Mandatory Non-Medical Face Coverings for All Essential Employees and Activities
Mandatory Non-Medical Face Coverings for All Essential Employees and Activities
We applaud both Governor Ige and Mayor Caldwell's bold first steps to mitigate the spread of the deadly coronavirus COVID-19. We believe that the mitigation efforts can be further enhanced by the required use of non-medical face coverings.
While the mandatory work-from-home, stay-at-home Emergency Orders are valiant steps, we feel that many within the general population don’t fully comprehend the social responsibility, understand the Orders, or intentionally take advantage of broad interpretations of "essential businesses" being allowed to continue to operate. As a result, significant portions of the population continue to operate business and behave as usual and increase the transmission of COVID-19 putting themselves, their families, and the greater community at risk. Governor David Ige and Dr. Bruce Anderson were both quoted during the March 26, 2020 press conference that the public should “act like [you] have COVID”. The photos of the lines outside of Costco in Iwilei and Waipio that same day are perfect examples of "Essential Activities" continuing to increase the risk of transmission amongst the public. Food preparers have also been shown not wearing face coverings.
As of 3 PM on March 28, 2020 there have been a total of 151 confirmed cases, 12 of which have required hospitalization. Just as alarming are the 4 confirmed cases of community spread. This means the existing measures in place are not enough and the trajectory is soon to take off, with the contagion peaking in weeks, not months. The clock is ticking and the time to take stronger action is NOW.
We need other measures in place to “flatten the curve” and provide our healthcare system the time and resources it needs to avoid overwhelming our hospitals. No other county or state within the U.S. has shown to effectively manage the pandemic. There is great fear that following the same strategies and relying solely upon “stay at home” orders will not work and continuing to do so will cost lives.
Following the lead of countries who have shown success in managing the pandemic, such as Japan, Hong Kong, Singapore and Korea, we would ideally like to increase testing and utilize cell-phone tracking to reduce transmission rates. However, it’s become apparent that our rate of testing will not be sufficient to stay ahead of contagion trajectory. We nevertheless can adopt their social practice of mask wearing to further the effectiveness of flattening the curve.
While there have not been many empirical studies or data to support public mask-wearing to reduce viral transmission, there is a noticeable commonality amongst the most successful countries in combating COVID-19 is the prevalent "mask culture". “The use of face masks has become ubiquitous in China and other Asian countries such as South Korea and Japan. Some provinces and municipalities in China have enforced compulsory face mask policies in public areas,” which we believe has assisted with the success of their respective mitigation efforts. In conjunction with continued hand washing, social distancing, isolation of vulnerable people and other common hygiene best practices, we believe a strategy including non-medical face coverings by the general population will drastically slow the spread of the virus.
Since the start of the coronavirus outbreak some places have fully embraced wearing face masks, and anyone caught without one risks becoming a social pariah. It is seen as a safer practice and more considerate. In mainland China, Hong Kong, Japan, Thailand and Taiwan, the broad assumption is that anyone could be a carrier of the virus, even healthy people. So in the spirit of solidarity, you need to protect others from yourself. Some of these governments are urging everyone to wear a mask, and in some parts of China you could even be arrested and punished for not wearing one.
Some argue that ubiquitous mask wearing, as a very visual reminder of the dangers of the virus, could actually act as a "behavioral nudge" to you and others for overall better personal hygiene. "Putting on a mask every day before you go out is like a ritual, like putting on a uniform, and in ritual behavior you feel you have to live up to what the uniform stands for, which is more hygienic behavior like not touching your face or avoiding crowded places and social distancing," said Donald Low, a behavioral economist and professor at the Hong Kong University of Science and Technology.
But in many other parts of the world, from the UK and the US to Sydney and Singapore, it's still perfectly acceptable to walk around bare-faced. We believe this has directly contributed to the U.S. now being the global leader in the number of confirmed cases with over 100,000, surpassing China. Hawaii has always touted itself as the cultural mixing pot of the world, and mask culture establishing itself in Hawaii is the perfect example of East meeting West. We believe we the times are changing and there will and should be a cultural shift.
The New York Times online website on March 28, 2018 featured an article on hits home page entitled, More Americans Should Probably Wear Masks for Protection. “Masks work by stopping infected droplets spewing from the wearer’s nose or mouth, rather than stopping the acquisition of the virus from others. That is why the W.H.O. and C.D.C. recommend that people already infected with the coronavirus wear masks, to protect others who may have come into close contact with them…surgical masks do protect people a bit more than not wearing masks at all. And when masks are combined with hand hygiene, they help reduce the transmission of infections.”[7,8] When researchers reviewed the SARS outbreak in 2003, they found that washing hands more than 10 times daily was 55 percent effective in stopping virus transmission, while wearing a mask was actually more effective — at about 68 percent. Wearing gloves offered about the same amount of protection as frequent hand-washing, and combining all measures — hand-washing, masks, gloves and a protective gown — increased the intervention effectiveness to 91 percent.
We believe a mandate; amendment to the existing Emergency Order, or a new Emergency Order issued by the Mayor should:
- require every person within Honolulu County (residents and visitors alike) to wear a non-medical grade, canvas or cloth-like face covering in order to leave their home or place of stay for all Essential Activities
- require every Essential Business and its employees, Essential Infrastructure workers, and employees of Essential Government Functions wear a non-medical face covering while at work
This mandate would effectively work under the premise that we assume EVERY PERSON in Honolulu County is an asymptomatic COVID-19 carrier. This "mandated mask culture" will mimic the social norms in other Asian countries, like Japan, whereby sick persons minimize the spread of their illness by containing respiratory droplets within the mask. Responsible citizens aren’t wearing these masks to protect themselves, rather, to protect everyone else around them. Creating this mandated social norm will remind people every day of their societal responsibility, accountability, and forge broader self-awareness of the threat and consequences of everyone’s individual actions.
Under the mandate requiring non-medical face coverings, this practice will:
1. minimize risk of spreading the virus by infected AND asymptomatic people in conjunction with continued hygiene and social distancing best practices,
2. allow essential business to continue to operate without disruption while assisting in the mitigation efforts of the contagion threat,
3. NOT create any additional burden to the economy with the emergency orders already in place, but will instead ENHANCE their effectiveness,
4. create a new social norm, and instill a greater sense of self-awareness, responsibility and accountability,
5. create an outlet for creativity, engagement and activism for many people who have been confined to their homes while practicing self-isolation,
6. create a micro industry for many people and local businesses, to make, manufacture and sew non-medical grade masks and face coverings for the general population with materials and resources here on-island,
7. NOT diminish the supply of desperately needed medical masks for hospitals and healthcare workers, and instead, will enable the release an abundance of excess inventory the general public and non-healthcare private businesses have been stockpiling for private and personal use, which can then be released and donated to the hospitals,
8. enable philanthropic organizations to focus resources on supporting the healthcare system, financial assistance and general community welfare, and
9. be supported by many engaged, informed, and socially responsible citizens of the community, especially the medical community as evidenced by the signatures herewith.
We believe that bold initiatives like these are what make Hawaii unique. It shows what we can do when we come together, and why we are truly one Ohana, and why we will be the first State in America to defeat the coronavirus. We will be an example for the rest of the Nation. Wearing a face covering tells the people around you, “I care about you.” That is Aloha.
 Hawaii Data Collaborative. https://www.hawaiidata.org/covid19
 Financial Times. https://www.ft.com/graphics March 24, 2020
 The Lancelet Respiratory Medicine. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30134-X/fulltext March 20, 2020.
[4,5] BBC News. https://www.bbc.com/news/world-52015486 March 26, 2020.
 CNN. https://www.cnn.com/2020/03/27/health/us-coronavirus-friday/index.html March 27, 2020.
 New York Times. https://www.nytimes.com/2020/03/27/health/us-coronavirus-face-masks.html?action=click&module=Top%20Stories&pgtype=Homepage March 28, 2020.
 Annals of Internal Medicine. https://annals.org/aim/fullarticle/744899/facemasks-hand-hygiene-prevent-influenza-transmission-households-cluster-randomized-trial October 6, 2009
 U.S. National Library of Medicine, National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190272/ November 27, 2007
[10,11] Office of the Mayor of the City & County of Honolulu, Emergency Order No. 2020-02 (COVID-19 [Novel Coronavirus]) Stay at Home / Work from Home Order. March 22, 2020.