The Union Health Ministry recently recommended the use of homemade face masks for those stepping out of their houses, saying this would “help in protecting the community at large” from the coronavirus pandemic. This week, few states and cities like Delhi, Uttar Pradesh, Chandigarh and Mumbai made wearing face masks mandatory in public places. The US Centre for Disease Control (CDC) also recently recommended wearing face masks in public places.
While China lifted its lockdown in Wuhan on Wednesday, countries are still reporting a surge in the number of cases. Once the curve starts to flatten, countries may brainstorm on making masks compulsory for everyone in public spaces to avoid a second wave of infections. However, the efficacy of face masks in protecting against infection is debatable.
What WHO has said on face masks
In its interim guidelines, the World Health Organisation (WHO) maintains that as per current evidence, COVID-19 is transmitted by symptomatic cases through droplets. Moreover, those showing no symptoms or those who are in the “pre-symptomatic” period – which is the period between them getting infected and showing symptoms – can pass on the infection to others.
Considering this, WHO has advised that medical masks can be one of the preventive measures that can limit the spread of the infection. “However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted,” it says. It defines medical masks as surgical or procedure masks that are flat or pleated and can be affixed to the head with straps.
Further, it says there is “limited evidence” that wearing a medical mask by healthy individuals or by contacts of a sick patient may be beneficial. “However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.”
The WHO has said that medical masks should be reserved for healthcare workers and those showing symptoms and everyone else should “cover their nose and mouth with a bent elbow or paper tissue when coughing or sneezing”.
For countries urging citizens to use non-medical masks, WHO has advised the authorities to consider the following: numbers of layers of fabric/tissue, the breathability of material used, ability to repeal water, shape and fit of the mask.
The idea behind wearing face masks
A 2013 article published in the International Journal of Infection Control says that it is “generally believed” that the primary purpose of cloth masks is to prevent the spread of infections.
An article published in the journal Nature on April 3 points out that surgical masks effectively reduce the emission of influenza virus particles into the environment but not tiny viral particles, known as aerosols. In the context of COVID-19, the article says that surgical face masks may be used by symptomatic people to reduce transmission.
Further, there is also the question of people complying with these guidelines. A 2014 article published in the Singapore Medical Journal (SMJ) says that people are more likely to wear face masks due to the perceived susceptibility and severity of being afflicted with “life-threatening diseases”.
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