Well-Being Prevention & Cures

Some Americans refused to wear masks during the 1918 pandemic. Here’s how it worked out.

a person at a protest holds a sign that says "the new symbol of tyranny" with a photograph of a medical face mask
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Story at a glance

  • Public health experts have drawn several parallels between the current coronavirus pandemic and the influenza pandemic in 1918.
  • During both pandemics, public health officials recommended face masks to protect against infection.
  • Face masks are now much more effective than they were in 1918, but some Americans still doubt their efficacy in preventing the spread of disease.

While much of the current coronavirus pandemic is indeed unprecedented, there are some echoes of pandemics past — especially when it comes to the public health campaign to encourage the wearing of face masks.  

In 1918, the issue was framed as one of patriotism, with mandates in certain cities and localities, including San Francisco, and a world war helped propel both the manufacturing of face coverings and a public health awareness campaign. Today, wearing a face mask has also been politicized another way, with protesters calling them “un-American.”


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Both then and now, some Americans refused to wear them — with the most common complaints being that the face coverings were uncomfortable. After World War I ended, some dissenters even formed an “Anti-Mask League,” according to History.com.

“You read routinely about people not wanting to wear them because they’re hot and stuffy,” says Nancy Bristow, a professor at the University of Puget Sound and author, told History. “Some people argue against them because they say that they create fear in the public, and that we want to keep people calm; which I think is really an excuse to critique them because someone doesn’t want to wear them.”’


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But while the rhetoric may sound familiar, the masks themselves were much different and much less effective. Most masks were made out of gauze, mesh and other porous materials, and some accounts even describe people poking holes in them through which to smoke cigarettes. 

One early study recorded that while people used masks outdoors, they removed them when they were socializing or working indoors, concluding that mask ordinances did not decrease the number of cases or deaths. But another study in 1927 found that they were effective when worn by those who were already infected or exposed to infection. 

Since then, public health experts have realized that it is important to make the distinction between wearing a mask yourself, which protects others from being infected by you, and others wearing masks, which protects you from being infected by others. And whether or not wearing face masks played a role, history does show that strict preventative measures are effective in fighting infectious disease. 

“Today we can look back and see that they flattened the curve and the communities that did enforce much stricter regulations and for a longer period of time and began earlier had lower death rates,” Bristow told History. “But they didn’t have that data tabulated yet, so I think in the aftermath it wasn’t as clear that what they had done had been effective.”


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