Covid-19: ‘Wearing a mask can create a false sense of security’ – warns World Health Organisation
"The use of a mask alone is insufficient to provide an adequate level of protection and other measures should also be adopted."
The World Health Organisation (WHO) warned that the use of masks can create a false sense of security.
The organisation issued this warning in its latest advisory on the use of masks in communities, during home care and in health care settings in areas that have reported cases of Covid-19.
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Medical masks, defined as surgical or procedure masks, are flat or pleated and some are shaped like cups. They are affixed to the head with straps.
They are tested according to a set of standardised test methods that aim to balance high filtration, adequate breathability and optionally, fluid penetration resistance.
Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted.
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Community settings
Studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.
There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure.
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.
Medical masks should be reserved for health care workers.
The use of medical masks in the community may create a false sense of security leading to neglect of other essential measures such as hand hygiene practices and physical distancing.
It also takes masks away from those in health care who need them most, especially when masks are in short supply.
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WHO advised that persons with symptoms should:
• Wear a medical mask, self-isolate, and seek medical advice as soon as they start to feel unwell. Symptoms can include fever, fatigue, cough, sore throat, and difficulty breathing. It is important to note that early symptoms for some people infected with Covid-19 may be very mild.
• Follow instructions on how to put on, take off, and dispose of medical masks.
• Follow all additional preventive measures, in particular, hand hygiene and maintaining physical distance from other persons.
WHO offered the following advice to decision-makers to ensure they apply a risk-based approach:
1. Purpose of mask use – the rationale and reason for mask-use should be clear.
2. Risk of exposure to the Covid-19 virus in the local context – the population, current epidemiology about how widely the virus is circulating as well as local surveillance and testing capacity should be considered as well as The individual working in close contact with public.
3. Vulnerability of the person/population to develop severe disease or be at higher risk of death.
4. Setting in which the population lives in terms of population density, the ability to carry out physical distancing and risk of rapid spread.
5. Feasibility – availability and costs of the mask, and tolerability by individuals
6. Type of mask – medical mask versus non-medical mask.
Potential advantages of the use of mask by healthy people in the community setting include reducing potential exposure risk from infected person during the “pre-symptomatic” period and stigmatisation of individuals wearing mask for source control.
Potential risks to be taken into account in any decision-making process:
- Self-contamination that can occur by touching and reusing contaminated mask.
- Depending on type of mask used, potential breathing difficulties.
- False sense of security, leading to potentially less adherence to other preventive measures such as physical distancing and hand hygiene.
- Diversion of mask supplies and consequent shortage of mask for health care workers.
- Diversion of resources from effective public health measures, such as hand hygiene.
We are excited & encouraged to receive a donation from the Motsepe Foundation. Top of the list is 200 thousand surgical masks. pic.twitter.com/PsUQ0RJpTI
— Zweli Mkhize (@DrZweliMkhize) April 7, 2020
Types of masks
WHO stressed that it is critical that medical masks and respirators be prioritised for health care workers.
The use of masks made of other materials such as cotton or fabric, also known as non-medical masks, in the community setting has not been well evaluated.
There is no current evidence to make a recommendation for or against their use in this setting.
The organisation is collaborating with research and development partners to better understand the effectiveness and efficiency of non-medical masks.
Decision-makers can recommend the use of non-medical masks as long as the following features related to non-medical masks are taken into consideration:
- Number of layers of fabric/tissue.
- Breathability of material used.
- Water repellence/hydrophobic qualities.
- Shape of mask.
- Fit of mask
Symptomatic people visiting a health care setting should:
- Wear a medical mask while waiting in triage or other areas and during transportation within the facility.
- Not wear a medical mask when isolated in a single room, but cover their mouth and nose when coughing or sneezing with disposable paper tissues. Tissues must be disposed of appropriately, and hand hygiene should be performed immediately afterwards.
Mask management
- Place the mask carefully, ensuring it covers the mouth and nose, and tie it securely to minimize any gaps between the face and the mask.
- Avoid touching the mask while wearing it.
- Remove the mask using the appropriate technique: do not touch the front of the mask but untie it from behind.
- After removal or whenever a used mask is inadvertently touched, clean hands using an alcohol-based hand rub or soap and water if hands are visibly dirty.
- Replace masks as soon as they become damp with a new clean, dry mask.
- Do not re-use single-use masks.
- Discard single-use masks after each use and dispose of them immediately upon removal.
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