How People Needed To Be Convinced To Wear Masks During 1918 Pandemic

As the Spanish flu swept through the US in 1918 and 1919, face masks became ubiquitous to help in preventing the spread of the disease, much as they have today during the coronavirus pandemic.

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However, many refused to wear them in 1918, saying that government-mandated mask enforcement violated their civil liberties. An "Anti-Mask League" was even formed in San Francisco to protest the legislation.

But men, it turns out, needed more convincing than did women to heed the advice of public health officials.

Some men associated masks with femininity, and behaviors like spitting, careless coughing, and otherwise dismissal of hygiene made men the "weak links in hygienic discipline" during the 1918 pandemic, according to a 2010 report published in the US National Library of Medicine. So public health leaders rebranded personal care as a display of patriotism and duty to incentivize men to wear masks.

"The influenza pandemic offered a teaching moment in which masculine resistance to hygiene rules associated with mothers, schoolmarms, and Sunday school teachers could be replaced with a more modern, manly form of public health, steeped in discipline, patriotism, and personal responsibility," reads the report.

It's yet another instance of history rhyming. Fast forward to the present-day coronavirus pandemic and anti-lockdown protests dot the US, with many — men and women — refusing to wear masks and citing their civil liberties as a reason for defying public health orders.

Many of the adverts and public health messaging during the 1918 pandemic encouraging the public to practice good hygiene depicted men and young boys. Here's what some of them looked like.

The Spanish flu of 1918 was one of the worst pandemics in history, eventually killing 50 million people worldwide.

St. Louis, Missouri, October 1918.​

One precaution taken to quell its spread through the US was enforcing mask-wearing, or at least covering the mouth with handkerchiefs to prevent the disease from being transmitted.

A poster distributed by Rennsselaer County Tuberculosis Association in New York in 1918.​

And public health messaging displayed on posters typically showed men and boys.

The Spanish flu outbreak coincided with World War l. Male soldiers returning home from Europe dispersed to their home states and stations, spreading the disease in the process.

A poster distributed by the National Tuberculosis Association in 1918. ​

The male-centric public health advertising could then simply be a reflection of the experience of male soldiers during that period of wartime.

The "unsanitary herding of men" in war settings made for a perfect environment for disease to spread.

Men were also shown in ads calling for an end to spitting, which made it easier for the disease to be transmitted.

United States Shipping Board Emergency Fleet Corporation/Free Library of Philadelphia​

According to the report, the "public health villains blamed for careless coughing, spitting, and sneezing during the influenza pandemic were frequently represented, at least visually, as men behaving badly."

The prevalence of men in the ads also could be that it was considered indecent to depict women performing such natural bodily functions as sneezing, although some public health posters do illustrate women and not men.

But it's also likely that men saw masks as a threat to their masculinity, associating the gauze with passive motherly figures and the like.

A newspaper clip from 1918. ​

Men and boys were also seen as the "weak links in hygienic discipline" during the interwar period of 1918 through the 1930s, according to the report.

A poster distributed by the US Public Health Service in 1918.​

According to the report, some public health leaders felt that the methods of educating "modern men and boys" at the time were too old-fashioned.

So to help persuade members of the male population to do their part in controlling the disease, officials aimed to introduce a "more manly style of health education," usually by encouraging patriotism and engaging in civic duty.

One Oregon newspaper clip reads: "We appeal to your civil patriotism to co-operate with us in our effort to stamp out the Spanish Influenza or "Flu" Plague in Portland by wearing a mask."

A newspaper clip from January 1919. ​

Others were more lighthearted, like a cartoon depicting an interaction between two boys, with one proudly brandishing a "hankachif" made for him by his mother.

A newspaper cartoon from 1918. ​

During the 2020 coronavirus pandemic, the Centers for Disease Control and Prevention recommends the wearing of masks or face coverings.

But what did work in 1918 and 1919 was enforcing and sustaining social distancing measures. That, too, involved everyone doing their part and taking individual accountability.

A 2018 report from market research company Ipsos found that women are more likely than men to consider hygiene habits very important. Studies also show that women are better at hand-washing than men, a relevant feat in the 2020 coronavirus pandemic. Recognizing gender disparities in personal hygiene remains an issue.

"We need to make sure men don't feel too macho to worry about germs," Rosie Frasso, program director of public health at Thomas Jefferson University, told The New York Times in mid-March.

Repackaging health education into man-friendly messaging has become a mainstay into the 21st century.

Personal hygiene products, from body wash to razors, have long been tailored for men and women individually, as The Atlantic reports. Men's scents have overwhelmingly "grassy," "minty," and overall bold-smelling scents, with rugged-looking packaging to match.

Even such basic needs as water have been given "macho" branding that appeals to male consumers. The buzzy canned water startup Liquid Death turned to aggressive punk rock imagery for its eco-friendly tallboy cans of water.

If men did indeed feel as though masks and personal hygiene weren't aligned with their masculinity, it makes sense as to why officials felt the need to adapt public health calls-to-action accordingly.

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