What medical experts say about face masks

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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Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.

Written by Will Brodie

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