What do world leaders really mean by refusing to wear face masks?
Wearing a face mask communicates values beyond belief in medical advice. It carries political, economic and social resonance, especially when leaders do it - or don't.

By Dr Claudia Pagliari, a psychologist and eHealth expert from the Usher Institute
Published 17 June 2020
In the midst of a global pandemic, where the disease can be spread through coughing or sneezing, covering your mouth and nose in public might seem like an obvious thing to do. Yet, whether it’s on a trip to the supermarket or giving an address to the nation, wearing a mask has become much more than a way to hold back the virus. Depending on which part of the world you live in, it may be interpreted as a political, social, economic or moral gesture.
World leaders’ willingness to wear face masks in public is particularly significant, since it has potential to influence the attitudes, beliefs and behaviour of millions of people. Like a facial tick during a game of poker, it may also say a lot about their personality and leadership style.
Choosing not to wear a mask
When a president or prime minister chooses not to wear a mask in public, it can convey various messages. For example:
“This disease doesn’t pose a serious threat to health”
- This could be grounded in “the science” available at the time; for example, it was initially thought that most people would only experience mild symptoms from Covid-19.
- Given the devastating impacts experienced since then, the risks of conveying this message have been hugely magnified.
“I do not think masks are useful”
- Many governments have advised against mask wearing by non-symptomatic people, so leaders may simply be following this.
- Or it may signal a personal belief. The US Centres for Disease Control was one of the first Western health agencies to recommend that citizens use face coverings in public, but the US President has stated that while this is okay he has no intention of doing so himself.
“I am not personally at risk”
- Leaders may believe their social or economic position will somehow shield them. In a Covid-19 press briefing the UK Prime Minister famously declared that he was still visiting hospitals and shaking hands, just before being struck down with the illness himself.
- Ego and machismo can add to this illusion of invulnerability. Brazil’s President appears to have made it a matter of pride to forego safety precautions in public.
“This country is open for business”
- Leaders may fear losing out to their global competitors if their country appears weakened.
- Or they may be more concerned about effects on the economy than on public health.
“I sympathise with political groups that oppose mask wearing”
- This may reflect pressure from business leaders or a desire to appease potential voters who oppose mask wearing on ideological grounds.

Choosing to wear a mask
Conversely, by wearing a mask during an outbreak, world leaders may hope to communicate that they are responsible citizens, that the disease is serious and that masks offer protection. Or they may simply wish to be seen to be doing ’something’, to give people confidence in a time of high uncertainty and anxiety.
Whatever the motivation is, world leaders’ behaviour sets an example for others to follow and sends broader messages about respect for public health.
Evidence and availability
The main reasons behind governments’ advice on mask wearing are evidence and availability.
Although there are scientifically logical reasons for encouraging mask wearing by the public, scientific evidence to support this isn’t strong, because it's not easily subjected to experiments.
It is also thought that many governments cautioned against mask wearing because of a fear that panic buying would leave vital medical services without them. This has been an obvious risk in the UK, which has faced a supply crisis in Personal Protective Equipment, or PPE.
This doesn’t explain why so many governments held back from advising people to make their own masks, although an increasing number are now doing so. One reason is a fear that they might encourage people to take more risks by giving a false sense of security.
As these examples show, behaviour in a crisis like Covid-19 can have as much to do with beliefs and attitudes as with science and supplies.

The political landscape
Unfortunately, the coronavirus pandemic is taking place alongside a global populist movement, which has brought a generation of political ‘hard men’ into power. This has seen the veneration of the economy over other considerations, negative attitudes towards globalist institutions like the World Health Organization, scepticism over science, and a railing against ‘big government’. Masks have become the latest totem of this movement, as they did during the Spanish Flu of 1919-20, where they were seen by protestors as symbols of heavy-handed state control.
This has been particularly evident in the USA during Covid-19, with examples of armed hardliners storming government buildings to protest against the lockdown and mask-wearers being attacked in the street for supposedly suppressing others' “rights” not to do so.
When politicians also refuse to wear masks, it legitimises some of this behaviour and erodes trust in the institutions recommending them.
Fortunately, the symbolism in masks hasn’t eluded public health officials trying to get the message across to citizens, despite their leaders’ naked visages.

Leaders, of whatever political persuasion, need to understand the impact of their actions and the consequences of prioritising votes over health. Like lives, power only last so long.
On 5 June the World Health Organisation changed its position on face masks, in response to new evidence, and now recommends that they should be worn anywhere that social distancing is difficult. Whether this translates into world leaders’ behaviour remains to be seen.
About the author

Dr Claudia Pagliari is a Senior Lecturer in Primary Care and Informations, and Programme Co-Director of MSc Global eHealth.
Photograph of Trump, Stefani Reynolds/EPA, all other images via Getty Images