Face masks’ wide public use began with Spanish flu, and soon embroidered ones became popular

There’s nothing new about wearing face masks to combat the spread of disease – reusable, patterned cloth ones were worn by many in the Spanish flu epidemic
The practice spread widely, even to rural Australia, as this writer was reminded on a visit to an elderly godmother soon after the Sars outbreak ended in 2003

Jason Wordie

Published: 8:45am, 8 Mar 2022

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The Spanish flu epidemic, which broke out in 1918 and claimed tens of millions of lives by the time it finally subsided, in 1921, first brought the concept of face masks to the world’s attention.

Hitherto seen only in operating theatres and similar medical settings, this earlier global pandemic helped make populations aware that forms of nose and mouth covering, such as face masks, helped reduce the spread of highly transmissible infectious diseases.

Broader public health lessons from the Spanish flu epidemic had been generally absorbed by the 1930s; among the hygiene-conscious Japanese, in particular, along with parts of East Asia influenced by Japanese cultural norms, such as Korea and Formosa (now Taiwan), face masks became commonplace among anyone with respiratory infections liable to cause coughing and spitting.

Influenza was not the only disease where face masks were deployed in an effort to “flatten the infection curve”. During the wartime Japanese occupation of Hong Kong, a sudden diphtheria outbreak in the Sham Shui Po prisoner-of-war camp swiftly led to quarantine of patients in specific huts to help break the chain of infection.

A street sweeper wears a cloth face mask while working during the 1918 influenza pandemic in New York. Photo: Gado/Getty Images

Confirmed cases were isolated, and camp-produced masks, made from white cotton, gauze or other fabrics, were worn by all those undergoing quarantine, and anyone else who came into close contact with them. These masks were sterilised by boiling before reuse. Scarce resources meant single-use disposability – the norm today for such items – was impossible.

Face masks also became commonplace during the Spanish flu epidemic in some seemingly unlikely places. Not long after Hong Kong’s severe acute respiratory syndrome (Sars) outbreak subsided in 2003, I visited my elderly godmother in rural Queensland.

A Hong Kong kindergarten teacher checks a child’s mask during the Sars outbreak in 2003. Photo: SCMP/Robert Ng

A single visit to Hong Kong years before in her late 70s – her only ever trip out of Australia – had sparked off a wide-ranging interest and enthusiasm for anything to do with the place. Talk inevitably turned to how the Sars outbreak had been handled; the universal wearing of face masks in Hong Kong during that time naturally came into our conversation.

Somewhere, she had read that certain local fashion designers – whether to be trendy or ironic had never seemed clear – had used beaded face-mask designs as part of their season fashion collections; this particular nonsense naturally attracted much practical, countrywoman’s mirth. “Now, how on Earth would something like THAT ever hope to keep the germs away?” she chortled.

Reusable cloth face masks had been a dimly remembered part of my godmother’s infancy and early childhood – she had been born in 1919, the year the Spanish flu really began to spread around the globe.

Masked pedestrians cross a road in Hong Kong during the coronavirus pandemic. Photo: Bloomberg

On recalling that she still had them, we pulled out the battered fibre suitcase from under the bed in the spare room, in which Jimmy, her much-loved, threadbare, jointed teddy bear, Margaret the celluloid sleeping doll, whose porcelain eyes opened and shut, school prize books, old birthday cards, and all the other carefully preserved treasures and souvenirs from her long-ago bush childhood, were carefully stored.

Tucked away in a brown paper envelope, among other handmade garments, were several baby- and infant-sized cloth face masks, brightly embroidered with bunny rabbits, sprays of flowers, Red Cross symbols and other patterns, along with a few adult-sized versions that her mother had made to match.

Like the current Covid-19 pandemic, the Spanish flu took a few years to finally burn itself out globally; meanwhile, these items were everyday attire in rural Queensland and – much like today’s commercially available patterned masks – some people took the opportunity to stamp an individual style on what was, ultimately, a tiresome, health-driven necessity.

To my lasting regret, I didn’t think to photograph these historically important artefacts, and sadly have no idea what eventually became of them when that dear person finally passed away, several years later.