Should I wear a face mask to protect myself from COVID-19?

Whether or not the seemingly healthy general public should be wearing face masks to stop the spread of COVID-19 is an issue that has received increased attention recently. More and more the feeling is that everyone should be wearing face masks when out and about, especially on public transport, in supermarkets and in other places you’re likely to come into close contact with others.

The current advice from the World Health Organization (WHO) is that if you are healthy you only need to wear a mask if you are looking after someone suspected of having COVID-19, the disease caused by the new coronavirus (SARS-CoV-2). The US Centers for Disease Control and Prevention (CDC) on the other hand, only recommends healthy people wear a face mask if they are looking after someone who is unable to wear a face mask and they are sick. Both groups recommend that those who are unwell wear a face mask.

As our understanding of SARS-CoV-2 grows, WHO and the CDC are being encouraged to rethink their recommendations around face masks. On April 2, 2020 the Strategic and Technical Advisory Group for Infectious Hazards, which advises WHO, said it would meet to evaluate new evidence. The US Surgeon General Jerome Adams also appears to have changed his stance on face masks and has asked the CDC to review its guidance. The CDC has confirmed that it is “aggressively” reviewing new data.

New evidence in support of face masks

Inconclusive and conflicting information about the benefits of widespread use of face masks appear to have contributed to the current recommendations. However, new evidence indicates that it’s probably time we all started putting on a face mask when we’re heading out to places where we’ll encounter other people.

• Coughs and sneezes can travel up to 23-27 feet (7-8 meters) in a high-momentum gas cloud according to research conducted at the Massachusetts Institute of Technology (MIT) in the US. This is much further than the 3-6 feet (1-2 meters) we’re allowing under social distancing measures.
• As many as 25% of people with COVID-19 may not show symptoms (be asymptomatic), the CDC director has reported. Results from China also confirmed that 94 (12.9%) of 731 children with COVID-19 did not have any symptoms.
• SARS-CoV-2 is shed from the cavity behind the nose and mouth (pharynx) in people with mild upper respiratory tract symptoms, according to German researchers.
• SARS-CoV-2 viral shedding is particularly high during the first week of symptoms in patients with mild upper respiratory tract symptoms, according to the same group of German researchers.
• Patients without symptoms may have similar viral loads to those with symptoms, suggests the results of an analysis carried out in China.

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Two important points for those wearing face masks

While we wait for WHO and the CDC to update their guidance, many more people are opting to wear face masks in public. Here are two important points to remember:

1. Health Care workers need respirators and face masks more than the general public do to protect themselves while they work with sick patients. Do not run out and buy up stocks of masks, especially N95 respirators, leaving Health Care and other essential workers with none. Use what you already have available or make your own.
2. You still need to wash your hands and practice social distancing while wearing a face mask because it is unclear exactly what level of protection wearing a face mask will provide.