Though the government has adopted a 'no mask, no service policy' to contain the raging coronavirus, many people still refuse to put on the essential facial covering.

Why are people so reluctant about masks? Experts think right communication strategy, community engagement approach and enforcement of law can help implement the policy.

As masks have been the key safety gear to reduce the coronavirus infection, they said the government should make people understand the importance of masking through an effective campaign and disseminating the right information.

According to them, the government also should give people masks free of cost in addition to ensuring quality and appropriate masks for them as low-quality and substandard ones have flooded the market for lack of monitoring.

In November, the government issued a circular to strictly implement its 'no mask, no service policy', but it still remains only on paper.

Why this public apathy?

Talking to UNB, Dr Be-Nazir Ahmed, former director (disease control) of the DGHS, said many people hardly feel the urgency of wearing masks as they have got an impression from "various activities of the government that corona infection is now not a serious matter."

He said the government has repeatedly been saying it has succeeded in tackling coronavirus. "Such a statement creates a public perception that the virus has been controlled and inspires them to take the issue lightly."

The government has also stopped briefing on coronavirus which also sent out a negative message among people about the corona situation, the expert said.

Besides, he said, now there is apparently no restriction on public gatherings once the offices and business and transport services reopened.

"Thousands of people gathered at different parts of the country, including the National Mausoleum, to celebrate the Victory Day on Wednesday. Such gatherings without any restrictions encourage people to think corona is no longer a serious problem, the expert observed.

Dr Be-Nazir said it is also the fact that the coronavirus fatality rate is very low in Bangladesh compared to many badly affected countries. "Most people, except elderly and those who have an underlying health conditions, are recovering fast in the country. So, people's fear of the virus is also decreasing."

The expert said many people argue that wearing masks for a long time is uncomfortable as it irritates the skin and makes breathing difficult, causes oxygen deficiency or Carbon dioxide intoxication and some other problems. "Most of the problems people talk about wearing masks are more psychological than reality," he added.

How to change the attitude?

Dr Be-nazir said many people do not wear masks as they cannot afford to buy it regularly. "People can make masks at home and use those after cleaning, but they don't know this information."

"So, there's a communication gap. The government should take a behavioural-change communication strategy to create a positive attitude among people towards wearing masks by giving them the right information," the public health expert said.

Dr Be-Nazir said the government can also promote masking by distributing the essential safety gear among people free of cost.

"As we've a big RMG industry, the government can ask the BGMEA to provide 85 crore pieces of cloth-made masks as part of their Corporate Social Responsibility (CSR). I think it's not a big deal for the garment factory owners," he observed.

The expert said the government can provide each of 17 crore people with five masks. "It'll have a huge impact. When the government gives people the mask, it'll motivate them in a greater way."

Which masks people should wear?

Muzaherul Huq, former regional adviser of the World Health Organisation (WHO), said, "We need to give people the right message at the right time. But we've been failing to do that from the very beginning of the corona pandemic. When we're supposed to enforce lockdown, we announced general holidays letting people move here and there and even gather at the sea beach," he said.

The health expert said the government has adopted the "no mask no service policy" but it has no communication strategy to implement it. "The government is asking people to wear masks. But it's not saying which masks people should wear."

He said cloth-made double or triple-layer masks is the appropriate mask for people and they can make it at home instead of buying surgical and N-95 ones.

Dr Muzaher said low-quality surgical masks are now available everywhere, but those are inappropriate ones for people. "The government should not allow selling this type of low-quality masks. There should be a strong market monitoring mechanism to prevent the production and sale of the substandard masks."

President of Swadhinata Chikitsak Parishad Dr Iqbal Arsenal said common people should not use very thick N-95 or equivalent masks and even the surgical one since they are not at high risk as doctors and nurses are. "General people should use cloth-made masks."

He suggested people make masks with clothes at home and use those. "This type of mask is very suitable for common people as they can wash those regularly. It also can check the waste of money. Such masks also can be disposed of easily."

Iqbal said as there are many asymptomatic corona patients, masks can protect people from getting infected by such patients. "It also helps the infected people refrain from spreading the virus."

Law enforcement needed

Dr Muzaherul Huq said the government has made masking mandatory and it is occasionally penalising people for not using the safety gear under the Communicable Diseases (Prevention, Control and Eradication) Act, 2018. "The government needs to strictly enforce this law by deploying police in every area of the capital instead of sporadically conducting mobile courts."

He said when people are showing apathy to the government's repeated calls to wear masks, there is now no alternative to strictly enforcing the law to force them to abide by it.

Besides, he said, community engagement is now very important to convince people to wear the mask and follow the health safety rules. "The government should give the responsibility to the city and municipality mayors, ward councillors and Union Parishad chairmen and members for ensuring the cent percent masking across the country.

He said WHO has also a recommendation to engage people in the efforts to tackle the coronavirus. "The government's efforts to control coronavirus is getting weaker mainly for lack of people's involvement in it."