Medical experts give their verdict on the value of face masks

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In Singapore and Germany, you can be fined for not wearing a face mask in public. In France, it is compulsory to wear a face mask in high schools and on public transport, and businesses can refuse service to customers who are not wearing a mask. In the US, the Centres for Disease Control and Prevention recommends wearing cloth face coverings in grocery stores, pharmacies, and petrol stations.

In Australia?

The official advice is this: “Most people will not benefit from wearing a surgical mask.

“Masks are of benefit to people who are sick, so they don’t cough on others, and healthcare workers who have frequent, close contact with sick people

“Surgical masks in the community are only helpful in preventing people who have coronavirus disease from spreading it to others. If you are well, you do not need to wear a surgical mask as there is little evidence supporting the widespread use of surgical masks in healthy people to prevent transmission in public.”

And the national cabinet just rejected a proposal to make face masks compulsory.

It’s pretty unequivocal.

But some experts now see a role for masks, especially on public transport, where we can be exposed at close range to others for extended periods, the conditions likely to enable virus transmission.

Chief medical officer Professor Brendan Murphy told Nine Media that the Australian Health Protection Principal Committee had recognised that “in a public transport situation, people may choose to wear masks when up close to other people and we recognise that is not an unreasonable thing to do”.

University of New South Wales (UNSW) infectious disease expert at the Kirby Institute, Professor Raina MacIntyre, backed the use of masks where “you see people breaking the social distancing requirements all the time”. This includes on public transport and in supermarkets.

“Every country, particularly ones that are going to open up and get things going again, is going to have to consider it … It’s a low-risk intervention and there’s a potential benefit,” she said.

“First, it will prevent someone who is infected from emitting virus into the air around them; and second, it may well protect people from inhaling contaminated air or being sprayed by sneezes and coughs.”

Prof. MacIntyre said she understood why cities with a higher disease incidence than in Australia demanded the wearing of face masks.

“This is because COVID-19 can be transmitted from people without symptoms or in the two days before they develop symptoms. So, if mask use is high in the community, it may prevent onward transmission from infected people and also protect well people.”

UNSW professor of epidemiology Mary-Louise McLaws told SBS News she also backed the use of “non-medical grade” masks on Australian public transport.

“They provide somewhere between 10 and 60 per cent protection compared to a medical-grade mask. One would say that’s not enough in hospitals … but in conditions such as public transport, that’s better than no protection at all.”

Clinical researcher Dr Meg Jardine, of The George Institute for Global Health, says wearing a mask can be “an altruistic act that helps prevent you contaminating your environment”.

“The more virus fragments you have in your environment, the more likely you are to be affected,” she says.

“If you can just reduce the number of fragments, you’re going to reduce risk.”

The ABC’s Dr Norman Swan told the Coronacast podcast that wearing masks on public transport could help reduce the already low risk of transmission in Australia “and you could be a bit more relaxed about social distancing on rail trips”.

All the experts emphasise that medical-grade masks must be preserved for use by professionals on the frontline in clinics and hospitals.

“We don’t recommend that members of the community use N95 or P2 masks because we need to keep them for our frontline medical workers,” occupational hygienist Kate Cole told ABC News.

“It’s kind of wasting that mask and taking it away from the people that need it the most,” Ms Cole said.

While there is some support for mask use in places where social distancing is difficult, there are also warnings about the dangers of using masks.

University of Newcastle professor of nursing Brett Mitchell told The Guardian that unless you have medical instruction on how to use a mask, you could make things worse for yourself.

“The front of the mask will ‘catch’ pathogens. Every time you adjust or touch your mask, your hands could become contaminated. Everything you then touch could become contaminated,” Prof. Mitchell says.

“It’s important not to touch the mask until you remove it,” implores the CSIRO.

“Using a mask incorrectly can actually make it more dangerous,” agrees deputy chief medical officer Professor Paul Kelly.

Dr Jardine says as soon as a mask is removed it must be treated as a “contaminated object”.

She says cloth masks are generally not quite as good as surgical masks, and their effectiveness depends on the number of layers in the mask.

“You need multiple layers, a fine weave, high thread count, water-resistant material and good fit around the face,” Prof. MacIntyre says.

“They should be washed daily or can become contaminated.”

“Another important thing to be aware of is not to wear a mask with an exhalation valve, because a mask like that filters the air coming into your mask but not the air going out,” Ms Cole said.

“So, if you’re sick and you’re wearing a mask with a valve and you sneeze or cough, for example, it’s just coming straight out of the mask unfiltered.”

Dr Jardine warns that the slower airflow through masks can be an issue for people with breathing difficulties.

And most experts are concerned by the “false sense of protection” masks can provide.

Ms Cole says masks are not “a silver bullet”, just one way to minimise risk.

“Physical distancing, staying at home, washing your hands and not touching your face are more effective than simply wearing a mask,” she says.

“Wearing a mask can’t supersede all those other things.”

Will you be wearing a mask in public?

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Written by Will Brodie

103 Comments

Total Comments: 103
  1. 0
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    Before we start comments on face masks can I please ask that we stop using Americanisms at the beginning or start of the headline it was stated from the Get Go this is rubbish,does that mean at the end we finish with give stop what nonsense.
    As far as masks are concerned these are a total waste of time unless they are a completely sealed unit,even then as soon as you touch it you transfer any pathogens onto your fingers and then to whatever else you touch.They may help with limiting further spread from infected people or give some limited protection to those in the front line but are otherwise a waste of time,especially to those who seem to like wearing without covering their noses

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      @tiggr55 Excellent Comment, The wearing of masks is counter-productive in stemming the transmission of the disease. Wearing one with a beard, borders on stupid.

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      You can’t turn the tide I am afraid. And nor should we want to . Languages in use are constantly changing, and are therefore called “living languages. If you think a bit you will realise how English has changed since you were young. It will continue to be influence by other languages than American English.
      Your further comments largely repeat what has already been said in the article.

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      Eventually all persons who want to use public transport will be required to use them or the sparsely occupied transport system will financially collapse.

      If particles are limited from getting out of a mask, then they’re probably going to have a harder time getting in.

      The questions around masks all began because we were suddenly in short supply. If we had a surplus, no doubt the health directives would be more educational, e.g. how to wear a mask, the benefits of a mask and the financial benefits of keeping busy public transport safe.

    • 0
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      Agreed 100 percent Brissiegirl

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      Yep Brissie girl 100% correct. Australia ran out of masks late January. I got a supply from work, and the boss told me he got the very last box in Victoria at that time and that was late January. I tried to buy some after that and there was nothing around.
      So of course the medical big wigs said, don’t worry about masks. yes if we had them in abundance then it would have been a different story.
      So when i went to the shops wearing one of the only few masks that was available to the general public at the time, everybody frowned at me.
      I didn’t care. I am a home care worker with a very severly disabled client. I had to do what I could to stay healthy for her.

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      Yes Brissiegirl – I totally agree with you also.

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      Very wise thing to do Rosret, I work in a Pharmacy so I see myself as a carrier and patients as carriers too..and of course there are people coughing etc everywhere in the Pharmacy….so much complacency around

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      So we completely ignore the results from Taiwan and Hong Kong where everybody wore masks from the beginning. They have a combined lower death rate and t=infection rate than Australia, with a larger combined population.

      I agree that it is likely the initial shortage of masks that caused the advice that we are getting. So masks do not prevent the disease, so said the article, but health workers are to wear them as they are likely to come into contact with people with the disease, also said the article. A contradiction. If everybody wears masks the asymptomatic would also be wearing masks, thus reducing the chances of community infection. QED

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      @sceptic – All spot onm, as far as I can see. Even the WHO has finally come out with this advice. Although in WA I am not currently wearing a mask, since we have no community transmission detected so far, I was wearing one for several weeks before this situation emerged and will be slapping one back on the first community case we get. Guaranteed we’ll all be wearing them eventually, unless a vaccine is found, but our governments are going to hold out as long as possible until better supplies of masks are available – which they damn well better be once the thing really gets going in Australia.

  2. 0
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    If you have a beard, if you don’t know how to wear a mask, you don’t have the disease, you don’t know or have the right type of mask, or don’t work closely with people who have the disease, then don’t wear one!

    All you are doing is wasting material, cash and safety resources, whilst polluting the world even more.

    Other countries are making the wearing of masks mandatory, but mainly because so many people have the disease, or because it makes people feel better about the mess their governments have got them into.

    You might have some psychological, panic-based, misinformed paranoia, but then you might not want to venture outside of your cupboard wherein you are hiding. Then it is OK to wear a mask, but make sure it is a Batman mask because it will do the same amount of good. Maybe a Skywars mask would do as well.

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      Hi Janus, it is true in some of your simulations, – ie there is no local disease, masks make absolutely no difference, but different if there is local infection, spreading.

      Then the issue is, not masks, or masks, but the efficacy of masks.

      I have long advocated that the masks be saturated with an anti Viral chemical, – eg Borax, that will kill the virus as it induces a highly Alkaline envrionment that Viruses have no evolutionary possibility to overcome.

      To my mind, the emphasis should be on how long a mask can be effective.

      Against Viruses, not germs

      Of course our corporations will not like that, they will want you to buy as many masks as you can afford without starving your children, – or at least making them too hungry for you to bear,
      But your (and my) welfare will be tied directly to how efficient our masks are. = when we need masks.

      This is not rocket science, virtually any university can research on how efficient a mask can be, – probably most hospitals, – get onto them, ask how efficient a Borax or other high alkaline substance can be in comparison with a plain paper mask, – keep asking until they tell you.. get back to us on YLC please.

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    I think an experiment should be conducted before any consumption is made on whether mask protect us from the virus. Mask must be preventing all the nurses and doctor’s from getting the virus…There would have to be an experimented on mice or Tiggar…..to determine whether mask can prevent us catching the virus.

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    Being trained in aseptic, sterile techniques and compounding medications, including toxic and non toxic medication in a pharmacy sterile suite ( worked in one for 3 years) , masks are essential, to prevent any bacteria or viral shedding from being transferred into an intravenous bag. A mask decreases the bacterial and viral load. Proper use of putting a mask on and off with sterile techniques, ie washing hands with soap or an alcohol based soap before putting a mask on and before taking a mask off. Hands or gloves should not touch the mask. Education is required. It is a personal choice and as long as one wears a proper mask and employs proper sterile techniques, it is not a sense of false security.

    • 0
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      Thank you Laura, I believe mask can pretect us.

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      It’s a personal choice for now. Chances are that in Australia, too, unless a vaccine is found, we’ll all be required to wear them eventually.

    • 0
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      I agree Jan and Hirajima. At the hospital, I was taught a mask decreases the bacterial and viral load from one person to another as well as not contaminating prepared medication. But please remember one can still get the disease via transmission into the eyes, droplet and aerosol form, as well as via the hands. In an enclosed space, a mask will help to decrease the viral load. Regarding cloth masks, as long as there are 3 layers, they do provide a barrier, better than nothing. Masks have been made mandatory for a reason overseas in supermarkets and pharmacies, due to community transmission, especially from super spreaders, and asymptomatic carriers. A cloth mask needs to be handled even with sterile infection control procedures before and after use and washed, hot setting, with soap etc and after drying, wash your hands or sanitise and put it into a sanitised plastic bag ( sprayed with isopropyl alcohol or glen 20, alcohol needs to be above 64 percent to 70 % as anything higher than that, the alcohol will evaporate).

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      Laura do you agree with me?, and do you think the Borax might be better than the alcohol solution, on a number of questions?

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      Yes forgot the Borax, Lookfar…I remember your post…definitely to consider!

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      yes laura, then your hands are disinfected when you spread the Borax solution, but even more interesting (imho) is the potential of negative ions in your surgery or whatever, – to target those negatively charged molecules and remove them from your room.

      Negative ions are long described to make you feel energised, – as when near a waterfall, but negative ions, in a hospital room, can if correctly placed/sprayed, sweep the positive ions coating the virus onto the positive plate where they are stuck.

      This offers interesting possibilities for Doctor’s surgery’s and such to be free of the Virus, kindly see,
      https://www.
      ature.com/articles/srep11431

      Cheers.

    • 0
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      @Lookfar – very interesting, especially that Nature reference. Not so sure about loading masks up with Borax – couldn’t that be toxic?

  5. 0
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    Haha, it really is amusing how Australia makes such a job of work out of avoiding masks, when the clear and growing evidence around the world is that even fabric, non-medical masks will assist in reducing (no, not eliminating, not even N95s give that guarantee!) the transmission of viruses. Let’s face it, we cool Aussies are just seeking any flimsy justification we can for avoiding looking uncool like all those people in numerous countries to our north. Better dead and cool, hey? (By the way, I am putting a humorous spin on this, but I really do think we all try soooo hard to avoid the inevitability… heck, even 100 years ago Aussies wore masks to reduce the Spanish flu!)

  6. 0
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    I wear a face mask when:

    1. I’m on public transport;

    2. When I’m walking along the street where too many people have their faces buried in their ‘Dumb’ phones and leaving social distancing to everyone else; and

    3. Anytime I’m in a crowd (which isn’t often as I avoid times when they are happening) when social distancing becomes difficult.

    Even though “the national cabinet just rejected a proposal to make face masks compulsory” and some medical professionals are of the opinion they will not help me,
    I DON”T find that “PRETTY UNEQUIVOCAL”.

    Why do I not agree and continue to wear a face mask?

    Hmmm!

    How do I know those without face masks are without corona virus?

    How do I know those without face masks aren’t asymptomatic?

    When it can be guaranteed that EVERY person without a mask is WITHOUT CORONA VIRUS, then I’d be happy to turn in my supply of masks. Until then I would find the risk too high; as medical professionals in other jurisdiction think it is necessary and, in some cases, foolhardy to not do so.

    • 0
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      Agreed 100 percent. You do what is right for you and how you feel, to feel safe and comfortable. There is a problem with social distancing and complaceny happening, right now.

    • 0
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      Great response! My thinking exactly. But too many will die rather than wear one. Silly really. The main issue will be when everyone is coughing and sneezing all over supermarkets and still refusing to wear one. I hope that at that point, managers will ask them to leave.

  7. 0
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    “The front of the mask will ‘catch’ pathogens. Every time you adjust or touch your mask, your hands could become contaminated. Everything you then touch could become contaminated,” Prof. Mitchell says.

    So masks do “catch” pathogens.

    • 0
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      Right on Brissiegirl, so if you have a Virus killer in your mask, – eg Borax, it will kill any Virus you
      ‘catch’. – and if it is in your clothes as well, – even more effective.

      So if you have a virus killer in your mask you may have 20 minutes, or so before the virus overwhelmes it, – by which time you can have bought your goods and gone, – but if you are All wearing Borax masks, you may be able to relax and take your time, as you and all your friends will have a Covid-19 Dead zone around you. – as you and all the rest of us, want.

  8. 0
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    Hirajima I agree. Public transport has limited capacity under physical distancing and in NSW we’ve been told to drive to work if possible! Well that’s practical NOT. I don’t disagree that people need to be careful about sanitising and wearing masks properly etc, but it’s time we all got over ourselves and thought about the greater good. People are certainly being complacent about distancing because thus far we’ve been comparatively lucky in Aus. We have yet to get through winter. If everyone wears a mask in public places there is a higher degree of protection for all. My mask protects you – your mask protects me. Govt just doesn’t want to do any sort of backflip on their early advice.

    • 0
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      Washing hands , sanitising etc is a must but what happens if are out in public, you just washed and sanitised your hands and then you touch a surface that may be contaminated. So, sanitisation is essential before and after touching every single thing in contact in public, if one is not at home….Just a thought that came to my mind.

  9. 0
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    wearing masks in crowded spaces is about limiting spread of virus particles rather than protecting the wearer – it’s altruistic behaviour. Virus particles can be exhaled some distance and the mask interrupts this flow. Yes, the particles will collect in the mask and drip onto clothing and can be spread by touch but it’s less problematic than exhaling into someone’s face. Masks work, see this experiment at HKU.
    https://fightcovid19.hku.hk/hku-hamster-research-shows-masks-effective-in-preventing-covid-19-transmission/

  10. 0
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    I typically spend half a year around asia where people wear routinely masks whenever they feel unwell and choose not to past their illness onto others. I’m gobsmacked to see that some westerners are unable to consider others. I would also not that the asian mask wearers have had a much lower C-19 death rate.

    • 0
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      Right on, Lescol – and see my post a bit further down about Vietnam’s Covid-19 stats and the wearing of face masks. “It’s common sense, stupid.”

    • 0
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      Yes, I do think Asian cultures are more community minded. Aussies are too much along the lines of, “No-one’s going to tell me what to do!” (by the way, despite my nickname here, I am white Australian, not Asian… but I do appreciate how many Asian cultures do things. Well, not so much the CCP, hehe 😛 )

    • 0
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      Good point Lescol and yes people in Asia wear masks when they are unwell as a matter of courtesy….and just look at Taiwan which has a similar population number as Australia!!!!

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