‘Face coverings for covid-19: from medical intervention to social practice’ published today in @bmj_latest : http://bmj.com/cgi/content/full/bmj.m3021 with phenomenal @OxPrimaryCare @TBProof team @trishgreenhalgh @dr_nina_g @SKGTonkinCrine and Koot Kotze A thread:

1/ Debates on masks framed the use of face coverings by the public during covid as medical tool. Focussing on implementation, we should shift from the medical narrative to one that views face coverings as social practice.

2/ Face coverings as ‘social practice’ incorporates symbolic meaning (wearing a mask as sign of strength vs infringement of civil liberties), social expectations, norms & mandates. Interventions need to be grounded in social and cultural practices of affected communities.

3/ Eg. Community-led #masks4All campaign that started in Czech republic, appeals to a shared set of values, (my mask protects you, your mask protects me) used celebrity influencers, music, community mask making & sharing, and spread globally, incl rural hospital in South Africa

4/ So how to shift public health messaging from medical intervention to social practice? Please less emphasis on ‘risk‘ ‘ self contamination’ ‘donning and doffing’ balance mask efficacy with acceptability and comfort

4/ ‘Embracing social narratives could enable the public to select a face covering that is meaningful to them and that they will be more likely to wear. ’ are of me & my sister - despite being on different continents we made our face coverings from the same material.

5/ Thank you to @kittylaroar, George Hospital Trust and @ingridsuidA for valuable input on the article. /End