Surgical mask culture and fashion in Taiwan

photos from Designer Base and Wired.com

 In Taiwan, as well as many Asian countries, it is common to see people wearing surgical masks on public transportation, at work, in stores, and walking around the city. These face masks come in different colors, shapes, and have unique designs (pandas, stripes, animal print, etc), and the ever ubiquitous Hello Kitty! There are even designer lines featured. People wear masks if they have even the slightest cold or to protect them from other people's germs. Also, with a shocking 83:100 ratio of motor scooters to people, scooter drivers also wear these masks to guard against the dust and heavy pollution in traffic. I'd like to think that this surgical mask culture is embedded in a relational and collectivistic

Nicki Minaj

way of thinking and a deep concern for others' well-being and health. There is also the social stigma and shame of being caught with a sneeze without a mask on! Who knows? Maybe this practice will catch on in the U.S. now that Nicki Minaj wore a trendy and colorful surgical mask at the MTV Video Music Awards. In the meantime, I am still trying to figure out my own surgical mask alter-ego.

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I also wanted to share this insightful perspective I received from Abraham (Nick) Morse, MD, MBA (Twitter handle "urogynMD")
 "I admire the community spirit and societal commitment that characterizes many Asian cultures.  Sometimes, I wish we had more of that here in the old USA.  However, it is important not to overestimate the actual infection control benefit of wearing surgical masks.  
If these masks tend to be single-layer textile (as opposed to the hospital standard which is three-layers with a moisture barrier in the middle) then they probably do relatively little to reduce "outbound" risk of infection and probably do nothing to reduce "inbound" risk.   The problem is that once the mask gets saturated with moisture, the evidence suggests that it does little to reduce the production of microdroplets from sneezing or coughing.  Even with the mask on, you should probably sneeze and cough into the crook of your elbow.  Also, once saturated, it can capture airborn microdroplets produced by others.  From the pics you posted Christine, it looks like some folks may be wearing more effective masks underneath the more fashionable cover - that does probably help considerably.
Interestingly, a recent Cochrane Review (a very respected unbiased eveidence-based medicine organization) about the effectiveness of surgical masks in reducing patient infections in the operating room concluded "Face masks are thought to reduce the number of postoperative wound infections. Incorrectly worn masks may increase the contamination of the wound. This review of trials found no clear evidence that wearing disposable face masks increases or reduces the number of surgical wound infections in clean surgery".  So, even in the operating room, there is a big component of ritual involved."