WHO Friday changed its guidelines on using face masks, advising that face masks should be worn in public to stop the spread of COVID-19, which has over 6.7 million cases worldwide with a death toll that is nearing 400,000.
In a statement, WHO’s Director-General Dr. Tedros Adhanom Ghebreyesus said the body has updated its guidance keeping in mind evolving evidence. “WHO has developed this guidance through a careful review of all available evidence, and extensive consultation with international experts and civil society groups,” Ghebreyesus said in the statement.
What are WHO’s new guidelines?
The new guidelines on face masks are a move away from what WHO said previously. So far, it maintained that there was not enough evidence to suggest that healthy individuals should wear masks and encouraged the use of medical face masks only by those who were sick or caring for the sick.
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Now, in the revised guidelines it suggests that everyone should wear fabric masks (non-medical) in public. Fabric masks should contain at least three layers of different materials. On the other hand, any person showing the symptoms of COVID-19 should wear a medical mask apart from self-isolating and seeking medical advice as soon as they feel unwell.
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It has advised governments to encourage the general public to wear masks where there is a widespread transmission and physical distancing is difficult such as while using public transport, in shops or other confined environments.
Further, in areas with widespread transmission, WHO advises medical masks (surgical or procedure masks that are flat or pleated) for all people working in clinical areas of a health facility and not just workers dealing with patients with COVID-19.
Are there any disadvantages of encouraging the general public to wear masks?
WHO mentions some potential harms and disadvantages of the use of face masks by healthy people in the general public. These include increased risk of self-contamination due to manipulation of a face mask, potential self-contamination if non-medical masks are not changed when soiled or wet, potential headache or breathing difficulties and a false sense of security, leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene.
Face mask guidelines around the world
India: With the Centre allowing re-opening of malls, hotels, restaurants and places of worship from June 8, the Ministry of Health and Family Welfare (MoHFW) Thursday issued standard operating procedures (SOPs) for these to contain the spread of the novel coronavirus (Covid-19). As per these guidelines wearing masks is compulsory for those entering religious places, restaurants, offices and shopping malls.
US: The Centers for Disease Control and Prevention (CDC) maintains that everyone should wear a cloth face cover when they go out in public but not use face masks meant for healthcare workers.
UK: The government has advised that the public consider wearing face coverings in enclosed spaces where there is a greater chance of coming across individuals that people don’t normally meet. The government maintains that evidence from the Scientific Advisory Group for Emergencies (SAGE) suggests that face coverings can reduce the risk of transmission if one is suffering from COVID-19. Further, the BBC reported that hospital visitors and out-patients will be required to cover their faces and that hospital staff will be required to wear medical masks, even if they are not in a clinical setting.
Spain: Spain has made wearing masks compulsory both indoors and in public spaces wherever social distancing is not possible. Children below the age of six years and those having respiratory illness are exempt from this rule.
Germany: In late April, Germany enforced new rules as per which donning cloth masks became mandatory when using public transport and other public areas such as shops, depending on the region.
Singapore: In Singapore, the government recommends that masks (preferably reusable) should be worn whenever people step outside their homes, when they use public transport or hire private cars, walk to or in markets. Essential workers should also wear masks when they are at their workplaces. Further, the advisory says masks should only be removed during strenuous exercise outdoors such as running and jogging, “but you must put it back on once you have completed your exercise.”
Anyone caught without a mask outside their homes will be issued fines of $300 and repeat offenders are liable to pay higher fines or face prosecution.
South Korea: Masks are compulsory for people when using public transportation or when using taxis.
What does the evidence say?
Last month, The Indian Express reported that while the utility of face masks was initially debatable during the pandemic, the dominant scientific opinion now says that masks are useful and that even relatively simple home-made masks can offer a great degree of protection against COVID-19. For instance, in one study, researchers from universities in Arizona, Harvard and Sydney have, using mathematical models for a population in New York, shown that if 70% of people wore an effective professional mask every time they ventured outdoors, the pandemic could be eliminated from the city.
Another study pointed out that the use of home-made masks was adequate to prevent community transmission of the disease. Even so, the lead author of this study Jeremy Howard maintains that wearing masks should not lead people to ignore physical distancing rules.
In its new guidelines, the WHO has said, “Masks can be used either for protection of healthy persons (worn to protect oneself when in contact with an infected individual) or for source control (worn by an infected individual to prevent onward transmission).”
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