Messaging around masks hardly a mystery to uncover

Opinion

Hey there, time traveller!
This article was published 11/04/2020 (2005 days ago), so information in it may no longer be current.

To mask or not to mask? A month into the COVID-19 lockdown, there are clear signs of confusion among the public.

When we were all told to stay home and stop socializing, we were also told it was unnecessary to cover our faces in public if we practised rigorous social distancing and hand hygiene. The advice seemed sound, particularly since public health officials wanted to ensure that all available medical-grade masks were made available to people working in health care.

But then, that simple narrative began to unravel.

First, there were images from Asia where widespread public use of medical-grade masks was thought to have played a small part in helping to slow the spread of the virus. Then, epidemiologists concluded the number of asymptomatic carriers of COVID-19 was much greater than originally thought, and that some form of face covering could reduce the threat they posed to healthy people.

The real turning point came on April 3, when the Centers for Disease Control and Prevention in the U.S. recommended the use of non-medical face coverings by the public, particularly in cities with major outbreaks. Several days later, Dr. Theresa Tam, Canada’s chief public health officer, followed with a similar recommendation for anyone in a public setting where physical distancing cannot be guaranteed.

Not every agency followed suit.

The World Health Organization is not recommending use of non-medical face coverings. Its position is based largely on studies that showed cloth masks offer little protection against droplets from coughs or sneezes. The European Centre for Disease Prevention and Control fell somewhere in between, recommending the use of non-medical face masks to help control transmission from asymptomatic or pre-symptomatic carriers.

However, the European CDPC was concerned the public might misconstrue its recommendation and seek medical-grade masks for personal use. It also noted that “face masks may provide a false sense of security leading to suboptimal social distancing, poor respiratory etiquette and hand hygiene — and even not staying home when ill.”

Just about every public health official agreed on one thing: improper use of masks might increase the risk of transmission. This includes improper disposal and touching contaminated areas of the mask while removing it.

All of which brings us back to our central question — mask or no mask?

Dr. Brent Roussin, Manitoba’s chief public health officer, acknowledged in Friday’s COVID-19 briefing there is some confusion over who should wear masks. Roussin echoed the position taken by the WHO, which is that medical masks must be reserved for health-care workers, and that non-medical masks should not replace social distancing and hand hygiene.

Roussin did not come right out recommending non-medical masks. Instead, it sounded a bit like he was just tired of fighting our anxiety over the issue. In other words, as long as we’re not hoarding medical-grade personal protective equipment (PPE) for personal use, and we’re practising social distancing, we can wear a pillow case or an old hockey sock on our faces and it’s OK with him.

There are only three fundamental truths when it comes to masks and COVID-19: first, medical-grade masks only need to be worn by those working on the front lines of health care; second, there is a global shortage of medical masks for those who truly need them; and third, far too many of us are ignoring the first and second truths.

It’s only anecdotal evidence, but my own trip out on Thursday afternoon for groceries, wine and gas suggested there is either a profound misunderstanding of mask messaging, or a deliberate effort to ignore it out of a misguided sense of self-preservation. The gross majority of people I saw were not wearing masks. Of those who did, almost all appeared to be wearing some form of medical-grade mask. They seemed to be blissfully ignorant that while we haven’t seen the same spike in infections or hospitalizations that other cities have seen, Manitoba is still experiencing a shortage of PPE.

Shared Health Manitoba continues to assert that it has enough PPE to see it through the foreseeable future. Even so, nurses have been told to reuse masks for an entire shift and PPE supplies are low enough that they are kept under lock and key at most hospitals to stop hoarding. The shortage has extended beyond hospitals to private doctors offices. Medical associations across the country are reporting that more walk-in clinics are shuttering because they do not have access to the most basic PPE. That’s bad news for people who are sick from things other than COVID-19.

So, let’s cut through the noise and settle on three indisputable facts.

Unless you work in health care, or are in close contact with someone who is infected with COVID-19, you do not need a medical-grade mask.

You can wear a non-medical mask if it makes you feel better, but it won’t protect you from contracting the virus if you ignore social distancing and hand hygiene.

Finally, if you’re holding onto a stash of masks to protect you while running errands, you are contributing to a global shortage of PPE and putting health-care workers at risk.

Even though it’s in three parts, it’s a pretty simple message that none of us has an excuse to misconstrue.

dan.lett@freepress.mb.ca