NEW YORK/PALO ALTO, U.S. -- Krystal Ji, a China-born lawyer working in San Francisco's busy Financial District, believes that wearing face masks reduces her risk of contracting the new coronavirus. But a seemingly minor incident last week convinced the 26-year-old to ditch them.
Ji was waiting for the elevator in her company's lobby, wearing a mask. When the elevator came, a man behind her saw the mask and decided to wait for the next one, even though there was plenty of room.
"I was so embarrassed and became super self-conscious whenever I put my masks on," Ji told the Nikkei Asian Review. "Even though my bosses and colleagues never said anything about me wearing masks, I just thought I might make them feel uncomfortable."
Ji's experience hints at a fundamental difference in how masks are viewed in the West versus Asia. Many U.S. residents of Asian descent appear to be conflicted over whether to wear them -- lest they make others nervous or, worse, invite racist attacks.
Public anxiety in the U.S. has grown alongside rising case numbers. Since the country confirmed its first infection in January, the tally has soared past 1,300, with concentrations in the states of New York, Washington and California.
But while China, for one, insists that people wear masks in an attempt to limit community spread, U.S. officials have strongly advised against wearing them. This advice comes from the top -- U.S. Surgeon General Jerome Adams -- who has repeatedly said people should just wash their hands and avoid crowds.
"Seriously people- STOP BUYING MASKS!" Adams tweeted earlier this month. "They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can't get them to care for sick patients, it puts them and our communities at risk!"
Likewise, the Centers for Disease Control and Prevention website says "the routine use of respirators outside of workplace settings" is not recommended among healthy individuals.
While American consumers have certainly bought their share of masks since the crisis started, not everyone is at ease wearing them in public. There are multiple reasons for this, "but I think the most important one is cultural," said Xi Chen, assistant professor of health policy and economics at the Yale School of Public Health.
"Traditionally, Western societies believe only those infected should wear face masks because they could spread the virus, but healthy people do not need to do so."
But the differences in policy are also "economic," Chen said.
Medical-grade masks are "definitely effective" in reducing the likelihood of infecting others as well as lowering one's own chances of infection, Chen said. But "if everybody needs one face mask every day, we would need at least 300 million. In the American market there is definitely no such supply."
Over 90% of the personal protective equipment used in the U.S. is made overseas, with China as the biggest supplier, according to the Department of Health and Human Services.
But since the coronavirus broke out, the Chinese government has directed factories to prioritize domestic demand. Hospitals across the U.S. are rationing their surgical mask supplies and only fit-tested health care workers can receive N95 respirators. Many U.S. state health departments have made their emergency mask stockpiles available.
Some doctors in the U.S. are also arguing that masks give wearers a false sense of security.
"Masks usually don't prevent you from catching disease," said Dr. Fred Davis, associate chair of Emergency Medicine at Northwell Health's Long Island Jewish Medical Center. "The standard is basically hand hygiene, which is cleaning your hands [and] washing your hands effectively. The problem is if you're not sick, having the mask on gives you that false sense that you're safe and then you forget to wash your hands."
"You keep that mask on all day, it gets wet and it just breeds its own site of infection," Davis continued.
Besides washing hands, U.S. experts stress the importance of keeping one's distance from others. The CDC notes that respiratory viruses spread from person-to-person through close contact, within 2 meters. Surgeon General Adams tweeted this week that people should "take everyday precautions to keep space between yourself and others" and "when you go out in public, keep away from others who are sick, limit close contact."
But Yale University's Chen -- while conceding that the lower population density in the U.S. makes masks less of a must-have -- draws a distinction between rural towns and large cities where maintaining distance is not always easy.
"I think they should say something more specific -- in bigger cities, it makes sense [to wear masks], especially for vulnerable groups," Chen said.
When New York City declared a mask shortage last week, Health Commissioner Oxiris Barbot said in a statement that "while we do not advise healthy New Yorkers wear masks, they do provide a public health benefit in some situations."
All this leaves Asian communities in the U.S. wondering what to believe and how to protect themselves.
"I think people should wear masks in New York because of the density of the population here and the lack of infrastructure for people to have access to sanitation," said a 25-year-old Chinese woman in the city, who asked not to be named. "But I won't wear masks because local authorities don't recommend wearing masks in public, and I've seen people wearing masks who got attacked.
"Wearing masks is not accepted by the culture here."
Some are haunted by concerns over hate crimes. There have been multiple reports of coronavirus-related public assaults on Asians -- with and without masks.
On Tuesday, a teenager kicked a 59-year-old Asian man to the ground from the back and spat in his face in the Upper East Side of Manhattan, while yelling "F--king Chinese coronavirus," according to the New York Post. On the same day, a 23-year-old Asian woman was reportedly punched in the face by an acquaintance in the Midtown area. The suspect used racist slurs before fleeing, according to NBC News.
Last week, a Facebook video showed a New York City subway rider yelling at an Asian passenger and repeatedly ordering him to move, then spraying the Asian stranger with what appeared to be Febreze.
Min Ong, a 24-year-old marketing associate in San Francisco, told Nikkei that reading news about Asians being attacked while wearing masks partly drove her to leave her masks at home, even though her parents in Thailand constantly remind her to wear one.
"Being the only one wearing a mask, plus being an Asian, made me feel uncomfortable to keep the mask on," Ong said.
Rather than encouraging residents to cover up with masks, the state of New York introduced large-scale social distancing measures this week, banning gatherings exceeding 500 participants and ordering Broadway theaters to shut their doors.
Cassy Liu, a freelance writer in Los Angeles, disagrees with the common American perspective on masks.
"Not wearing masks just because you don't have any symptoms now makes no sense," she said, noting it can take 14 days for symptoms to appear. "Even if you are healthy, you need to consider others around you with weaker immune systems. You can easily infect others without even knowing [that you] had the virus."
Yale's Chen sees a danger of the American public underestimating the coronavirus and said it is vital to increase testing. For now, people who are infected may not fully understand their risk because of the shortage of test kits and the long incubation period.
"In an ideal world, if everyone knows for sure if they are infected or not, we can advise only the infected to wear masks," Chen said. "But now there are people on the streets who don't understand their risk, and this could put the population in danger."