Originally posted this on the 1st of April 2020
The absence of lack of evidence for mask wearing in community settings does not equate to evidence of ineffectiveness. (The Lancet, Leung 2020 03 02 - attached below)
It has been shown in studies that any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence. (Plos, Van der Sande 2008; Disaster Medicine and Public Health Preparedness, Davies 2013 - both attached below)
The aim of wearing improvised, non-medical masks when out amongst others doing essential tasks (eg food shopping) is to prevent inadvertent transmission from those who may be asymptomatic to vulnerable members in the community, in order to flatten the curve.
‘My mask protects you, your mask protects me’
The link below, available via the #masks4all youTube, gives access to the titles and links of 41 research papers illustrating this point, and a table summarising the pertinent points of all 41 papers, a resource created by Jeremy Howard, statistician and ethicist.
Via this link below, a youTube video, #masks4all, and a newspaper article in the Washington Post, 28 March, 2020, ’Simple DIY masks can help flatten the curve - We should all wear them in public’ can be viewed, both by Jeremy Howard, statistician and ethicist, - where the gist of the pertinent points of the 41 research papers have been synthesised into a manageable watch or read for the lay public:
The difference in countries where mask wearing in community settings is the norm or has been encouraged (South Korea, Taiwan, Singapore, China, Czech Republic) vs not (USA, UK, Italy, Spain and many/most? other European countries) is striking, as this Financial Times graph below shows.
Sure there are other factors at play leading to this difference (eg earlier, firmer measures re social distancing/lockdowns, earlier or more testing, more or better contact tracing)
However, when resources of a country are stretched to its limit (as in SA even more than in USA, UK and Europe), does it make any sense NOT to bring in a measure which can be effective, and does not cost much (or anything), and can be implemented via innovative, grass-roots, community-led initiatives?
It should be urgently considered that public messaging needs to pair the importance of wearing, improvised, non-medical masks in community settings, for when people are out amongst others, with hand washing and social distancing.
Reports emerged Tues, 31 March, 2020, which indicate that the CDC could be the first to break ranks with the WHO line strongly recommending people not wear masks in community settings.
A CDC official stated off the record yesterday that discussions were in progress about changing the message to the public from ‘don’t wear masks out in public’ to ‘wear (i presume and hope, non-medical, improvised) masks when out in public'
We understand that the current WHO line came about to discourage the general public panic buying up precious medical stocks needed far more urgently for the medical frontline community.
However, two separate issues have been conflated and need to be separated:
The public wearing medical masks and gloves when out amongst others
vs
The pubic wearing improvised, non-medical masks when out amongst others
The latter line must be encouraged and the former line, strongly discouraged/condemned.
The two need to be separated
Let South Africa 🇿🇦 lead by example in the Global South with an effective innovative, grass roots improvised, non-medical masks for people when out in public can slow the transmission of Covid-19 - and help to flatten the community based approach of encouraging the use of non-medical / homemade / improvised masks - when out in public eg shopping, in conjunction with hand washing and physical distancing - for communities
South Africa can be the example for USA, UK and most of Europe and lead the way - together with the Czech Republic and other countries which embraced mask wearing at community level in ways which don’t deplete the stocks of medical masks for the medical community on the frontlines.
It needs to be urgently considered that the public messaging should pair the importance of wearing, improvised, non-medical masks in community settings, for when people are out amongst others - with hand washing and social distancing.
In Czech Republic, speedy adherence to the wearing of non-medical, improvised face masks in the general population was apparently achieved over the last few weeks, in spite of this country not having a culture of wearing face masks (unlike in Asian countries), apparently by utilising, amongst other measures, social media influencers.
Let social media distribute useful advice too, not just fake news.
This is also a pragmatic manner to do this - as maximum coverage can be achieved with minimum cost
We all know how fake news can go viral.
Let useful messages also go viral too.
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