Should we be wearing a face mask when we leave the house? Two doctors answer our coronavirus questions.
When you leave the house, what do you tick off your list? Phone – check. Keys – check. Protective face mask – ?
On Friday (17 April), London Mayor Sadiq Khan called for people to wear non-medical face masks in public as “additional protection” to social distancing. He added: “These would NOT be medical masks - which must be reserved for health and care workers who desperately need them - but scarves or reusable face coverings to reduce the risk of the virus spreading. It is time to act.”
Pre-coronavirus, I can safely say I’d never seen anyone walking around Southwark, the London borough I live in, wearing a face mask for protection. And I’d never have contemplated wearing one myself. But, as the numbers being admitted to hospital with the virus rose, so did my anxiety about leaving the house without protection. So I bought a cheap, reusable, washable face mask off the internet. And, for many people, like me, suddenly a mask or face covering has become part and parcel of our daily accoutrement as we fight the invisible enemy that is Covid-19.
Much like my phone and my keys, now I wouldn’t feel comfortable walking out of the front door without knowing I had something to cover my mouth and nose - a scarf, or the mask - on my person.
But is there any point to a mask, I find myself wondering?
A quick Google search brings up the news that in Lombardy, the worst hit region of Italy, face masks are now mandatory. And in America, the US Centers for Disease Control and Prevention recommends people in the US wear “cloth face coverings” when they go out.
So should we be wearing masks in the UK? And what about the people who haven’t embraced wearing a mask?
Speaking with my friends and colleagues, it seems I have immersed myself in a face-covering bubble. Stylist digital deputy editor Jaz Kopotsha is firmly in the ‘anti-mask’ camp, and she gave me two reasons for not wearing a face mask.
“Firstly, I’m really not convinced an uncertified ‘medical’ mask from the shop down the road is effective. Well, effective enough,” she says.
“I understand the ‘better safe than sorry’ rationale. And I understand that some masks may genuinely be useful as a preventative measure if you have symptoms and don’t want to accidentally sneeze on someone. But we’re dealing with Covid-19 here and I’m not about this false sense of security they’re encouraging. It’s just not enough.
“Secondly, they look really bloody uncomfortable and, vanity aside, I don’t fancy wandering around secretly panicking about not being able to breathe through the material covering my nose and mouth.”
As the debate around masks and protective face-coverings rages on, I wanted to know: what does covering your face really do to help fight the virus? So I asked two doctors.
Do masks stop the spread of viruses?
“The coronavirus causing Covid-19 is relatively large and the risk of transmission appears to be reduced by wearing a mask. The mask provides a physical barrier to help trap the virus,” Dr Sarah Brewer, Medical Director of Healthspan says.
“There is emerging evidence that wearing a mask when in contact with other people may help to reduce the spread of the disease - the mask provides some protection against coughed air droplets from others carrying the virus and, if you are a carrier, helps to protect others from catching the infection from you.”
Dr Christie Lewis, NHS GP, adds: “There is much debate and disparity on the rules surrounding masks in different countries. Several studies have researched whether masks provide an extra level of protection but there is not a conclusive outcome.
“There needs to be more robust studies undertaken therefore we can only follow the current guidance in the UK and by the World Health Organisation (WHO) which states that masks are NOT a substitute for social distancing, keeping two meters apart, or carefully washing your hands.”
What is the current advice around wearing masks in the UK?
The UK government is not currently advising most people to wear masks. But, this weekend, a group of more than 100 UK doctors wrote an open letter to The Times saying they were “alarmed at official inaction over the need for the public to wear homemade face masks”, which could be made by volunteer groups.
Chief scientific adviser Sir Patrick Vallance confirmed the issue was under review on 13 April, and the government’s Scientific Advisory Group for Emergencies (SAGE) is set to make recommendations to ministers. He said: “We would give new advice if we saw new evidence. As you know the WHO has stayed with their recommendation around masks, we look at this and update our view from time to time.”
Robert Peston asked a question about the public wearing face masks on tonight’s UK government daily coronavirus briefing (21 April).
Matt Hancock replied: “We are advised by the science and we’ve been asked this question many times. We listen to what the scientists say.” He said SAGE met today and he looks forward to hearing their updated advice around the public wearing face masks.
The European Centre for Disease Prevention and Control reported in April that the use of face masks in public may serve as a means of source control to reduce the spread of the infection in the community by minimising the excretion of respiratory droplets from infected individuals who have not yet developed symptoms or who remain asymptomatic.
It added that the use of face masks in the community should be considered only as a complementary measure and not as a replacement of the preventive measures already recommended including physical distancing, respiratory etiquette, meticulous hand hygiene and avoiding touching the face, nose, eyes and mouth.
The use of non-medical face masks could be considered, especially if – due to supply problems – medical face masks must be prioritised for use as personal protective equipment by healthcare workers. This is based on limited indirect evidence supporting the use of non-medical face masks as a means of source control.
Appropriate use of face masks is the key to the effectiveness of the measure and can be improved through education campaigns, the report adds.
Why is there conflicting advice about face masks?
Dr Lewis says: “Health Agencies seem to be reticent around giving official guidance on mask wearing for three main fears. Firstly, it may lead to stockpiling making it harder for frontline medical staff and other key workers to access professional-level protection. Secondly, it may give people a false sense of security, leading to people not abiding by the rules of social distancing and careful hand washing.
“And finally, there may be a risk of misuse, as masks not used and disposed of properly can cause more harm than good.”
Dr Brewer adds: “My concern is that if we all start buying masks there may be a reduced supply for those who really need them – ie healthcare and other frontline workers.
“Wrapping a scarf around your face and wearing glasses may help to provide a barrier against airborne droplets from those carrying the virus (and help to protect others from you if you are carrier). Other measures such as social distancing are also designed to help prevent transmission.”
Is there anything else we should be doing to protect ourselves?
“Follow all the guidance on social distancing and washing hands,” Dr Brewer says. “There is some preliminary evidence published in the Irish Medical Journal that having a good vitamin D status may help to improve outcomes in people infected with the coronavirus. Although this is by no means certain, it is important to follow the advice of Public Health England to take a vitamin D supplement during the cold months of the year.”
World Health Organisation guidelines: when and how to wear a mask
- If you are healthy, you only need to wear a mask if you are taking care of a person with suspected COVID-19 infection.
- Wear a mask if you are coughing or sneezing.
- Masks alone are not effective, so if you do wear a mask only use them in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
- If you wear a mask, then you must know how to use it and dispose of it properly.
How to wear a mask properly:
- Before putting on a mask, clean hands with alcohol-based hand rub or soap and water.
- Cover mouth and nose with mask and make sure there are no gaps between your face and the mask.
- Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.
- Replace the mask with a new one as soon as it is damp and do not re-use single-use masks.
- To remove the mask: remove it from behind (do not touch the front of mask); discard immediately in a closed bin; clean hands with alcohol-based hand rub or soap and water.