A novel coronavirus (SARS-CoV-2) emerged in the city of Wuhan, China in December 2019
and has now spread worldwide. Since the end of February 2020, the COVID-19 spread
to South Korea and there was a rapid increase in COVID-19 cases from the end of February
to mid-March. Fortunately, due to the efforts from both government and private sectors,
the spread of the disease has been declining rapidly and only a few cases were reported
There are several reasons why COVID-19 has been relatively well controlled in South
Korea. Wearing a face mask in public seems to have been one of the major contributing
factors. During the COVID-19 pandemic, the use of face masks has been discouraged
in several countries, particularly in Europe. However, our government has strongly
advised wearing a mask (11, 12) from the beginning. Hence, we felt it would be highly
informative to share the experience of South Korea from a public health perspective.
In South Korea, an aggressive “trace, test, and treat” program was put in place. The
general public was advised to avoid large gatherings and crowded places, and to keep
quarantine protocols, such as wearing a mask, washing hands, and social distancing.
Among these, wearing a mask is counted as one of the most effective preventive measures
among general protocols. According to a recently published article, 63.2% of Koreans
reported wearing a facial mask when they were outside (1). In another international
survey, the reported rate of wearing face masks among Koreans was even higher (94%)
and the highest among 28 countries (2).
There are several reasons why wearing a mask has been well accepted by public in South
Korea. In 2015, there was an outbreak of 186 patients with MERS-CoV infection, including
38 fatalities in South Korea. The epidemic has lasted for 2 months and the government
quarantined 16,993 individuals(3). The MERS outbreak strengthened the behavior of
wearing a mask in the face of unexpected threat of respiratory viral infections.
The increased awareness of particulate matter (PM) also needs to be mentioned. South
Korea has had the highest PM level among OECD countries (4). Over the last few years,
people in Korea became more and more aware of the problem after government started
to issue alerts. Yellow dust (also called yellow sand or Asian dust), a natural source
of particulate matter(PM), originates from the deserts of Mongolia and northern China,
particularly in springtime, and has long been a public health issue after a formal
warning in February, 2014 (5). The professional medical societies in South Korea have
warned about health hazards from impaired infant health to increased adult mortality
rate, and people are advised to wear a facial mask when PM level is very high(,
, , , ). This increasing public concern regarding PM has made wearing
a face mask a matter of everyday life during epidemics of respiratory diseases in
The acceptance of wearing face masks might be influenced by cultural differences.
In European countries, wearing a face mask traditionally has been taken to indicate
illness or bad intention. By contrast, it seems to be generally regarded as a sign
of thoughtfulness and modesty in South Korea. Interestingly, young Korean pop (Kpop)
singers made mask-wearing a fashion trend. So, wearing a mask is considered as a fashion
item by young persons in many Asian countries.
Although N95 respirators showed several advantages over medical masks in experimental
conditions, several meta-analyses have concluded that there are insufficient data
to support the superiority of N95 respirators over medical masks in protecting against
transmissible respiratory pathogens including SARS-CoV-2 in clinical settings (,
, ). A recently published article clearly showed the effectiveness of surgical
face masks in reducing respiratory viral shedding(17).
To conclude, considering the relatively low incidences of severe cases or mortality
and good control of COVID-19 in several countries where self-quarantine principles
are well established, wearing protective masks is an important strategy to stop the
spread of respiratory viruses such as SARS-CoV-2. Among several ways that were helpful
for South Korea to combat this pandemic effectively, adhering to quarantine protocols
such as wearing an appropriate mask in the proper way seems to have been vital. Maintaining
social distance at all times and washing hands thoroughly also must have played a
critical role for controlling COVID-19.
Declaration of Competing Interest
The authors have nothing to declare.