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Why we think face masks should be a part of Britain’s Exit Strategy

The debate surrounding the public wearing face masks continues to divide opinion in the UK. The World Health Organisation’s advice remains the same as it has for the past few months, with protective masks only being required for those who are ill (who should of course be self-isolating) and carers dealing with COVID-19 patients.

Both the WHO and the UK Government continue to argue that masks should not be recommended for public use due to the following factors:

  • they can be contaminated by other people's coughs and sneezes, or when putting them on or removing them
  • frequent hand-washing and social distancing are more effective
  • they might offer a false sense of security

Despite this; the populations of China, South Korea, Taiwan and other Asian countries have long worn face masks in public. Reasons for this vary but the common consensus seems that it is due to the high level of pollution in large urban areas and their experience with SARS and H1N1 outbreaks.  East Asia has been dealing with the Covid-19 pandemic longer than Europe and should be used as a case study in how to best deal with the virus. We think the graph below is rather startling:

Face Masks impact on infection - FT

There are undoubtedly a variety of factors as to why Asia has seemingly performed better than Europe and the US in dealing with COVID-19 but such a correlation should not be dismissed either. South Korea went to great lengths to ensure mask provision for the general population and are perhaps the world leader in dealing with the pandemic. Their affordable mass testing, clear communication, strong native manufacturing and use of technology have all been cited as the reason behind this.

But it is no longer just Asia who are using face masks to help fight the pandemic. Many European countries have also made wearing masks in public compulsory such as Austria, Germany and Poland. Germany in particular should be noted as in a similar fashion to South Korea, they are seen as the leaders in Europe for tacking Covid-19, with a death rate being less than a third of the UK’s despite a similar number of infections. Again, there are a huge number of factors which influence this difference but the steps they are taking should be analysed diligently.

So why are so many countries seemingly ignoring the WHO’s official guidance and forcing their people to wear face masks in public?

Face Masks and German Public Transport

The focus of the WHO’s face mask guidelines is from the wearer’s perspective. Their argument, combined with the false sense of security, is that wearing a mask does little to prevent you from contracting the virus. This we’re sure is the case but a great many recent studies have shown that wearing a face mask helps reduce the chance of the wearer infecting others. One of the key methods of transmission for COVID-19 is through people coughing and this propelling the virus into the air. If this is caught in a face mask being worn by the infected person then the chance of public infection could be reduced.

As we know, COVID-19 most often only presents mild symptoms or in some cases none at all. Therefore, people could still be out and about without realising they even have the disease and infecting others. Whilst no guarantee, if the entire population were to wear cloth face masks, be that bought or home-made, then the risk of infecting others as we begin to relieve the lockdown measures could be reduced.

It cannot be argued that regular hand washing and maintaining social distance are far more effective measures for the public to prevent the spread of COVID-19. Face masks should become a part of that public strategy, not a replacement. However, on public transport and in shops keeping the recommended 2 metres can be impossible. Therefore, a face mask (worn by everyone) may add a small amount of additional protection in such situations.

This is why so many countries are starting to make face masks compulsory in public spaces.

Disposable Face Masks

One aspect of the debate surrounding the public wearing face masks in the UK is the availability of supply. As you are all no doubt aware, the PPE shortage has been a major issue here and quite rightly, the Government and healthcare professionals wish to guard the NHS's supplies of face masks.

However, what is being discussed are a number of varied products which come under the category of face masks. The respiratory face masks used by healthcare workers fighting COVID-19 on the frontline are the FFP3, FFP2 or occasionally N95 varieties. These types of face masks should be worn exclusively by the health service and not used by the general public for shopping, working or commuting. If you do see these styles being advertised online please avoid as you are either diverting medical supply or purchasing a counterfeit.

The more complicated face mask to understand with maintaining supply for the NHS are the disposable surgical (sometimes called dental) style masks pictured above. You will have no doubt seen these in your local shop or online and due to their appearance and use are tempting for the public as they look more protective than they in reality are. This style of mask is needed by the health service but similarly to cloth based coverings aren’t effective in preventing infection of the wearer from airborne diseases. Traditionally, they are used in a wider medical capacity and are still just as necessary as before this outbreak. Supplies of this style of mask should be maintained for the health and care services.

Cloth Face Masks

Next, are cloth face masks. As recommended by the Centres for Disease Control and Prevention, cloth face coverings should be worn in public settings where social distancing is harder to maintain. They are simply fabric woven to shape your face with elastic loops so you can secure it around your ears, some styles pictured above. What is important about this mask is it cannot effect NHS supply. There are several of these cloth masks available at the moment, which assuming they are at least dual layered, correctly sized and produced hygienically will perform well in preventing you spreading illness through coughing in public. Only purchase if you can wash the mask either by hand or in the machine at temperatures over 650C. Alternatively, scarves, buffs and similar will also do the same role if worn correctly and are suitably thick material. There are also some great guides online about how to make your own cloth face covering. We’ll add some links below if you fancy being creative.

Which leaves cloth masks with replaceable filters. A comparatively new entrant into the mass market these masks are increasingly popular in other parts of the world such as Africa. In short, they are a standard cloth face mask as shown above but with a filter pocket. The replaceable filter is the key element of these masks as there is some strong research that they can prevent inhaling or exhaling particles as small as 5μm (micrometre). As many airborne illnesses are dispersed as droplets in the air via coughing and sneezing which are far larger than this there is potential for some genuine protection for the wearer, as well as those around them. However, this a new aspect of the face mask debate so although there is potential, there is not a tremendous amount of research as of yet to back this. The filter and mask MUST be sterilized after every use to ensure hygiene and no indirect contamination. These cloth masks with filters will perform identically to the standard cloth face mask. But they also could offer an additional level of protection from infection which although unconfirmed at this stage may make a difference.

We are currently looking at developing our own face masks and after extensive research and discussion into this topic we have decided the cloth face mask with a replaceable filter is the best option for the general public. First and foremost, their production cannot effect the vital NHS supply chain. Secondly, the filter could potentially protect the wearer from contracting airborne diseases such as COVID-19 whilst in public. Thirdly, this style of mask performs identically, with or without the filter, to a standard cloth face masks which do offer protection from those with the disease spreading it to others inadvertently. So if your business wants to re-open but wants to ensure your staff and customers are as protected as they reasonably can be, then a cloth mask with a replaceable filter we think is the way to go.

Make Your Own Face Mask:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

https://www.goodhousekeeping.com/health/a31902442/how-to-make-medical-face-masks/