“The elimination of reusable masks is a questionable historical choice”

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Professor Bruno Strasser, in 2015. Carmen Püntener

In an article co-written with physician and surgical historian Thomas Schlich, and published in the medical journal The Lancet on May 22, biologist and historian of science Bruno Strasser retraces the history, evolution and adaptation of medical masks to the culture of “all-disposable”. For the researcher and his counterpart, they have become, over time, both a symbol of the fragility of modern medicine and of public health.

The Covid-19 pandemic inspired you to do research on masks. Why ?

It was especially the question of the shortage of masks that intrigued us, because we have known for a very long time that the mask is essential in the fight against infectious diseases, that it is cheap and easy to produce. It is therefore surprising that we were caught off guard when the pandemic arrived, with dramatic situations for the nursing staff in many hospitals. Beyond the way we prepared ourselves and the reasons why we did not have larger stocks, we wondered why the mask had become a disposable object of consumption when it was not always it . Until the 1970s, that is to say very recently, medical masks were almost all reusable. They were the subject of extensive research, they were scientifically evaluated, and their development led to models whose performance was considered very satisfactory, often even superior to that of disposable masks. It is this paradox that motivated our research.

What stages have you distinguished in the history of the face protection mask?

The mask appeared in its modern form in the context of surgery in the late XIXe century in present-day Poland when surgeon Johann Mikulicz-Radecki learned from a colleague bacteriologist that the droplets of saliva are full of living microbes. He then started to wear a mask while operating and found that it reduced the number of post-operative infections in his patients.

In itself, the mask was not new. Before Louis Pasteur’s discoveries, in the middle of the XIXe century, it was believed that the contagion was caused by “miasmas” present in the stale air. This is why the doctors of the plague of the XVIIe century wore the famous mask in the shape of a bird’s beak, containing spices and aromatic herbs to neutralize miasma. Until the very end of the XIXe century, there was no firm distinction between masks intended to avoid infections and masks used by firefighters operating in the midst of toxic fumes for example. This is why we find at that time, in France, in the United Kingdom and in the United States, a multitude of patents for the invention of multipurpose masks used simultaneously against toxic fumes, dusts and infections. But it was surgery that invented the “modern” mask, intended exclusively to prevent the transmission of microbes from the mask wearer to the patient.

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