TO WEAR a mask or not to wear a mask is very much the big question.
Having initially been told by the British government that there was "no evidence" to support healthy people wearing them, last week a Cabinet source suggested that covering up with a face mask may be a requirement for everyone returning to work once lockdown is lifted.
And just this week, 100 top doctors signed a letter calling for the public to wear home-made face masks whenever they leave their homes.
Meanwhile, Dr David Nabarro, special envoy for Covid-19 at the World Health Organisation (WHO), suggested during an interview last week that "some form of facial protection is going to become the norm".
Coronavirus: Stormont to discuss the wearing of masks after Scotland recommendation
Already it is compulsory to wear masks while shopping or using public transport in Austria and parts of Italy, and those living in the Czech Republic and neighbouring Slovakia must wear masks whenever they go out.
Yet while some believe wearing a mask can act as a physical barrier to prevent infection with coughed or sneezed particles, others argue that people can accidentally infect themselves when taking a mask off, and that a mask can make people less fastidious about adhering to measures proven to slow the disease’s spread, such as hand-washing.
Paul Hunter, a professor in medicine at the University of East Anglia, recently reviewed 31 studies researching the efficacy of face masks in preventing respiratory illness, such as flu, and says the quality of the research is poor.
"It would be as easy to make an argument for opposing the widespread use of masks as it would be to make an argument promoting their use," he says. "It’s no wonder the public is confused."
We asked three experts – Professor Hunter, David Heymann, professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, and Dr Jenna Macciochi, a lecturer in immunology at the University of Sussex – just what we should do.
- Should I wear a mask to protect myself?
Face masks provide a physical barrier between you and coronavirus particles in the air, but some are more effective than others.
Thin disposable surgical masks protect from large droplets but won’t block very small particles that may carry the virus.
More advanced masks contain filters that will block the smaller particles – but these are hard to find outside of medical settings. (FFP2 and FFP3 masks are the respirator masks commonly used by doctors and nurses in Europe, while N95 is used by medics in the US.)
Dr Macciochi says that "to be effective, a mask has to be fitted correctly, worn correctly and disposed of correctly – which is not something the general public has been trained in".
Not wearing a mask properly, is, she says potentially more hazardous than not using one at all, as you may infect yourself with the very particles the mask is protecting you against when you take it off.
There is also the possibility that wearing a mask brings a false sense of security. Countless studies have shown that when people feel safe, they take more risks.
Masks are also limited in the protection they offer as coronavirus is transferred when the virus comes into contact with any mucus membrane – not just the nose or mouth, but the eyes, too.
"Protective eye covering is just as important as wearing a mask, because if coronavirus droplets hit the mucus membranes of the eyes, they can be a source of infection," says Prof Heymann.
"Wearing a mask for personal protection by the general public has not been shown to protect against infections such as influenza and has no role to play in personal protection against Covid-19.
"If you’re in a situation where you can’t physically distance – if you’re working in a care home, for example – then a properly fitting mask should be worn as a precaution to protect the elderly, because if a carer is infected, virus-containing droplets could infect them, too."
- Will a mask protect others?
The other consideration when wearing a mask is that they can work both ways, protecting others from droplets that are released from our mouths and noses. As a result, some experts say that if you are sick, you should wear a mask to protect those around you – even at home, particularly if you can’t isolate yourself in one room.
"People who are coughing and sneezing and can’t physically distance themselves from others – for example, in a household when they are isolated with other family members – should wear a mask to protect others from infected droplets they may be producing," says Prof Heymann.
Even if you don’t have symptoms, you could be shedding the virus and infecting other people without knowing. A study in Singapore suggested that around 6 per cent of all cases began this way. So it may be considerate to wear a mask if you’re out in public, even if you don’t have any symptoms.
"This argument has merit," says Prof Hunter. "Some have said that one of the reasons that Asian countries may have been less hard hit by the virus is because they have a culture of wearing masks whenever they’re ill."
- Where can I buy a good mask?
If you’re looking for a surgical face mask, you’re probably going to be paying over the odds, and/or facing a lengthy wait. Most of those on amazon.co.uk are being shipped from China and won’t turn up until next month.
Meanwhile, casetify.com is selling reusable cloth masks, with a filter built in, for £12 – and for every one bought, they will donate another to a health worker. But is it even ethical to be buying masks when the NHS doesn’t have enough?
Some trusts say they have a shortage of PPE, with staff being told to clean and reuse the supplies they have – even masks that are intended to be disposable.
At a press conference on April 12, Health Secretary Matt Hancock said "face masks should be saved for those in health and care who really need them’.
While it is nigh on impossible to identify if the mask you’re looking at buying online or in your local shop is one that might otherwise have gone to the Health Service, Prof Hunter says it seems "logical" to suggest that if masks are being bought up by the public, then they are not available to NHS workers or those working in care.
Realistically, if you want to do the right thing, then you should be leaving medical ventilator masks (such as FFP2 or FFP3 and N95) masks to the professionals.
In the US, the leading public health protection agency – the Centers for Disease Control and Prevention (CDC) – is advocating that the general public uses home-made cloth face masks.
- How should you handle a mask?
ALWAYS wash your hands before putting on or removing your mask. Take care not to touch your eyes, nose and mouth, and wash your hands again immediately after removing it. Don’t touch the mask while wearing it.
The WHO recommends that a mask is replaced as soon as it is damp, and surgical masks should only be used once and then disposed of.
It would be sensible to use your home-made mask just once before washing it on a 60C setting to kill any virus particles that may have settled on it.
© Solo dmg media
