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

Question Addressed: In contrast with pain, dyspnoea is not visible to the general public, who lack the corresponding experiential baggage. We tested the hypothesis that the generalised use of face masks to fight severe acute respiratory syndrome coronavirus 2 dissemination could change this and sensitise people to respiratory health.
Methods: General population polling (1012-person panel demographically representative of the adult French population, quota sampling method; 517 (51%) female). 860 (85%) answered "no" to "treated for a chronic respiratory disease" ("respiratory healthy"), and 152 answered "yes" ("respiratory disease"). 14% of respiratory healthy respondents reported having a close family member treated for a chronic respiratory disease (RH-family ⁺ ). Respondents described mask-related attitudes, beliefs, inconveniencies, dyspnoea and changes in their respiratory health vision . RESULTS: Compliance with masks was high (94.7%). Dyspnoea ranked first among mask inconveniencies (respiratory disease 79.3%, respiratory healthy 67.3%; p=0.013). "Air hunger" was the main sensory dyspnoea descriptor. Mask-related dyspnoea was independently associated with belonging to RH-family ⁺ (OR 1.85, 95% CI 1.16-2.98) and removing masks to improve breathing (OR 5.21, 95% CI 3.73-7.28). It was negatively associated with considering masks effective to protect others (OR 0.42, 95% CI 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 Question: Wearing protective face masks leads to the mass discovery of breathing discomfort. It raises public awareness of what respiratory diseases involve and sensitivity to the importance of breathing. These data should be used as the fulcrum of respiratory health oriented communication actions.
Competing Interests: Conflict of interest: L. Serresse has nothing to disclose. Conflict of interest: N. Simon-Tillaux has nothing to disclose. Conflict of interest: M. Decavèle has nothing to disclose. Conflict of interest: F. Gay has nothing to disclose. Conflict of interest: N. Nion has nothing to disclose. Conflict of interest: S. Lavault has nothing to disclose. Conflict of interest: A. Guerder has nothing to disclose. Conflict of interest: A. Châtelet is an employee of the IFOP polling institute. Conflict of interest: F. Dabi is an employee of the IFOP polling institute. Conflict of interest: A. Demoule reports grants, personal fees and non-financial support from Philips, Respinor and Lungpacer, personal fees from Baxter, Getinge, Lowenstein and Gilead, personal fees and non-financial support from Fisher & Paykel, grants from French Ministry of Health, outside the submitted work. Conflict of interest: C. Morélot-Panzini reports personal fees for lectures and board membership from AstraZeneca, GSK, SOS Oxygène, ADEP, ISIS, Resmed, Chiesi, Menarini, Vivisol, Air Liquide, Lowenstein, Fisher & Paykel, outside the submitted work. Conflict of interest: C. Moricot has nothing to disclose. Conflict of interest: T. Similowski reports personal fees from AstraZeneca France, Boehringer Ingelheim France, TEVA France, Chiesi France, Lungpacer Inc. and ADEP Assistance, personal fees and non-financial support from Novartis France, grants from Air Liquide Medical Systems, outside the submitted work.
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