The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis

The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis Frederic Keck, Enguerran Macia This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-2096465/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Jul, 2023 Read the published version in BMC Public Health → Version 1 posted 8 You are reading this latest preprint version Abstract The pandemic of Covid-19 has led to reluctance or resistance to wear a mask in countries that made it compulsory. The acceptance to wear a mask against respiratory diseases depends on conceptions of scientific authority and of the personality in the public space. It has material and symbolic dimensions that can be covered under the term “government of masks”. We have questioned populations on these two aspects in territories we call sentinel because they are more exposed than others to emerging infectious diseases: Dakar (Senegal) and Seine-Saint-Denis (France). Our results show that the perception of the state is different in these territories and determines the uses of masks against Covid-19. While in Seine-Saint-Denis, the state provides more masks than in Dakar, the trust in the efficacy of mask wearing is lower. From a symbolic point of view, the mask is for many people an intrusion of the state into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare state to watch over the health of the population. A state that is both more coercive and more protective produces a lower level of adherence to mask-wearing recommendations than a state where prescribing authorities, particularly religious, are more diverse, and where individuals must obtain masks themselves. face mask Covid 19 state public space Introduction The pandemic caused by the coronavirus SARS-Cov2, called Covid-19 by the World Health Organization, was identified in China in December 2019 and spread worldwide, causing the death of more than 6 million people. In the absence of a vaccine in the early stages of the pandemic, social distancing measures and the wearing of surgical masks became necessary to resume social life after the more severe measures of containment, quarantine or curfew, put in place by governments. The surgical mask is simple to manufacture, inexpensive, and its effectiveness in containing viral particles has been demonstrated in several studies (Greenhalgh et al., 2020 ; Lai et al., 2020; Chen et al., 2020). However, the reluctance, or even resistance, that the recommendation or obligation to wear a mask as a health measure may have aroused, makes it necessary to analyze the anthropological and sociological reasons that lead people to adhere or not to these public health campaigns (Ike et al., 2020 ; Zhang et al. 2021 ). The objective of this article is to analyze the reasonings associated with the wearing of masks in territories that we will call "sentinel", i.e. in which the populations are particularly vulnerable to emerging diseases because of the density and diversity of their population, but also because of the precariousness of their living conditions. Based on original data collected before the dissemination of vaccines in Dakar, the economic and political capital of Senegal, and in the department of Seine-Saint-Denis, a poor suburb close to the French capital, we have sought to understand the relationship between the State and individuals through the mask, considered as a material and symbolic interface. This analysis could, in fine, be used to better communicate with the populations of sentinel territories in the event of a future epidemic transmitted by air. Mask use before the Covid-19 pandemic: a series of health crises The surgical mask was met with reluctance as it moved from health practices to the public sphere, demonstrating the extension of medical power into individual lives (Foucault, 2003 ). It was first designed and disseminated for hospital staff in contact with patients with infectious diseases, following the spread of microbiological knowledge in the 1890s (Shooter, Smith and Hunter 1959 ). The cloth worn by surgeons over their mouths in the operating room was later worn in the open by Chinese and American physicians during the pneumonic plague pandemics in 1910 and influenza in 1918 (Lynteris, 2018 ). Campaigns to promote masks and other social distance measures in 1918 had already met with resistance (Tomes 2010 ). The widespread use of surgical masks was later made possible by the invention of the disposable plastic mask in the 1950s (Strasser& Schlich, 2021). The SARS (Severe Acute Respiratory Syndrome) epidemic of 2002–2003 made wearing masks commonplace in Asian societies not only in times of health crisis but also in ordinary times, for example as a protection against air pollution (Kleinman & Watson, 2006). In 2011, a survey in Tokyo of a sample of 120 people showed that half wore masks regularly while the other half rarely or never wore them (Burgess & Horii, 2012 ). About 100 of them said that the mask protected them from chronic communicable diseases. Young women reported wearing the mask to avoid sunburn or simply to hide the fact that they had not had time to apply makeup. Social or occupational compulsion was cited as the major reason for wearing the mask, even though the state had not made it mandatory (Burgess & Horii, 2012 ). In China, mask wearing is seen by individuals as a way to take responsibility and mobilize in the face of an epidemic. It was not mandated by the Chinese state during the SARS crisis, but it externally reinforced orientalizing prejudices describing Chinese citizens as "gagged by power" (Sin, 2016 ). Mask stockpiling had been one of the measures by which states, coordinated by the World Health Organization, prepared for future pandemics to limit their health and economic consequences since the SARS crisis (Lakoff, 2017 ). The H1N1 pandemic in 2009 did not lead to widespread mask use. For example, a study in Mexico City showed that masks were very quickly removed when the perception of infectious risk decreased (Condon, 2010). Factors prompting or limiting mask use were highlighted during the H1N1 pandemic: socio-demographic factors, knowledge and awareness of the pandemic, perceived severity and susceptibility, local history of pandemics, social "pressure," etc. (Sim et al., 2014). Mask use during the Covid-19 pandemic: material and symbolic dimensions At the beginning of the Covid-19 pandemic, caused by a virus similar to that of SARS, most states recommended the wearing of masks exclusively for health personnel, in a context of global shortage of mask manufacturing and delivery. Citizens therefore had to respond to conflicting messages that masks were more or less useful in the public space depending on their availability at the hospital. In France, for example, the unavailability of masks at the beginning of the pandemic led the government to say they were useless before imposing them when masks were available, blurring the rationalizations associated with its use (Deroche, et al., 2021 ). The idea that masks were readily available was not immediately accepted at the beginning of the Covid-19 pandemic, due to the combined effect of their scarcity and price. In Senegal, for example, the first masks available to the population were sold at 500 FCFA each (about $ 1), while the minimum monthly salary is 59,000 FCFA. Early studies on mask wearing against Covid-19 have highlighted several resistance factors, quite similar to those analyzed in the context of the H1N1 pandemic: difficulty in perceiving the severity of the disease, physical and social discomfort, barriers to communication of information, perception of identity and autonomy, social pressures etc. (Shelus et al., 2020 ). A survey conducted in April 2020, for example, showed that 76% of Germans find it "weird" to wear a mask in public spaces but that 80% of them are willing to put the mask on in the street if it is legally required (Rieger 2020 ). In Ghana, a survey of truck drivers found that few wear masks in their vehicles, and fewer still wear them properly, but those who do are more likely to cite personal safety and the safety of their loved ones (92%) than social pressure (from the President or their boss) or legal obligation (Agyenmang et al., 2021). In Saudi Arabia, the requirement to wear masks in public, coupled with the availability of low-cost masks, resulted in a mask-wearing rate of 87% in public spaces and 80% in workplaces, although 32% reported discomfort when using it (Al Naam et al., 2021 ). Surveys have shown a differential in mask acceptability according to age and gender (Haischer et al., 2020 ). Older people wear masks more often, which may be explained by their greater susceptibility to so-called "severe" forms of the disease. In most surveys, women are also more likely to wear masks than men (Howard, 2021b ). Women more often emphasize the material discomfort of the mask - for breathing in particular - and men the symbolic discomfort - mainly for communication (Howard, 2021a ). In countries with an Islamic culture, women's veiling may have been a factor in favor of wearing masks because there was no reluctance to hide one's face in public space (Al Naam et al., 2021 ). Conversely, in countries marked by opinion movements opposed to the Islamic veil, there was greater resistance to wearing the mask (Inglis & Almila, 2020 ; Chen, 2012 ). To explain the differential acceptability of the mask, then, two types of analysis must be mobilized: through material use and through symbolic use. The mask is indeed a "frontiers object" (Tsang & Prost, 2021) that defines the person in his or her relationship with others, by separating what can be hidden and what can be shown: persona means "mask" in Latin (Mauss, 1950 ). It is also a material object whose manufacture and circulation reveal and transform the imagination of societies. It can be standardized according to industrial norms or, on the contrary, appropriated by artisanal techniques, which changes its availability and its uses. We can therefore speak of techniques of governing masks in the sense that these objects orient people's behavior in a public space where they must arbitrate between authority and intimacy. Controversies over the question of "should one wear a mask or not?", which take on great importance in the confrontation between the individual and the state, seem to be less vivid in societies where a greater diversity of forms and materials has been observed for masks, notably in South America (Souza, 2020 ). A comparative approach to acceptability is therefore necessary to describe several modalities of relations between the individual and the state mediated by the mask. Objective and hypothesis Our investigation aims to describe the perception of mask wearing as a function of two precedents: exposure to past health crises, which makes the material discomfort of the mask more or less acceptable (e.g., H1N1), and participation in controversies about the person, which makes the symbolic discomfort more or less acceptable (e.g., discussions about the wearing of veils in public spaces). We assume that the obligation to wear a mask is not perceived equally according to how the state and society represent what a person is in the face of a potentially infected environment. In this way, we return to observations that have been made in other surveys on mask wearing, but from an interrogation of the government of masks, defined as a "conduct of conducts" made visible by the wearing of a mask (Foucault, 1976). To test this hypothesis, we interviewed people in territories that we conceive as sentinel, in the sense that they are particularly sensitive to the effects of emerging diseases and the need to prepare for them (Keck, 2020 ). Because of the density and diversity of their populations, but also because of the precariousness of their living conditions, emerging diseases develop there more than elsewhere and are the subject of surveillance programs. Wearing a mask to limit the effects of a pandemic is therefore one of the measures taken to anticipate it. These territories also have in common that they have a large Muslim community. It was therefore possible to test whether religious conceptions of the individual, i.e. appropriate ways of presenting oneself in the public space, could influence public health practices. The two sentinel territories selected for this study were: Seine-Saint-Denis, a hyper-urbanized department north of Paris (France) and the city of Dakar, the capital of Senegal. Seine-Saint-Denis was the French department most exposed to the Covid-19 epidemic, with 2500 people dying from the disease in August 2021 for 1.6 million inhabitants, leading to an excess mortality of 130%. This high number is explained in particular by the concentration of the population in small dwellings and by the lack of hospital resources. Immigrant populations, particularly from North Africa, represent 30% of the department's population and are more exposed to the pathological effects of the virus (Brun and Simon 2020 ). In Senegal, as of May 2022, 86,230 cases of Covid-19 had been confirmed, officially resulting in 1,966 deaths. Almost half of the cases (more than 40,000) were in the city of Dakar, which has a population of just over one million. The city of Dakar hosts 23% of the population and half of the country's hospitals. Monitoring of the pandemic by health authorities seems to have been better there than elsewhere, even if the number of deaths reported for Covid remains very low in Senegal, as in sub-Saharan Africa in general (Duboz, 2022). Data And Method Population sample This study was conducted from August to October 2021 on a sample of 606 individuals in Dakar and 250 individuals in Seine-Saint-Denis, at a time when wearing a mask was mandatory in the public space in France as in Senegal. The Dakar sample was constructed using the combined quota method (cross-section by age, gender and town of residence) in order to strive for representativeness of the population aged 20 and older living in the department of Dakar. Data from the Agence Nationale de la Statistique et de la Démographie dating from the last census (2013) were used. The quota variables used were gender (male/female), age (20–29 / 30–39 / 40–49 / 50–59 / 60 and over, with an upper age limit of 100 years, but concretely, the oldest participant was aged 90) and town of residence. The towns were grouped by the four arrondissements making up the department of Dakar: Plateau-Gorée (5 towns), Grand Dakar (6 towns), Parcelles Assainies (4 towns) and Almadies (4 towns). Practically, this method requires constructing a sample that reflects the proportions observed in the general population. For example, according to the last census, women aged 20–29 living in town of Medina (arrondissement of Plateau-Gorée) represented 1.5% of the population aged 20 and older living in the department of Dakar. The sample has been constructed so as to reflect this proportion and include 9 women aged 20–29 living in this town. In order to limit any bias associated with this sampling method, the investigators worked at different moments of the day (and sometimes on Saturday and Sunday) and, in each town of residence, began their investigation from different starting points each day. Eight trained investigators (PhD students in Sociology and Medicine) started out each day from different points in each town to interview individuals in Wolof, Haalpulaar or French in every third home, i.e. the dwelling behind every third front door or entrance gate. Investigators had a certain number of individuals to interview (women aged 20–29 / men aged 20–29 / women aged 30–39 / men aged 30–39 / women aged 40–49 / men aged 40–49 / women aged 50–59 / men aged 50–59 / women aged 60 and over / men aged 60 and over) to meet the quotas. Only one person was selected as a respondent in each home. Investigators went to the house, inquired about the inhabitants and then chose the first person they saw who met the characteristics needed for the quotas. In Seine-Saint-Denis, middle school students aged 13 to 15 interviewed 250 people in public places (markets, squares) in Blanc-Mesnil (175 people) and Montreuil (75 people) during the day. The majority of respondents were adults (60% between 30 and 60 years old) and the number of women was equal to the number of men (52%). However, the sample was not drawn with reference to a predefined distribution; it is smaller and less representative than the Dakar sample. The two samples can therefore only be compared with caution. However, this comparison is made possible by the fact that the questionnaires used in France and Senegal were exactly the same with a few exceptions: age was assessed with two questions in Dakar in order to obtain the official and, above all, the real age of the individuals; ethnicity was asked in Dakar but not in Seine-Saint-Denis. In both territories, data were collected through directed, individual interviews carried out face-to-face using a questionnaire. In-person interviews ranged from 15 minutes to more than 30 minutes, depending on respondent availability and desire to talk. Questions about mask use against Covid-19 Several issues can be distinguished in the notion of mask government: the relationship to scientific authority and the relationship to public space. Several questions aimed to determine whether individuals adhere to public health campaigns recommending mask use and what the basis of their confidence was. The first question measured adherence: Do you think that wearing a mask is effective against Covid-19? Two other questions were used to determine the need for the mask: Do you use the mask to protect yourself? Do you use the mask to protect others? A fourth question asked about trust figures in the health campaign: Who are the appropriate authorities to recommend wearing the mask? Three responses were offered: Scientific authorities (medical doctor, pharmacist, expert in the media); religious authorities (imam, priest, pastor...); political authorities (mayor, deputy, president of the Republic)? Other questions focused more on the conditions of physical use of the mask in a public space. One question concerned the places where wearing a mask is considered necessary: what are the spaces in which you wear a mask? Six answers were proposed, going from the most public to the most private spaces: public transport; market, supermarket, shops; professional office; in the street; hospital; family, home. The effects of wearing a mask were assessed by a question with four response modalities: do you feel uncomfortable wearing the mask? To breathe; to look at others; to talk; for other reasons (please specify). Finally, a last question concerned the method of obtaining masks, indicating the associated economic cost: how did you obtain your masks? Four answers were possible: purchased disposable; purchased in cloth; donated by an administration; made in cloth. Analyses Bivariate analyses (Chi-square tests) were used to compare data collected in France and Senegal. Although the sample design methods were different, the survey populations were similar in age and gender distribution. Results Adherence to public health campaigns and legitimacy of authorities The Seine-Saint-Denis sample had a much lower proportion of people who said they believed in the effectiveness of the mask (75%) than in Dakar (89% in Dakar; Chi2(1ddl) = 27.44; p < 0.001). Similarly, Seine-Saint-Denis was distinguished by a lower proportion of people who reported wearing the mask to protect themselves (47% versus 94% in Dakar; Chi2(1ddl) = 248.64; p < 0.001); and a lower proportion of people using the mask to protect others (53% versus 87% in Dakar; Chi2(1ddl) = 116.39; p < 0.001). In both Dakar and Seine-Saint-Denis, the authorities considered most competent to recommend mask use were scientific authorities, followed by political and religious authorities (Table 1 ). Despite this general result shared by both populations, large disparities were observed: Dakar residents gave more credence to scientific authorities (87%) than Seine-Saint-Denis residents (58%, Chi2(1ddl) = 66.85; p < 0.001). Similarly, Dakar residents were more likely to consider religious authorities to be in a position to make recommendations about masks than their French counterparts (27% vs. 2%; Chi2(1ddl) = 70.16, p < 0.001). On the other hand, in both populations, less than half of the individuals felt that political authorities were legitimate in recommending wearing masks. Table 1 Which authorities are responsible for recommending the use of masks? Types of authority Dakar (N = 606) Seine-Saint-Denis (N = 250) Scientific 87% 58% Political 43% 40% Religious 27% 2% Places where masks are worn and economic conditions In Dakar and Seine-Saint-Denis, public transport was where the mask was most often worn: 95% and 62% of individuals respectively. This difference is significant (Chi2(1ddl) = 155.02; p < 0.001): the inhabitants of Dakar wear the mask more often in public transport than those of Seine-Saint-Denis. In both territories, the mask is then most often worn in markets or supermarkets: by 81% of individuals in Dakar and 60% in Seine-Saint-Denis (Chi2(1ddl) = 41.59; p < 0.001). While the workplace ranked third in Seine-Saint-Denis, it ranked only fifth in Dakar, after the hospital and outdoor public spaces (Table 2 ). Finally, the home was only in last place in both populations, but with a significant difference, since while barely 6% of Dakar residents said they wore a mask in their home, 19% did so in Seine-Saint-Denis (Chi2(1ddl) = 34.95; p < 0.001). Table 2 In which spaces do you wear the mask ? Types of spaces Dakar (N = 606) Seine-Saint-Denis (N = 250) Public transport 95% 62% Markets 81% 60% Hospital 48% 41% Office 34% 53% Street 45% 47% Home 6% 19% In Dakar, the vast majority of masks were disposable, purchased by individuals (81%) and very few were provided by the administration (7%), but a significant proportion of the population created their own masks (9%). In Seine-Saint-Denis, most of the masks were also disposable and purchased by individuals (60%), but more than a quarter of the individuals had received their masks from the state (27.5%). On the other hand, very few (3%) used self-sewn masks. In Dakar, the most important discomfort associated with wearing a mask was respiratory (69.6%), followed by discomfort in speaking (26.9%) and discomfort in seeing (6.1%). In the Seine-Saint-Denis sample, the discomfort reported was more related to communication conditions: 47% considered the mask to be a hindrance to breathing, 38% to speaking and 8% to seeing. Discussion The strong presence of the state in Seine-Saint-Denis (visible in the number of masks provided by the administration) paradoxically leads to a greater mistrust of mask wearing. This can be explained by the fact that the state initially reserved the wearing of masks for hospital staff in a context of shortage of medical facilities, which is reinforced in a densely populated region like Seine-Saint-Denis. The experience of precariousness and vulnerability leads some people to wear the mask in the intimate space, but this form of concern for loved ones remains hidden, while other people wear it less in the public space to defy the repressive state. From a symbolic point of view, the mask is for many people an intrusion of the state into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare state to watch over the health of the population. To analyze this contradictory dual relationship to the state, we can distinguish the "left hand of the state" that gives masks to individuals and the "right hand" that punishes them if they do not wear masks (Bourdieu, 2012 ). Conversely, the state has made little commitment to pandemic control measures in Senegal, with only a few curfews. People cope with masks pragmatically in a context where public health is not a priority. Religious authorities then play a more important role in Dakar, as they frame the chains of giving and counter-giving through forms of religious offering (Bondaz & Bonhomme, 2017 ). Thus, it is understandable that in our sampled individuals more readily refer to religious authorities about whether the mask should be worn in public. In Dakar, scientific, political, and religious authorities all appear more legitimate to promote the wearing of the mask than in Seine-Saint-Denis. While the state plays a central role in France in "conducting conducts," West Africa is characterized by a multiplicity of legitimate power arrangements. If individuals are able to use these powers when their injunctions are divergent, in the case of the pandemic, they were unanimous in October 2020, recommending without reservation the wearing of a mask. At the Magal in Touba - the great pilgrimage of the Mourides - the state, religious and medical authorities all urged individuals to wear masks in the public sphere, with a much better result in terms of adherence to public health campaigns than what was observed in France (Macia et al., 2022). Conclusion This study is the first comparison of mask wearing in two widely separated areas. Its results, which are limited by the comparability of the samples constructed, confirm other studies on the impact of age and gender in mask wearing, showing that older people and women follow mask wearing recommendations more. Above all, it clearly shows contrasting relationships to the state and to public space, and thus different forms of mask government for those who decide to wear them or not, depending on the influence of religious authorities in public life. A state that is both more coercive and more protective, such as France, produces a lower level of adherence to mask-wearing recommendations than a state where prescribing authorities, particularly religious, are more diverse, and where individuals must obtain masks themselves. While Seine-Saint-Denis and the city of Dakar are sentinel territories with regard to the spread of the epidemic, this notion does not have the same meaning in the use of masks: the Paris suburbs were more exposed than other French regions to the ambivalence of the State and its hesitations in times of pandemic, while the Senegalese capital played more the role of an outpost for the sanitary measures followed in Africa, in particular through the supervision of a major pilgrimage. While most states are lifting the obligation to wear masks as a result of the pandemic's resurgence, can the forms of mask government described in this study be used to predict its effects on the populations studied? Interviews with schoolchildren in Seine-Saint-Denis show that the most vulnerable families continue to wear masks, while the association between masks and the state decreases due to the greater availability of cheap masks. In contrast, in Senegal, it appears that the mask has become a health accessory like any other for managing epidemics, as evidenced by the high rate of adherence to anti-Covid measures revealed by our study. In both cases, it seems that the focus of the debate on mask government around the state has limited other ways of presenting oneself in the public space to protect against respiratory diseases. Declarations · Ethical approval and consent : This research has been conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from participants. The research study has been approved by the National Ethics Committee of Senegal headed by Pr Anta Tall Dia : https://www.cners.sn/ · Consent to publish : Authors consent this article to be published. · Funding information : No external funding was used for this research. · Conflict of interest : Authors declare no conflict of interest · Author contribution : F.K. and E.M wrote the main manuscript. F.K. conducted studies in Seine Saint Denis. E.M. conducted studies in Dakar. · Availability of data and materials : The data produced by the investigation in Dakar are available in a file entitled “Base masques 600”. The data produced by the investigation in Seine-Saint-Denis are available on reasonable request to corresponding author. · Acknowledgement : The authors wish to thank all the people who took the time to answer their questions. We also thank the interviewers who participated in this study, particularly Amadou H. Diallo, our team leader in Dakar, as well as Florise Pages and Ana Guevara, who supervised the collective inquiry in Seine-Saint-Denis. References Agyemang, E., Agyei-Mensah, S., Kyere-Gyeabour, E. (2021). Face Mask Use Among Commercial Drivers During the COVID-19 Pandemic in Accra, Ghana. Journal of Community Health . 46 (6), 1226-1235. https://doi.org/10.1007/s10900-021-01004-0. Al Naam, Y.A., Elsafi, S.H., Alkharraz, Z.S., Alfahad, O.A., Al-Jubran, K.M., Al Zahrani, E.M. (2021). Community practice of using face masks for the prevention of COVID-19 in Saudi Arabia. PLoS ONE 16 (2): e0247313. https://doi.org/10.1371/journal.pone.0247313 Bondaz, J., & Bonhomme, J. (2017). L'Offrande de la mort. Une rumeur au Sénégal . Cnrs Éditions. Bourdieu, P. (2012). Sur l'État. Cours au Collège de France (1989-1992) . Seuil. Brun, S., & Simon, P. (2020). L’invisibilité des minorités dans les chiffres du Coronavirus : le détour par la Seine-Saint-Denis. In Brun, S., & Simon, P. (ed.), Inégalités ethno-raciales et pandémie de coronavirus, De facto , 19, http://icmigrations.fr/2020/05/15/defacto-019-05/ Burgess, A., & Horii, M. (2012). Risk, ritual and health responsabilisation : Japan’s safety blanket of surgical face mask wearing. Sociology of Health and Illness 34 (8): 1184-1198. https://doi.org/10.1111/j.1467-9566.2012.01466.x. Chen, M. (2012). Masked States and the Screen between disability and security. Women Studies Quarterly, 40 (1-2): 76-96. https://doi.org/10.1353/wsq.2012.0004 Cheng, V.C., Wong, S.C., Chuang, V.W., So, S.Y., Chen, J.H., Sridhar, S. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of infectiology 8 :107–114. https://doi.org/10.1016/j.jinf.2020.04.024 Condon, J.B. (2020). Who is that masked person: The use of face masks on Mexico City public transportation during the Influenza A (H1N1) outbreak. Health Policy 95 (1): 50-56. https://doi.org/10.1016/j.healthpol.2009.11.009 Deroche, C., Jomier, B., Vermeillet, S. (2021). Santé publique : pour un nouveau départ. Leçons de l'épidémie de covid-19. Rapport du Sénat. Foucault, M. (2003). Society Must Be Defended . Lectures at the College de France, 1975-76. MacMillan. Greenhalgh, T, Schmid, M.B., Czypionka, T., Bassler, D., Gruer, L. (2020). Face masks for the public during the covid‑19 crisis. British Medical Journal 369 :1435. Haischer, M.H., Beilfuss, R., Hart, M.R., Opielinski, L., Wrucke, D., Zirgaitis, G. (2020) Who is wearing a mask? Gender-, age-, and location-related differences during the COVID-19 pandemic. PLoS ONE 15 (10): e0240785. https://doi.org/10.1371/journal.pone.0240785 Howard J, Huang, A., Li, Z., Rimoin, A.W. (2021). An evidence review of face masks against COVID-19. PNAS. 118 (4):e2014564118. https://doi.org/10.1073/pnas.2014564118 Howard, M.C. (2021a). Gender, face mask perceptions, and face mask wearing: Are men being dangerous during the COVID-19 pandemic? Personal Individual Differences 15;170:110417. https://doi.org/10.1016/j.paid.2020.110417. Howard, M.C. (2021b).The relations between age, face mask perceptions and face mask wearing. Journal of Public Health (Oxford) https://doi.org/10.1093/pubmed/fdab018. Ike J.D., Bayerle, H., Logan, R.A., Parker, R.M. (2020) Face Masks: Their History and the Values They Communicate. Journal of Health Community 25 (12):990-995. https://doi.org/10.1080/10810730.2020.1867257. Inglis, D., Almila, A.M. (2020) Un-Masking the Mask: Developing the Sociology of Facial Politics in Pandemic Times and After. Società Mutamento Politica 11 (21): 251-257. https://doi.org/10.13128/smp-11964 Keck, F. (2020) Avian Reservoirs. Virus Hunters and Birdwatchers in Chinese Sentinel Posts . Duke University Press. Kleinmann A., & Watson, J. (Eds.). (2006) SARS in China. Prelude to Pandemics . Stanford University Press. Lakoff, A. (2017). Unprepared. Global Health in a Time of Emergency. University of California Press. Lai, A., Poon, C., & Cheung, A. (2011). Effectiveness of facemasks to reduce exposure hazards for airborne infections among general populations. Journal of the Royal Society Interface 9 : 938–948. https://doi.org/10.1098/rsif.2011.0537 Lynteris, C. (2018). Plague Masks : The Visual Emergence of Anti-Epidemic Personal Protection Equipment. Medical Anthropology 37 (6): 442-457. https://doi.org/10.1080/01459740.2017.1423072 Mauss, M. (1950). Une catégorie de l'esprit humain : la notion de personne , celle de “moi”. In Mauss M., Sociologie et anthropologie. PUF. Rieger, M.O. (2020). To wear or not to wear? Factors influencing wearing face masks in Germany during the COVID-19 pandemic. Social Health Behaviour 3 : 50-4. https://doi.org/10.4103/SHB.SHB_23_20 de Souza, P.R. (2020). Protection masks with religious motifs: Covid-19 produces new religious materiality. International Journal of Latin American Religions 4 : 402–416. https://doi.org/10.1007/s41603-020-00117-z Shelus, V.S., Frank, S.C., Lazard, A.J., Higgins, I.C.A., Pulido, M., Richter, A.P.C. (2020). Motivations and Barriers for the Use of Face Coverings during the COVID-19 Pandemic: Messaging Insights from Focus Groups. International Journal of Environmental Research and Public Health 17 : 9298. https://doi.org/10.3390/ijerph17249298 Shooter, R.A., Smith, M.A., Hunter, C.J.(1959). A study of surgical masks. British Journal of Surgery 47 : 246–49. https://doi.org/10.1002/bjs.18004720312 Sin, M.S.Y. (2016). Masking fears: SARS and the politics of public health in China. Critical Public Health 26 :88–98. https://doi.org/10.1080/09581596.2014.923815 Strasser B., & Schlich, T. (2020), A history of the medical mask and the rise of throwaway culture. Lancet 396 (10243): 19-20 https://doi.org/10.1016/S0140-6736(20)31207-1 Tomes, N. (2010) "Destroyer and teacher": Managing the masses during the 1918-1919 influenza pandemic. Public health reports 125 (3): 48-62. https://doi.org/10.1177/00333549101250S308 Tsang, P.M., & Prost, A. 2021 Boundaries of solidarity: a meta-ethnography of mask use during past epidemics to inform SARS-CoV-2 suppression. British Medical Journal of Global Health ;6:e004068. doi:10.1136/bmjgh-2020-004068 Zhang, Y. S. D., Leslie, Y. H., Sharafaddin-Zadeh, Y., Noels, K.,& Lou, N. M. (2021). Public health messages about face masks early in the COVID-19 pandemic: perceptions of and impacts on Canadians. Journal of Community Health. https:// doi. org/ 10. 1007/s10900- 021- 00971-8 Additional Declarations No competing interests reported. Supplementary Files BaseMasques600.xlsx Cite Share Download PDF Status: Published Journal Publication published 05 Jul, 2023 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Major revision 08 Apr, 2023 Reviews received at journal 22 Mar, 2023 Reviewers agreed at journal 09 Mar, 2023 Reviewers invited by journal 09 Mar, 2023 Editor assigned by journal 08 Mar, 2023 Editor invited by journal 11 Nov, 2022 Submission checks completed at journal 11 Nov, 2022 First submitted to journal 23 Sep, 2022 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-2096465","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":151328108,"identity":"4d2fbd69-db1d-446a-b41a-15557e2027a5","order_by":0,"name":"Frederic Keck","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIiWNgGAWjYBAC+wMMDBJgxMPAwNhQARH9gE+LAQOKljNgQcYZRGhhgGhpbCNGi/Thgzc+7rGQZ+A5fPDjzHl2eeb9BxibK/D5hS8t2XLGMwnDBt62ZMmN25KLZW4kMDaewWcLD4+ZNM8BiQQGfh4zxofbDiTOkGBgf9iAVwv/N+k/YC383xgfzgFq4T/A2IhfCw+bNANIC28PG+PGBqAWhgRCWtiMLXsOSBi28RwzlpxxLBnosMRGAlqYH974caBOnp8n+eHHnho7oMMOH8SrBQ7YEExGojSMglEwCkbBKMADAC0MSEx75MEVAAAAAElFTkSuQmCC","orcid":"","institution":"French National Centre for Scientific Research","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Frederic","middleName":"","lastName":"Keck","suffix":""},{"id":151328109,"identity":"a04a08b2-066b-4fae-ae0c-e78f9ed5a4e8","order_by":1,"name":"Enguerran Macia","email":"","orcid":"","institution":"French National Centre for Scientific Research","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Enguerran","middleName":"","lastName":"Macia","suffix":""}],"badges":[],"createdAt":"2022-09-23 12:59:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-2096465/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-2096465/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12889-023-15968-2","type":"published","date":"2023-07-05T21:29:48+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":44733121,"identity":"049eda19-b480-45a0-b3f4-68793b64b76f","added_by":"auto","created_at":"2023-10-16 22:04:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":312154,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-2096465/v1/2f1b1fd4-67cd-46cc-8fef-07b5aacc9193.pdf"},{"id":29085460,"identity":"10872e75-ddfd-48af-98d0-9801688a30ec","added_by":"auto","created_at":"2022-11-15 14:33:43","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":138475,"visible":true,"origin":"","legend":"","description":"","filename":"BaseMasques600.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-2096465/v1/513ab2b60ef74dc8a2b4ff22.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe pandemic caused by the coronavirus SARS-Cov2, called Covid-19 by the World Health Organization, was identified in China in December 2019 and spread worldwide, causing the death of more than 6\u0026nbsp;million people. In the absence of a vaccine in the early stages of the pandemic, social distancing measures and the wearing of surgical masks became necessary to resume social life after the more severe measures of containment, quarantine or curfew, put in place by governments. The surgical mask is simple to manufacture, inexpensive, and its effectiveness in containing viral particles has been demonstrated in several studies (Greenhalgh et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Lai et al., 2020; Chen et al., 2020). However, the reluctance, or even resistance, that the recommendation or obligation to wear a mask as a health measure may have aroused, makes it necessary to analyze the anthropological and sociological reasons that lead people to adhere or not to these public health campaigns (Ike et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Zhang et al. \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe objective of this article is to analyze the reasonings associated with the wearing of masks in territories that we will call \"sentinel\", i.e. in which the populations are particularly vulnerable to emerging diseases because of the density and diversity of their population, but also because of the precariousness of their living conditions. Based on original data collected before the dissemination of vaccines in Dakar, the economic and political capital of Senegal, and in the department of Seine-Saint-Denis, a poor suburb close to the French capital, we have sought to understand the relationship between the State and individuals through the mask, considered as a material and symbolic interface. This analysis could, in fine, be used to better communicate with the populations of sentinel territories in the event of a future epidemic transmitted by air.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eMask use before the Covid-19 pandemic: a series of health crises\u003c/h2\u003e \u003cp\u003eThe surgical mask was met with reluctance as it moved from health practices to the public sphere, demonstrating the extension of medical power into individual lives (Foucault, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). It was first designed and disseminated for hospital staff in contact with patients with infectious diseases, following the spread of microbiological knowledge in the 1890s (Shooter, Smith and Hunter \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e1959\u003c/span\u003e). The cloth worn by surgeons over their mouths in the operating room was later worn in the open by Chinese and American physicians during the pneumonic plague pandemics in 1910 and influenza in 1918 (Lynteris, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Campaigns to promote masks and other social distance measures in 1918 had already met with resistance (Tomes \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). The widespread use of surgical masks was later made possible by the invention of the disposable plastic mask in the 1950s (Strasser\u0026amp; Schlich, 2021). The SARS (Severe Acute Respiratory Syndrome) epidemic of 2002\u0026ndash;2003 made wearing masks commonplace in Asian societies not only in times of health crisis but also in ordinary times, for example as a protection against air pollution (Kleinman \u0026amp; Watson, 2006).\u003c/p\u003e \u003cp\u003eIn 2011, a survey in Tokyo of a sample of 120 people showed that half wore masks regularly while the other half rarely or never wore them (Burgess \u0026amp; Horii, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). About 100 of them said that the mask protected them from chronic communicable diseases. Young women reported wearing the mask to avoid sunburn or simply to hide the fact that they had not had time to apply makeup. Social or occupational compulsion was cited as the major reason for wearing the mask, even though the state had not made it mandatory (Burgess \u0026amp; Horii, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). In China, mask wearing is seen by individuals as a way to take responsibility and mobilize in the face of an epidemic. It was not mandated by the Chinese state during the SARS crisis, but it externally reinforced orientalizing prejudices describing Chinese citizens as \"gagged by power\" (Sin, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMask stockpiling had been one of the measures by which states, coordinated by the World Health Organization, prepared for future pandemics to limit their health and economic consequences since the SARS crisis (Lakoff, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). The H1N1 pandemic in 2009 did not lead to widespread mask use. For example, a study in Mexico City showed that masks were very quickly removed when the perception of infectious risk decreased (Condon, 2010). Factors prompting or limiting mask use were highlighted during the H1N1 pandemic: socio-demographic factors, knowledge and awareness of the pandemic, perceived severity and susceptibility, local history of pandemics, social \"pressure,\" etc. (Sim et al., 2014).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eMask use during the Covid-19 pandemic: material and symbolic dimensions\u003c/h2\u003e \u003cp\u003eAt the beginning of the Covid-19 pandemic, caused by a virus similar to that of SARS, most states recommended the wearing of masks exclusively for health personnel, in a context of global shortage of mask manufacturing and delivery. Citizens therefore had to respond to conflicting messages that masks were more or less useful in the public space depending on their availability at the hospital. In France, for example, the unavailability of masks at the beginning of the pandemic led the government to say they were useless before imposing them when masks were available, blurring the rationalizations associated with its use (Deroche, et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The idea that masks were readily available was not immediately accepted at the beginning of the Covid-19 pandemic, due to the combined effect of their scarcity and price. In Senegal, for example, the first masks available to the population were sold at 500 FCFA each (about \u003cspan\u003e$\u003c/span\u003e1), while the minimum monthly salary is 59,000 FCFA.\u003c/p\u003e \u003cp\u003eEarly studies on mask wearing against Covid-19 have highlighted several resistance factors, quite similar to those analyzed in the context of the H1N1 pandemic: difficulty in perceiving the severity of the disease, physical and social discomfort, barriers to communication of information, perception of identity and autonomy, social pressures etc. (Shelus et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). A survey conducted in April 2020, for example, showed that 76% of Germans find it \"weird\" to wear a mask in public spaces but that 80% of them are willing to put the mask on in the street if it is legally required (Rieger \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In Ghana, a survey of truck drivers found that few wear masks in their vehicles, and fewer still wear them properly, but those who do are more likely to cite personal safety and the safety of their loved ones (92%) than social pressure (from the President or their boss) or legal obligation (Agyenmang et al., 2021). In Saudi Arabia, the requirement to wear masks in public, coupled with the availability of low-cost masks, resulted in a mask-wearing rate of 87% in public spaces and 80% in workplaces, although 32% reported discomfort when using it (Al Naam et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSurveys have shown a differential in mask acceptability according to age and gender (Haischer et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Older people wear masks more often, which may be explained by their greater susceptibility to so-called \"severe\" forms of the disease. In most surveys, women are also more likely to wear masks than men (Howard, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2021b\u003c/span\u003e). Women more often emphasize the material discomfort of the mask - for breathing in particular - and men the symbolic discomfort - mainly for communication (Howard, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021a\u003c/span\u003e). In countries with an Islamic culture, women's veiling may have been a factor in favor of wearing masks because there was no reluctance to hide one's face in public space (Al Naam et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Conversely, in countries marked by opinion movements opposed to the Islamic veil, there was greater resistance to wearing the mask (Inglis \u0026amp; Almila, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Chen, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). To explain the differential acceptability of the mask, then, two types of analysis must be mobilized: through material use and through symbolic use.\u003c/p\u003e \u003cp\u003eThe mask is indeed a \"frontiers object\" (Tsang \u0026amp; Prost, 2021) that defines the person in his or her relationship with others, by separating what can be hidden and what can be shown: \u003cem\u003epersona\u003c/em\u003e means \"mask\" in Latin (Mauss, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e1950\u003c/span\u003e). It is also a material object whose manufacture and circulation reveal and transform the imagination of societies. It can be standardized according to industrial norms or, on the contrary, appropriated by artisanal techniques, which changes its availability and its uses. We can therefore speak of techniques of governing masks in the sense that these objects orient people's behavior in a public space where they must arbitrate between authority and intimacy. Controversies over the question of \"should one wear a mask or not?\", which take on great importance in the confrontation between the individual and the state, seem to be less vivid in societies where a greater diversity of forms and materials has been observed for masks, notably in South America (Souza, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). A comparative approach to acceptability is therefore necessary to describe several modalities of relations between the individual and the state mediated by the mask.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eObjective and hypothesis\u003c/h2\u003e \u003cp\u003eOur investigation aims to describe the perception of mask wearing as a function of two precedents: exposure to past health crises, which makes the material discomfort of the mask more or less acceptable (e.g., H1N1), and participation in controversies about the person, which makes the symbolic discomfort more or less acceptable (e.g., discussions about the wearing of veils in public spaces). We assume that the obligation to wear a mask is not perceived equally according to how the state and society represent what a person is in the face of a potentially infected environment. In this way, we return to observations that have been made in other surveys on mask wearing, but from an interrogation of the government of masks, defined as a \"conduct of conducts\" made visible by the wearing of a mask (Foucault, 1976).\u003c/p\u003e \u003cp\u003eTo test this hypothesis, we interviewed people in territories that we conceive as sentinel, in the sense that they are particularly sensitive to the effects of emerging diseases and the need to prepare for them (Keck, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Because of the density and diversity of their populations, but also because of the precariousness of their living conditions, emerging diseases develop there more than elsewhere and are the subject of surveillance programs. Wearing a mask to limit the effects of a pandemic is therefore one of the measures taken to anticipate it. These territories also have in common that they have a large Muslim community. It was therefore possible to test whether religious conceptions of the individual, i.e. appropriate ways of presenting oneself in the public space, could influence public health practices.\u003c/p\u003e \u003cp\u003eThe two sentinel territories selected for this study were: Seine-Saint-Denis, a hyper-urbanized department north of Paris (France) and the city of Dakar, the capital of Senegal. Seine-Saint-Denis was the French department most exposed to the Covid-19 epidemic, with 2500 people dying from the disease in August 2021 for 1.6\u0026nbsp;million inhabitants, leading to an excess mortality of 130%. This high number is explained in particular by the concentration of the population in small dwellings and by the lack of hospital resources. Immigrant populations, particularly from North Africa, represent 30% of the department's population and are more exposed to the pathological effects of the virus (Brun and Simon \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In Senegal, as of May 2022, 86,230 cases of Covid-19 had been confirmed, officially resulting in 1,966 deaths. Almost half of the cases (more than 40,000) were in the city of Dakar, which has a population of just over one million. The city of Dakar hosts 23% of the population and half of the country's hospitals. Monitoring of the pandemic by health authorities seems to have been better there than elsewhere, even if the number of deaths reported for Covid remains very low in Senegal, as in sub-Saharan Africa in general (Duboz, 2022).\u003c/p\u003e \u003c/div\u003e"},{"header":"Data And Method","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003ePopulation sample\u003c/h2\u003e \u003cp\u003eThis study was conducted from August to October 2021 on a sample of 606 individuals in Dakar and 250 individuals in Seine-Saint-Denis, at a time when wearing a mask was mandatory in the public space in France as in Senegal.\u003c/p\u003e \u003cp\u003eThe Dakar sample was constructed using the combined quota method (cross-section by age, gender and town of residence) in order to strive for representativeness of the population aged 20 and older living in the department of Dakar. Data from the \u003cem\u003eAgence Nationale de la Statistique et de la D\u0026eacute;mographie\u003c/em\u003e dating from the last census (2013) were used. The quota variables used were gender (male/female), age (20\u0026ndash;29 / 30\u0026ndash;39 / 40\u0026ndash;49 / 50\u0026ndash;59 / 60 and over, with an upper age limit of 100 years, but concretely, the oldest participant was aged 90) and town of residence. The towns were grouped by the four arrondissements making up the department of Dakar: Plateau-Gor\u0026eacute;e (5 towns), Grand Dakar (6 towns), Parcelles Assainies (4 towns) and Almadies (4 towns). Practically, this method requires constructing a sample that reflects the proportions observed in the general population. For example, according to the last census, women aged 20\u0026ndash;29 living in town of Medina (arrondissement of Plateau-Gor\u0026eacute;e) represented 1.5% of the population aged 20 and older living in the department of Dakar. The sample has been constructed so as to reflect this proportion and include 9 women aged 20\u0026ndash;29 living in this town.\u003c/p\u003e \u003cp\u003eIn order to limit any bias associated with this sampling method, the investigators worked at different moments of the day (and sometimes on Saturday and Sunday) and, in each town of residence, began their investigation from different starting points each day. Eight trained investigators (PhD students in Sociology and Medicine) started out each day from different points in each town to interview individuals in Wolof, Haalpulaar or French in every third home, i.e. the dwelling behind every third front door or entrance gate. Investigators had a certain number of individuals to interview (women aged 20\u0026ndash;29 / men aged 20\u0026ndash;29 / women aged 30\u0026ndash;39 / men aged 30\u0026ndash;39 / women aged 40\u0026ndash;49 / men aged 40\u0026ndash;49 / women aged 50\u0026ndash;59 / men aged 50\u0026ndash;59 / women aged 60 and over / men aged 60 and over) to meet the quotas. Only one person was selected as a respondent in each home. Investigators went to the house, inquired about the inhabitants and then chose the first person they saw who met the characteristics needed for the quotas.\u003c/p\u003e \u003cp\u003eIn Seine-Saint-Denis, middle school students aged 13 to 15 interviewed 250 people in public places (markets, squares) in Blanc-Mesnil (175 people) and Montreuil (75 people) during the day. The majority of respondents were adults (60% between 30 and 60 years old) and the number of women was equal to the number of men (52%). However, the sample was not drawn with reference to a predefined distribution; it is smaller and less representative than the Dakar sample. The two samples can therefore only be compared with caution.\u003c/p\u003e \u003cp\u003eHowever, this comparison is made possible by the fact that the questionnaires used in France and Senegal were exactly the same with a few exceptions: age was assessed with two questions in Dakar in order to obtain the official and, above all, the real age of the individuals; ethnicity was asked in Dakar but not in Seine-Saint-Denis. In both territories, data were collected through directed, individual interviews carried out face-to-face using a questionnaire. In-person interviews ranged from 15 minutes to more than 30 minutes, depending on respondent availability and desire to talk.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eQuestions about mask use against Covid-19\u003c/h2\u003e \u003cp\u003eSeveral issues can be distinguished in the notion of mask government: the relationship to scientific authority and the relationship to public space.\u003c/p\u003e \u003cp\u003eSeveral questions aimed to determine whether individuals adhere to public health campaigns recommending mask use and what the basis of their confidence was. The first question measured adherence: Do you think that wearing a mask is effective against Covid-19? Two other questions were used to determine the need for the mask: Do you use the mask to protect yourself? Do you use the mask to protect others? A fourth question asked about trust figures in the health campaign: Who are the appropriate authorities to recommend wearing the mask? Three responses were offered: Scientific authorities (medical doctor, pharmacist, expert in the media); religious authorities (imam, priest, pastor...); political authorities (mayor, deputy, president of the Republic)?\u003c/p\u003e \u003cp\u003eOther questions focused more on the conditions of physical use of the mask in a public space. One question concerned the places where wearing a mask is considered necessary: what are the spaces in which you wear a mask? Six answers were proposed, going from the most public to the most private spaces: public transport; market, supermarket, shops; professional office; in the street; hospital; family, home. The effects of wearing a mask were assessed by a question with four response modalities: do you feel uncomfortable wearing the mask? To breathe; to look at others; to talk; for other reasons (please specify). Finally, a last question concerned the method of obtaining masks, indicating the associated economic cost: how did you obtain your masks? Four answers were possible: purchased disposable; purchased in cloth; donated by an administration; made in cloth.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAnalyses\u003c/h2\u003e \u003cp\u003eBivariate analyses (Chi-square tests) were used to compare data collected in France and Senegal. Although the sample design methods were different, the survey populations were similar in age and gender distribution.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eAdherence to public health campaigns and legitimacy of authorities\u003c/h2\u003e \u003cp\u003eThe Seine-Saint-Denis sample had a much lower proportion of people who said they believed in the effectiveness of the mask (75%) than in Dakar (89% in Dakar; Chi2(1ddl)\u0026thinsp;=\u0026thinsp;27.44; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, Seine-Saint-Denis was distinguished by a lower proportion of people who reported wearing the mask to protect themselves (47% versus 94% in Dakar; Chi2(1ddl)\u0026thinsp;=\u0026thinsp;248.64; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); and a lower proportion of people using the mask to protect others (53% versus 87% in Dakar; Chi2(1ddl)\u0026thinsp;=\u0026thinsp;116.39; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eIn both Dakar and Seine-Saint-Denis, the authorities considered most competent to recommend mask use were scientific authorities, followed by political and religious authorities (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Despite this general result shared by both populations, large disparities were observed: Dakar residents gave more credence to scientific authorities (87%) than Seine-Saint-Denis residents (58%, Chi2(1ddl)\u0026thinsp;=\u0026thinsp;66.85; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, Dakar residents were more likely to consider religious authorities to be in a position to make recommendations about masks than their French counterparts (27% vs. 2%; Chi2(1ddl)\u0026thinsp;=\u0026thinsp;70.16, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). On the other hand, in both populations, less than half of the individuals felt that political authorities were legitimate in recommending wearing masks.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWhich authorities are responsible for recommending the use of masks?\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of authority\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDakar (N\u0026thinsp;=\u0026thinsp;606)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSeine-Saint-Denis (N\u0026thinsp;=\u0026thinsp;250)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScientific\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e87%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolitical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligious\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003ePlaces where masks are worn and economic conditions\u003c/h2\u003e \u003cp\u003eIn Dakar and Seine-Saint-Denis, public transport was where the mask was most often worn: 95% and 62% of individuals respectively. This difference is significant (Chi2(1ddl)\u0026thinsp;=\u0026thinsp;155.02; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001): the inhabitants of Dakar wear the mask more often in public transport than those of Seine-Saint-Denis. In both territories, the mask is then most often worn in markets or supermarkets: by 81% of individuals in Dakar and 60% in Seine-Saint-Denis (Chi2(1ddl)\u0026thinsp;=\u0026thinsp;41.59; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). While the workplace ranked third in Seine-Saint-Denis, it ranked only fifth in Dakar, after the hospital and outdoor public spaces (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Finally, the home was only in last place in both populations, but with a significant difference, since while barely 6% of Dakar residents said they wore a mask in their home, 19% did so in Seine-Saint-Denis (Chi2(1ddl)\u0026thinsp;=\u0026thinsp;34.95; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eIn which spaces do you wear the mask ?\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of spaces\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDakar (N\u0026thinsp;=\u0026thinsp;606)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSeine-Saint-Denis (N\u0026thinsp;=\u0026thinsp;250)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic transport\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarkets\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e81%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStreet\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn Dakar, the vast majority of masks were disposable, purchased by individuals (81%) and very few were provided by the administration (7%), but a significant proportion of the population created their own masks (9%). In Seine-Saint-Denis, most of the masks were also disposable and purchased by individuals (60%), but more than a quarter of the individuals had received their masks from the state (27.5%). On the other hand, very few (3%) used self-sewn masks.\u003c/p\u003e \u003cp\u003eIn Dakar, the most important discomfort associated with wearing a mask was respiratory (69.6%), followed by discomfort in speaking (26.9%) and discomfort in seeing (6.1%). In the Seine-Saint-Denis sample, the discomfort reported was more related to communication conditions: 47% considered the mask to be a hindrance to breathing, 38% to speaking and 8% to seeing.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe strong presence of the state in Seine-Saint-Denis (visible in the number of masks provided by the administration) paradoxically leads to a greater mistrust of mask wearing. This can be explained by the fact that the state initially reserved the wearing of masks for hospital staff in a context of shortage of medical facilities, which is reinforced in a densely populated region like Seine-Saint-Denis. The experience of precariousness and vulnerability leads some people to wear the mask in the intimate space, but this form of concern for loved ones remains hidden, while other people wear it less in the public space to defy the repressive state. From a symbolic point of view, the mask is for many people an intrusion of the state into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare state to watch over the health of the population. To analyze this contradictory dual relationship to the state, we can distinguish the \"left hand of the state\" that gives masks to individuals and the \"right hand\" that punishes them if they do not wear masks (Bourdieu, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eConversely, the state has made little commitment to pandemic control measures in Senegal, with only a few curfews. People cope with masks pragmatically in a context where public health is not a priority. Religious authorities then play a more important role in Dakar, as they frame the chains of giving and counter-giving through forms of religious offering (Bondaz \u0026amp; Bonhomme, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Thus, it is understandable that in our sampled individuals more readily refer to religious authorities about whether the mask should be worn in public. In Dakar, scientific, political, and religious authorities all appear more legitimate to promote the wearing of the mask than in Seine-Saint-Denis. While the state plays a central role in France in \"conducting conducts,\" West Africa is characterized by a multiplicity of legitimate power arrangements. If individuals are able to use these powers when their injunctions are divergent, in the case of the pandemic, they were unanimous in October 2020, recommending without reservation the wearing of a mask. At the Magal in Touba - the great pilgrimage of the Mourides - the state, religious and medical authorities all urged individuals to wear masks in the public sphere, with a much better result in terms of adherence to public health campaigns than what was observed in France (Macia et al., 2022).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study is the first comparison of mask wearing in two widely separated areas. Its results, which are limited by the comparability of the samples constructed, confirm other studies on the impact of age and gender in mask wearing, showing that older people and women follow mask wearing recommendations more. Above all, it clearly shows contrasting relationships to the state and to public space, and thus different forms of mask government for those who decide to wear them or not, depending on the influence of religious authorities in public life. A state that is both more coercive and more protective, such as France, produces a lower level of adherence to mask-wearing recommendations than a state where prescribing authorities, particularly religious, are more diverse, and where individuals must obtain masks themselves. While Seine-Saint-Denis and the city of Dakar are sentinel territories with regard to the spread of the epidemic, this notion does not have the same meaning in the use of masks: the Paris suburbs were more exposed than other French regions to the ambivalence of the State and its hesitations in times of pandemic, while the Senegalese capital played more the role of an outpost for the sanitary measures followed in Africa, in particular through the supervision of a major pilgrimage.\u003c/p\u003e\n\u003cp\u003eWhile most states are lifting the obligation to wear masks as a result of the pandemic\u0026apos;s resurgence, can the forms of mask government described in this study be used to predict its effects on the populations studied? Interviews with schoolchildren in Seine-Saint-Denis show that the most vulnerable families continue to wear masks, while the association between masks and the state decreases due to the greater availability of cheap masks. In contrast, in Senegal, it appears that the mask has become a health accessory like any other for managing epidemics, as evidenced by the high rate of adherence to anti-Covid measures revealed by our study. In both cases, it seems that the focus of the debate on mask government around the state has limited other ways of presenting oneself in the public space to protect against respiratory diseases.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u0026middot; Ethical approval and consent : This research has been conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from participants. The research study has been approved by the National Ethics Committee of Senegal headed by Pr Anta Tall Dia : https://www.cners.sn/\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Consent to publish : Authors consent this article to be published.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Funding information : No external funding was used for this research.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Conflict of interest : Authors declare no conflict of interest\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Author contribution : F.K. and E.M wrote the main manuscript. F.K. conducted studies in Seine Saint Denis. E.M. conducted studies in Dakar.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Availability of data and materials : The data produced by the investigation in Dakar are available in a file entitled \u0026ldquo;Base masques 600\u0026rdquo;. The data produced by the investigation in Seine-Saint-Denis are available on reasonable request to corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026middot; Acknowledgement : The authors wish to thank all the people who took the time to answer their questions. We also thank the \u0026nbsp;interviewers who participated in this study, particularly Amadou H. Diallo, our team leader in Dakar, as well as Florise Pages and Ana Guevara, who supervised the collective inquiry in Seine-Saint-Denis.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAgyemang, E., Agyei-Mensah, S., Kyere-Gyeabour, E. (2021). Face Mask Use Among Commercial Drivers During the COVID-19 Pandemic in Accra, Ghana.\u003cem\u003e Journal of Community Health\u003c/em\u003e. \u003cem\u003e46\u003c/em\u003e(6), 1226-1235. https://doi.org/10.1007/s10900-021-01004-0. \u003c/li\u003e\n\u003cli\u003eAl Naam, Y.A., Elsafi, S.H., Alkharraz, Z.S., Alfahad, O.A., Al-Jubran, K.M., Al Zahrani, E.M. (2021). Community practice of using face masks for the prevention of COVID-19 in Saudi Arabia. \u003cem\u003ePLoS ONE\u003c/em\u003e \u003cem\u003e16\u003c/em\u003e(2): e0247313. https://doi.org/10.1371/journal.pone.0247313\u003c/li\u003e\n\u003cli\u003eBondaz, J., \u0026amp; Bonhomme, J. (2017). \u003cem\u003eL\u0026apos;Offrande de la mort. Une rumeur au S\u0026eacute;n\u0026eacute;gal\u003c/em\u003e. Cnrs \u0026Eacute;ditions.\u003c/li\u003e\n\u003cli\u003eBourdieu, P. (2012). \u003cem\u003eSur l\u0026apos;\u0026Eacute;tat. Cours au Coll\u0026egrave;ge de France (1989-1992)\u003c/em\u003e. Seuil.\u003c/li\u003e\n\u003cli\u003eBrun, S., \u0026amp; Simon, P. (2020). L\u0026rsquo;invisibilit\u0026eacute; des minorit\u0026eacute;s dans les chiffres du Coronavirus : le d\u0026eacute;tour par la Seine-Saint-Denis. In Brun, S., \u0026amp; Simon, P. (ed.), In\u0026eacute;galit\u0026eacute;s ethno-raciales et pand\u0026eacute;mie de coronavirus, \u003cem\u003eDe facto\u003c/em\u003e, 19, http://icmigrations.fr/2020/05/15/defacto-019-05/\u003c/li\u003e\n\u003cli\u003eBurgess, A., \u0026amp; Horii, M. (2012). Risk, ritual and health responsabilisation : Japan\u0026rsquo;s safety blanket of surgical face mask wearing. \u003cem\u003eSociology of Health and Illness\u003c/em\u003e \u003cem\u003e34\u003c/em\u003e (8): 1184-1198. https://doi.org/10.1111/j.1467-9566.2012.01466.x. \u003c/li\u003e\n\u003cli\u003eChen, M. (2012). Masked States and the Screen between disability and security. \u003cem\u003eWomen Studies Quarterly,\u003c/em\u003e 40 (1-2): 76-96. https://doi.org/10.1353/wsq.2012.0004\u003c/li\u003e\n\u003cli\u003eCheng, V.C., Wong, S.C., Chuang, V.W., So, S.Y., Chen, J.H., Sridhar, S. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. \u003cem\u003eJournal of infectiology\u003c/em\u003e \u003cem\u003e8\u003c/em\u003e:107\u0026ndash;114. https://doi.org/10.1016/j.jinf.2020.04.024\u003c/li\u003e\n\u003cli\u003eCondon, J.B. (2020). Who is that masked person: The use of face masks on Mexico City public transportation during the Influenza A (H1N1) outbreak. \u003cem\u003eHealth Policy 95\u003c/em\u003e(1): 50-56. https://doi.org/10.1016/j.healthpol.2009.11.009\u003c/li\u003e\n\u003cli\u003eDeroche, C., Jomier, B., Vermeillet, S. (2021). \u003cem\u003eSant\u0026eacute; publique : pour un nouveau d\u0026eacute;part. Le\u0026ccedil;ons de l\u0026apos;\u0026eacute;pid\u0026eacute;mie de covid-19.\u003c/em\u003e Rapport du S\u0026eacute;nat.\u003c/li\u003e\n\u003cli\u003eFoucault, M. (2003). \u003cem\u003eSociety Must Be\u003c/em\u003e \u003cem\u003eDefended\u003c/em\u003e\u003cem\u003e. Lectures at the College de France, 1975-76.\u003c/em\u003e MacMillan.\u003c/li\u003e\n\u003cli\u003eGreenhalgh, T, Schmid, M.B., Czypionka, T., Bassler, D., Gruer, L. (2020). Face masks for the public during the covid‑19 crisis. \u003cem\u003eBritish Medical Journal\u003c/em\u003e \u003cem\u003e369\u003c/em\u003e:1435.\u003c/li\u003e\n\u003cli\u003eHaischer, M.H., Beilfuss, R., Hart, M.R., Opielinski, L., Wrucke, D., Zirgaitis, G. (2020) Who is wearing a mask? Gender-, age-, and location-related differences during the COVID-19 pandemic. \u003cem\u003ePLoS ONE 15\u003c/em\u003e(10): e0240785. https://doi.org/10.1371/journal.pone.0240785\u003c/li\u003e\n\u003cli\u003eHoward J, Huang, A., Li, Z., Rimoin, A.W. (2021). An evidence review of face masks against COVID-19. \u003cem\u003ePNAS. 118\u003c/em\u003e(4):e2014564118. https://doi.org/10.1073/pnas.2014564118\u003c/li\u003e\n\u003cli\u003eHoward, M.C. (2021a). Gender, face mask perceptions, and face mask wearing: Are men being dangerous during the COVID-19 pandemic? \u003cem\u003ePersonal Individual Differences\u003c/em\u003e 15;170:110417. https://doi.org/10.1016/j.paid.2020.110417.\u003c/li\u003e\n\u003cli\u003eHoward, M.C. (2021b).The relations between age, face mask perceptions and face mask wearing. \u003cem\u003eJournal of Public Health (Oxford)\u003c/em\u003e https://doi.org/10.1093/pubmed/fdab018.\u003c/li\u003e\n\u003cli\u003eIke J.D., Bayerle, H., Logan, R.A., Parker, R.M. (2020) Face Masks: Their History and the Values They Communicate. \u003cem\u003eJournal of Health Community\u003c/em\u003e \u003cem\u003e25\u003c/em\u003e(12):990-995. https://doi.org/10.1080/10810730.2020.1867257.\u003c/li\u003e\n\u003cli\u003eInglis, D., Almila, A.M. (2020) Un-Masking the Mask: Developing the Sociology of Facial Politics in Pandemic Times and After. \u003cem\u003eSociet\u0026agrave; Mutamento Politica\u003c/em\u003e \u003cem\u003e11\u003c/em\u003e(21): 251-257. https://doi.org/10.13128/smp-11964 \u003c/li\u003e\n\u003cli\u003eKeck, F. (2020) \u003cem\u003eAvian Reservoirs. Virus Hunters and Birdwatchers in Chinese Sentinel Posts\u003c/em\u003e. Duke University Press. \u003c/li\u003e\n\u003cli\u003eKleinmann A., \u0026amp; Watson, J. (Eds.). (2006) \u003cem\u003eSARS in China. Prelude to Pandemics\u003c/em\u003e. Stanford University Press.\u003c/li\u003e\n\u003cli\u003eLakoff, A. (2017). \u003cem\u003eUnprepared. Global Health in a Time of Emergency.\u003c/em\u003e University of California Press.\u003c/li\u003e\n\u003cli\u003eLai, A., Poon, C., \u0026amp; Cheung, A. (2011). Effectiveness of facemasks to reduce exposure hazards for airborne infections among general populations. \u003cem\u003eJournal of the Royal Society Interface 9\u003c/em\u003e: 938\u0026ndash;948. https://doi.org/10.1098/rsif.2011.0537 \u003c/li\u003e\n\u003cli\u003eLynteris, C. (2018). Plague \u003cem\u003eMasks\u003c/em\u003e\u003cem\u003e:\u003c/em\u003e The Visual Emergence of Anti-Epidemic Personal Protection Equipment. \u003cem\u003eMedical Anthropology\u003c/em\u003e \u003cem\u003e37 \u003c/em\u003e(6): 442-457. https://doi.org/10.1080/01459740.2017.1423072\u003c/li\u003e\n\u003cli\u003eMauss, M. (1950). Une cat\u0026eacute;gorie de l\u0026apos;esprit humain : la notion de \u003cem\u003epersonne\u003c/em\u003e\u003cem\u003e,\u003c/em\u003e celle de \u0026ldquo;moi\u0026rdquo;. In Mauss M., \u003cem\u003eSociologie et anthropologie. \u003c/em\u003ePUF.\u003c/li\u003e\n\u003cli\u003eRieger, M.O. (2020). To wear or not to wear? Factors influencing wearing face masks in Germany during the COVID-19 pandemic. \u003cem\u003eSocial Health Behaviour 3\u003c/em\u003e: 50-4. https://doi.org/10.4103/SHB.SHB_23_20\u003c/li\u003e\n\u003cli\u003ede Souza, P.R. (2020). Protection masks with religious motifs: Covid-19 produces new religious materiality. \u003cem\u003eInternational Journal of Latin American Religions\u003c/em\u003e \u003cem\u003e4\u003c/em\u003e: 402\u0026ndash;416. https://doi.org/10.1007/s41603-020-00117-z\u003c/li\u003e\n\u003cli\u003eShelus, V.S., Frank, S.C., Lazard, A.J., Higgins, I.C.A., Pulido, M., Richter, A.P.C. (2020). Motivations and Barriers for the Use of Face Coverings during the COVID-19 Pandemic: Messaging Insights from Focus Groups. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e \u003cem\u003e17\u003c/em\u003e: 9298. https://doi.org/10.3390/ijerph17249298 \u003c/li\u003e\n\u003cli\u003eShooter, R.A., Smith, M.A., Hunter, C.J.(1959). A study of surgical masks. \u003cem\u003eBritish Journal of Surgery\u003c/em\u003e\u003cem\u003e \u003c/em\u003e\u003cem\u003e47\u003c/em\u003e: 246\u0026ndash;49. https://doi.org/10.1002/bjs.18004720312\u003c/li\u003e\n\u003cli\u003eSin, M.S.Y. (2016). Masking fears: SARS and the politics of public health in China. \u003cem\u003eCritical Public Health 26\u003c/em\u003e:88\u0026ndash;98. https://doi.org/10.1080/09581596.2014.923815\u003c/li\u003e\n\u003cli\u003eStrasser B., \u0026amp; Schlich, T. (2020), A history of the medical mask and the rise of throwaway culture. \u003cem\u003eLancet 396\u003c/em\u003e(10243): 19-20 https://doi.org/10.1016/S0140-6736(20)31207-1\u003c/li\u003e\n\u003cli\u003eTomes, N. (2010) \u0026quot;Destroyer and teacher\u0026quot;: Managing the masses during the 1918-1919 influenza pandemic. \u003cem\u003ePublic health reports \u003c/em\u003e125 (3): 48-62. https://doi.org/10.1177/00333549101250S308\u003c/li\u003e\n\u003cli\u003eTsang, P.M., \u0026amp; Prost, A. 2021 Boundaries of solidarity: a meta-ethnography of mask use during past epidemics to inform SARS-CoV-2 suppression. \u003cem\u003eBritish Medical Journal of Global Health\u003c/em\u003e ;6:e004068. doi:10.1136/bmjgh-2020-004068\u003c/li\u003e\n\u003cli\u003eZhang, Y. S. D., Leslie, Y. H., Sharafaddin-Zadeh, Y., Noels, K.,\u0026amp; Lou, N. M. (2021). Public health messages about face masks early in the COVID-19 pandemic: perceptions of and impacts on Canadians. \u003cem\u003eJournal of Community Health.\u003c/em\u003e https:// doi. org/ 10. 1007/s10900- 021- 00971-8\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"face mask, Covid 19, state, public space","lastPublishedDoi":"10.21203/rs.3.rs-2096465/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-2096465/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe pandemic of Covid-19 has led to reluctance or resistance to wear a mask in countries that made it compulsory. The acceptance to wear a mask against respiratory diseases depends on conceptions of scientific authority and of the personality in the public space. It has material and symbolic dimensions that can be covered under the term \u0026ldquo;government of masks\u0026rdquo;. We have questioned populations on these two aspects in territories we call sentinel because they are more exposed than others to emerging infectious diseases: Dakar (Senegal) and Seine-Saint-Denis (France). Our results show that the perception of the state is different in these territories and determines the uses of masks against Covid-19. While in Seine-Saint-Denis, the state provides more masks than in Dakar, the trust in the efficacy of mask wearing is lower. From a symbolic point of view, the mask is for many people an intrusion of the state into the private sphere, which hinders physical contact between family members. On the contrary, from the material point of view, the mask is a need that manifests the presence of the welfare state to watch over the health of the population. A state that is both more coercive and more protective produces a lower level of adherence to mask-wearing recommendations than a state where prescribing authorities, particularly religious, are more diverse, and where individuals must obtain masks themselves.\u003c/p\u003e","manuscriptTitle":"The government of masks in sentinel territories against Covid-19: Dakar and Seine-Saint-Denis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-11-15 14:33:38","doi":"10.21203/rs.3.rs-2096465/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2023-04-09T03:20:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2023-03-22T18:59:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"9d70050e-1cd7-40ca-bb5e-d6dcffe619cb","date":"2023-03-09T21:00:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2023-03-09T16:11:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-03-08T18:31:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2022-11-11T12:29:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2022-11-11T12:21:07+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2022-09-23T12:55:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5bce2189-a2ce-46c3-a94a-ef4295d1bef5","owner":[],"postedDate":"November 15th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2023-10-16T21:48:45+00:00","versionOfRecord":{"articleIdentity":"rs-2096465","link":"https://doi.org/10.1186/s12889-023-15968-2","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2023-07-05 21:29:48","publishedOnDateReadable":"July 5th, 2023"},"versionCreatedAt":"2022-11-15 14:33:38","video":"","vorDoi":"10.1186/s12889-023-15968-2","vorDoiUrl":"https://doi.org/10.1186/s12889-023-15968-2","workflowStages":[]},"version":"v1","identity":"rs-2096465","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-2096465","identity":"rs-2096465","version":["v1"]},"buildId":"wLkW0s4AflPzk-lpfg-fK","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}