ill once or twice a year before.)

From where I'm standing, sometimes the world feels roughly divided in two camps: those that want/have to forget about Covid-19, and those that still try to be careful and still wear masks. As a Covid-cautious person, and a Psychologist, I'm interested in the individual differences in attitudes, affect, and cognitive biases that could have something to do with the variability in how people respond to the Covid-19 pandemic. For example, Frangaki and colleagues (2021) showed that individuals high in optimism bias showed lower engagement with Covid-19 mitigations, i.e. engaged in more risky behaviour, than those low in optimism bias; conversely, those participants high in Covid-19-related anxiety and high perceived severity of the situation engaged more with Covid-19-related mitigations. 

Could empathy be of relevance here too? I found a study suggesting that empathy for vulnerable people might be related to higher mask wearing. I think as a society and individuals we should always do our best to protect the most vulnerable. But if I am completely honest – and I'm not proud of this – I am not doing it out of empathy for others. Mainly, I am doing it for selfish reasons. Because I know that it has been established that the virus that causes Covid-19 is a biosafety level 3 pathogen, and it has detrimental effects for everybody, whether they have prior illnesses or not.  

I often worry how other people perceive me as a lone masker. Faces and facial emotions are very important for communicating with each other. So, when a face is altered or covered in some way, that can have negative effects on social acceptance. Bylianto and Chant recently showed that masked faces are judged as less approachable and trustworthy than unmasked faces, and smiling whilst wearing a mask does not increase approachability or trustworthiness. I do wonder, though, whether the participants of this study tended to be individuals high in optimism bias and less Covid-cautious? Perhaps those who are still masking to avoid Covid-19 might have shown different pattern of results?

It is very difficult to do something that goes against 'group wisdom'. People are social animals. We want to be accepted in the group; we don't tend to want to stand out. The classic psychological research on social conformity by Solomon Asch is very relevant here. The results are typically interpreted as showing that people will ignore a blatant falsehood in order to conform to the popular wisdom and pressure. Interestingly, some researchers suggest that Asch's study doesn't only show evidence for social conformity, but also for people's tendency to stand their ground even if it means going against the popular (yet false) wisdom of influential people around them. In terms of Covid-19, I think the blatant falsehoods are ideas such as that the Covid-19 pandemic has finished, that contracting Covid-19 is not that bad for you, that hand-washing is an effective strategy against Covid-19, that getting vaccinated against Covid-19 is enough. 

I also think we have often been presented with a false dichotomy – the idea that we can protect people's health, or the economy, but not both. In fact, there is plenty of evidence that protecting the health of people has positive effects on the economy, and the reverse; a recent report in The Economist highlights the huge cost of Long Covid to the economy. Since there is no known cure for Long Covid and its effects on the economy have been devastating, I think it is important to make sure Covid-19 infections are avoided as much as possible.

However, if masking is too difficult, because other people don't do it, then you might stop doing it too, to maintain your psychological equilibrium. You might even try to avoid thinking about Covid-19 altogether. Avoidance is one of the strategies individuals use to deal with trauma, and the Covid-19 pandemic is definitely a collective trauma. However, research suggest that avoidance is not an ideal way to deal with a trauma, or Covid-19, as repeated Covid-19 infections can lead to cognitive and psychiatric problems too, compounding the problem further.

I often think that if more people masked, then masking would become normalised and more people would conform to wearing a mask. A recent study showed some evidence that social conformity can influence mask wearing; they showed that the higher the proportion of customers wearing respirators correctly, the higher the chance that new customers would also wear respirators correctly. On the other hand, social pressure (number of customers per square meter) seemed to have the opposite relationship, suggesting a problematic free-riding behaviour. Is this behaviour due to the false idea that one-way masking is enough? Or perhaps unmasked customers felt less pressure to mask when hidden among many people? It is difficult to know, as this was an observational study and people were not asked afterwards for reasons why they were masking or not masking. 

Personally, it gives me immense comfort and relief to see other maskers around me – not only because I know two-way masking is much more effective than one-way, but also because it reminds me that there are other people like me in the world that still mask to protect themselves and others from Covid-19 infection. 

So, on one hand, not masking and being infected with Covid-19 can be harmful in so many ways. On the other hand, I know that being a lone masker is difficult, and I suspect it can be psychologically harmful. Lone maskers need psychological and community support to continue masking and reduce the psychological harm involved in going against the grain. Here are my suggestions.

Join Covid-19-related groups

Solomon Asch's research suggests that finding allies helps.

I recently joined an organisation called World Health Network. This organisation was initiated by influential US academics from Nesci (who include one of the most amazing combination of words I have seen: 'compassionate science'), and among other things, it aims to produce up-to-date and valid information about Covid-19, by writing valid scientific articles and other communications about it, such as podcasts, blogs and newsletters. They welcome people using different levels of mitigations, as they recognise that not everyone can take all precautions needed, even if they wanted to. They believe that it is possible to end the pandemic, as long as we follow the science and put proper mitigations in place. 

I have felt very supported in social and working meetings. One of my contributions is to try and use creativity and poetry to enhance a sense of community and give people courage to continue being lone maskers. I think art and creativity can help provide the psychological support that lone maskers need. So, myself and a fellow WHNer created a social event called 'Poetry Jam with Aspa and Pan'.

Here is the contribution of WHN members: 

Covid is insidious.

People are scared.

Don't despair,

I am here.

The recently established psychosocial group also produced a kid's magazine on Covid-19, where they invite children and their parents to send photos of them masking, or Covid-19 related poetry. This is only one example of the wonderful projects that are going on at WHN, and WHN is only one example organisation trying to change the public narrative. 

Furthermore, there was recently a trend on Twitter/X called 'YallMasking', where people that are still masking due to Covid-19, post images of themselves masking and say why they are doing it. Participating in this has given me a sense of community and purpose and it made me feel so much better about being the only masker. There are also various Facebook groups, including 'still coviding in style', 'still-coviding Academia', which are also very helpful. 

Support at work

At some point I considered stopping masking at work, as I was really struggling with it, especially at staff meetings. I was worried that if I continued being the only masker, I would lose my job. But then I reasoned with myself: if I develop Long Covid, I will lose my job anyway and I might not be able to work again anywhere. So I decided to continue masking, although I found it incredibly difficult. 

To my immense surprise and gratitude, my colleagues and my bosses were very encouraging of my masking. When I was apologetic about it, or when I implied that I should not be part of something because I wore a mask and it might have negative effects on a work-related event, they all said: 'You should continue wearing your mask, there is absolutely no problem with it! Thank you so much for helping with x!'. I had come to them with a lot of negative self-talk, and they actively supported me to continue to mask, counteracting the anti-masking bully in my head. 

That is what I call compassionate leadership, and embracing different opinions and practices. The kindness of my bosses and colleagues really moves me and reminds me that people are not divided in two distinct camps of Covid-cautious and non-Covid-cautious people. That's too simplistic. On reflection, am I sometimes more judgemental than I would like to admit, regarding Covid-19 attitudes or other issues? Would I be so kind if it was the other way round? I am not so sure! I don't want to judge individuals that don't wear a mask. I know how difficult it is to be a lone masker, and I understand why most people want to forget about Covid-19. 

People are just trying to do their best in a very difficult situation. There are many things workplaces can do to improve things (for example, buy and use air purifiers), but I think there is a limit to what struggling universities can if they are not supported by governments anyway. (That's a story for a different article.) Given that there are masking bans in some places in the world that have terrible consequences especially on vulnerable people, I am really thankful that I am so supported to mask at work. And what about people that have children, as many of my colleagues do? Some people with children still mask (and so do their children), but it can't be easy. It is not possible for everyone to do that.

My department was nominated by the students and won 'Department of The Year' for three years, and I think the support and inclusion of different opinions and practices of students and staff is reflected on this award. They have certainly taught me how to be more empathetic and compassionate of others with different opinions – a 'contagion of empathy' if you like. Every single one of us, masked or not, has a story that makes them behave in a certain way; let's listen to that story, try to understand, inform and help any way we can. 

I think the fact that I was consistent at work helped the situation. Set clear boundaries and rules, so that others know what to expect; changing back and forth can create confusion, as I found out in a different context. And remember that everyone is struggling with Covid-19 in some way, whether they are masking or not, and it might be partly why you don't always get the support I am lucky to get at my workplace. 

Support from students – Teaching with a respirator

The students have been very supportive too. Teaching for me is communicating, engaging individuals and enthusing them with a certain area of knowledge. I do everything I can to engage all students, as I am aware that the student population is so diverse. I mask with a clear window for my face-to-face teaching, and I expected this to have negative effects on how students perceive me and my teaching. Again, to my surprise, I was nominated for two awards: teacher of the year, and outstanding contribution to student mental health support. Occasionally some students have said they could not hear me with a certain respirator, but I tried different respirators and I used an additional hand-held microphone and it seemed to improve things. Wearing a mask involves a lot of trial and error, and there are different masks for different people and different occasions, as Nina Wildflower, a science teacher (with a background in psychology) has been advocating for some years now. I also always provide extra sessions for any student that asks for them, just to be absolutely sure that no student is affected negatively by my masking. I am always particularly worried about students that might be hard of hearing, but it seems to have worked OK until now.   

As a lecturer, I am responsible for helping students achieve their potential cognitively and emotionally. Knowing that Covid-19 has cognitive and emotional consequences, including on executive function, I cannot bring myself to do something that contradicts my aims as an educator. I also want to model behaviour that is in accordance with valid scientific evidence. Given that I teach students about research methods and cognitive psychology, I feel I need to 'do as I teach'. 

Stay informed; don't die of ignorance

For a couple of years after the start of the pandemic, I just stayed at home, and stopped all unnecessary outings apart from work and seeing my family. But seeing that was not particularly good for me psychologically, I started to consider whether it is possible to live my life as it was, but with some adjustments that helped me socialise in a covid-safe way. To my surprise, the answer is that you can still do many things while being careful around Covid-19. 

Yes, it's very difficult being a Lone Ranger in Covid Town. But many people, including non-maskers, will support you in your decision to mask and include other Covid-19-related mitigations. I completely understand why many people don't wear a respirator, and they have my sympathy, as I struggle myself with it. But I would encourage everyone to employ some mitigations to protect themselves and their loved ones. Even if you have had some Covid-19 infections, it is better not to get more. Let's live by the science we teach as much as possible. Seek out reliable sources of information such as COVID Safety For Schools. (It would be excellent if educational establishments included this as part of health and safety training.) 

For my part, I will continue wishing there was no pandemic, and that I could engage with the world as before. At the same time, I will do everything I can, in my small way, to get us out of the pandemic. There is a personal cost, certainly, but there is also a lot of support. We need collaboration between honest, compassionate and well-informed scientists, leaders, and individuals, if we are to ever end this pandemic. Stay safe and follow the science – better antivirals and vaccines are on the way. We shall overcome – in the meantime, support those Lone Rangers, and try to protect each other.

• Dr Aspa Paltoglou is a Chartered Psychologist, Senior Lecturer in Psychology at Manchester Metropolitan University, and a member of the Psychologist and Digest Editorial Advisory Committee. [email protected]

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