Protection, freedom, stigma: A critical discourse analysis of face masks in the first wave of the COVID-19 pandemic and implications for medical education

Huo, Ran; Martimianakis, Maria Athina

doi:https://doi.org/10.36834/cmej.73155

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Abstract

Background: The COVID-19 pandemic has spotlighted the face mask as an intricate object constructed through the uptake of varied and sometimes competing discourses. We investigated how the concept of face mask was discursively deployed during the first phase of the COVID-19 pandemic. By examining the different discourses surrounding the use of face masks in public domain texts, we comment on important educational opportunities for medical education.

Method: We applied critical discourse methodology to look for key phrases related to face masks that can be linked to specific socio-economic and educational practices. We created an archive of 171 English and Mandarin texts spanning the period of February to July 2020 to explore how discourses in Canada related to discourses of mask use in China, where the pandemic was first observed. We analyzed how the uptake of discourses related to masks was rationalized during the first phase of the pandemic and identified practices/processes that were made possible.

Results: While the face mask was initially constructed as personal protective equipment, it quickly became a discursive object for rights and freedoms, an icon for personal expression of political views and social identities, and a symbol of stigma that reinforced illness, deviance, anonymity, or fear.

Conclusion: Discourses related to face masks have been observed in public and institutional responses to the pandemic in the first wave. Finding from this research reinforce the need for medical schools to incorporate a broader socio-political appreciation of the role of masks in healthcare when training for pandemic responses.

Résumé

Contexte : La pandémie de la COVID-19 a mis en lumière le masque facial comme sujet complexe, construit par des discours variés et parfois contradictoires. Nous avons étudié la manière dont le concept du masque a été déployé discursivement pendant la première phase de la pandémie, notamment en examinant les différents discours entourant son utilisation dans des textes du domaine public, tout en relevant d’importantes perspectives pédagogiques qui en découlent pour l’éducation médicale.

Méthode : Adoptant l’approche de l’analyse critique du discours, nous avons dégagé des énoncés clés qui peuvent être liés à des pratiques socio-économiques et éducatives précises. Nous avons créé une archive de 171 textes en anglais et en mandarin couvrant la période de février à juillet 2020 afin de comparer les discours sur le port du masque au Canada et en Chine, où la pandémie a été observée pour la première fois. Nous avons analysé la rationalisation du port du masque par le discours, ainsi que les pratiques et procédures qu’elle a permis de mettre en place lors de la première vague de la pandémie.

Résultats : Alors qu’au départ, le masque était destiné à servir d’équipement de protection individuelle, il est rapidement devenu un objet discursif lié aux droits et libertés, un étendard du droit de la personne d’exprimer ses opinions politiques et son identité sociale, et un symbole de la stigmatisation qui renforçait la maladie, la déviance, l’anonymat ou la peur.

Conclusion : L’analyse des discours relatifs au port du masque observés dans les réponses publiques et institutionnelles à la première vague de la COVID-19 confirme la nécessité pour les facultés de médecine d’intégrer dans l’enseignement de la gestion pandémique une appréciation sociopolitique plus large du rôle du masque en santé.

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