Lifting dyspnoea invisibility: COVID-19 face masks, the experience of breathing discomfort, and improved lung health perception – a French nationwide survey

Abstract

Question addressedIn contrast with pain, dyspnoea is not visible to the general public who lack the corresponding experiential baggage. We tested the hypotheses that the generalised use of face masks to fight SARS-CoV2 dissemination could change this and sensitise people to respiratory health.MethodsGeneral population polling (1012-person panel demographically representative of the adult French population –quota sampling method–; 517 women, 51%). 860 (85%) answered “no” to “treated for a chronic respiratory disease” (“respiratory healthy”, RH) and 152 “yes” (“respiratory disease”, RD). 14% of RH respondents reported having a close family member treated for a chronic respiratory disease (RH-family+ and RH-family−). Respondents described mask-related attitudes, beliefs, inconveniencies, dyspnoea, and changes in their respiratory health vision.ResultsCompliance with masks was high (94.7%). Dyspnoea ranked first among mask inconveniencies (RD 79.3%, RH 67.3%, p=0.013). “Air hunger” was the main sensory dyspnoea descriptor. Mask-related dyspnoea was independently associated with belonging to RH-family+ (Odds Ratio [OR] [95% confidence interval (CI)]: 1.85 [1.16–2.98]) and removing masks to improve breathing (OR 5.21 [3.73–7.28]). It was negatively associated with considering masks effective to protect others (OR]: 0.42 [0.25–0.75]). Half the respondents were more concerned with their respiratory health since wearing masks; 41% reported better understanding patients’ experiences.Answer to the questionWearing protective face masks leads to the mass discovery of breathing discomfort. It raises the public's awareness of what respiratory diseases involve and sensitises to the importance of breathing. These data should be used as the fulcrum of respiratory-health-oriented communication actions.

‘Involve me and I learn’: an experiential teaching approach to improve dyspnea awareness in medical residents

“…Thirdly, the ‘experiential understanding’ variable (experimental dyspnea-related improvement in understanding dyspneic patients’ experience) was the only variable that remained significantly associated with the overall course rating in multivariate analysis. The apparent importance of ‘experiential understanding’ in changing the participants’ perspective is consistent with observations showing that breathing discomfort linked to the use of COVID-19 face masks relates to improved perception of the lived experience of patients with chronic respiratory disease [ 20 ].…”

“…Ratings were particularly high, notably regarding dyspnea unpleasantness (median of 8). This observation is reminiscent of the high ratings associated, in the general public, with COVID-19 face mask-induced breathing discomfort, previously interpreted as illustrating the impossibility of imagining the intensity of a characteristic of which an individual has no direct experience [ 20 ]. We did not find differences according to the method used to self-induce dyspnea, in contrast with literature data differentiating inspiratory threshold loading and CO 2 stimulation [ 33 ].…”

“…This hypothesis was based on anecdotal observations of the impact of laboratory dyspnea on medical personnel (after his first personal encounter with air hunger, a young intensivist from our group once said that he would ‘ never again tell an agitated [dyspneic] mechanically ventilated patient to calm down ’ [ 19 ]). A population survey also demonstrated that the breathing discomfort associated with COVID-19 face masks can enhance the general public understanding of the lived experience of chronic respiratory disease patients [ 20 ]. More generally, the exposure of medical trainees to symptoms leads to improved empathy toward patient experiences experiential learning, see [ 21–23 ].…”

Changes in Behavior After Vaccination and Opinions Toward Mask Wearing: Thoracic Oncology Patient–Reported Experiences During the COVID-19 Pandemic

“…Especially those with more significant health risks showed higher compliance levels to social distancing measures. 14 However, other studies found that vaccinated people increased their social contacts after vaccination and decreased other measures like mask wearing and careful hand washing. 22 , 23 Consequently, a preprint from Denmark found an increase in infections of 40% in the first 2 weeks after vaccination with Pfizer-BioNTech.…”

The Difference in Electromyographic Activity While Wearing a Medical Mask in Women with and without Temporomandibular Disorders

“…On the other hand, wearing medical masks can provoke adverse health effects. Besides feeling discomfort [ 5 ], mask wearers report headaches [ 6 , 7 ], breathing difficulties [ 8 ], and can experience dermatological problems [ 9 ]. The irritation of nerves and other soft tissue in the neck and head region caused by the medical mask straps also contributes to headaches [ 6 ].…”