Government and experts debate on whether people should wear masks or not

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Government insists masks should be worn during the coronavirus pandemic, but a Stellenbosch expert disagrees.

Government says wear them but Stellenbosch expert disagrees.

While the country’s Covid-19 toll continues to soar – at least 1 505 infected and nine deaths reported by yesterday – the debate over the use of masks continues to rage, seemingly having created a gulf between national Health Minister Dr Zweli Mkhize and authorities in the Western Cape.

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While Mkhize this week reiterated government’s message for all people to wear masks, the Western Cape department of health has described wearing masks as “unnecessary and potentially risky”.

University of Stellenbosch health expert Dr Kerrin Begg said there was no conclusive evidence that the use of masks yielded good results, as no environmental studies had yet been done on their effectiveness, or on how masks prevented the spread of the coronavirus which causes Covid-19.

“To effectively contain the spread of the virus, washing your hands with soap and ensuring social distancing has thus far been the best thing to do to contain the pandemic,” Begg said.

“Masks can be dangerous, especially when people leave them lying around because they can lead to the spread of the infection, especially those belonging to people who are positive and their masks being laced with excretion,” she said,

Begg said the use of masks was “ideal in taxis and in informal settlements where social distancing was difficult”.

Asked which was the best type of mask to wear, she recommended “a medical mask”.

“Cloth masks are a compromise if not daily washed, in line with good hygiene.”

Forbes.com reported this week the Centres for Disease Control and Protection (CDC) would be recommending all Americans wear face coverings when they go to the grocery store, pharmacy or other public places.

“This new guidance is meant to complement the existing Coronavirus Guidelines for America that are in place through 30 April,” Forbes.com said.

“Previously, the CDC advised that only symptomatic people need to wear masks, partly to leave N95 and other medical-grade masks for healthcare workers who need them”.

“President [Donald] Trump said wearing face masks would be a recommendation, not a mandate.

“Some people don’t want to do that” and that people can “decide for themselves”, Forbes quoted

Trump as saying.

But how do South Africans feel about them?

The Citizen conducted a snap street survey in Kempton Park central business district on the reasoning behind wearing or not wearing masks, drawing mixed reactions.

“I have been buying disposable masks to last me for a week, but due to finances, am now washing my handkerchief to use,” said David Scott.

With her meagre monthly state grant, pensioner Maria Mavuso of Thembisa said she would “rather buy food than masks”.

“Schools are closed and my grandchildren depend on this grant for food,” Mavuso said.

“Where would I get extra money to buy a mask, if the government cannot provide citizens for free?”

Cynthia Mokoena said she found washable masks “better than disposable masks, because they last longer”.

“I can’t keep up with wearing something daily which I will have to throw away,” she said.

Some people said putting on masks amounted to “suffocation”.

“I put on a mask for a few minutes and because I suffer from asthma, it was as if I was suffocating myself and I threw it in a dustbin,” said Ethel Koyo.

That view was echoed by William Sonto: “I just cannot get used to putting a mask for a long time. I only wear a mask when inside a supermarket, but immediately pull out when outside to be able to breathe normally.”

Sidney Baloyi said: “Since the outbreak of the coronavirus in South Africa, I have never stepped out of my home without a mask.

When people die, why should I take chances with my life?”

Previous advice was against wearing mask unless one was health worker.

For the past few months, public health officials have advised healthy people not to wear masks as a way to protect themselves from coronavirus. But as we learn more about the virus, more experts are saying there is probably some benefit to covering our faces in public.

But for now, commercially made masks are virtually impossible to find. Many people have hoarded masks in recent months, and everyone agrees that any available supply of medical masks should be reserved for hospitals and emergency workers. That means if you want a mask, you probably have to make it yourself.

“Cover your face with cloth – however, you want to do that,” said Shan Soe-lin, a lecturer at the Yale Jackson Institute for Global Affairs, who was co-author of a widely shared article about the need to cover your face. “Cover your face pretty thoroughly from your mouth to your nose to prevent large aerosol droplets coming out or going in.”

Last week, the German Medical Association suggested citizens find or make a simple fabric mask for when out in public and leave medical-grade masks for frontline workers. In Austria, grocery store shoppers are now required to wear masks.

In New York, Governor Andrew M Cuomo has advised anyone over 70 to wear a mask.

The highest quality, most expensive medical masks – called N95 respirator masks – should be reserved for hospital workers and emergency responders who are regularly exposed to high viral loads, both from frequent contact as well as medical procedures that can spew tiny viral particles into the air. The rest of us don’t need that level of protection.

If you’re staying home and nobody in your family is infected, you don’t need a mask most of the time. But more experts now say that wearing a nonmedical or homemade mask to go the grocery store or pharmacy may be a good idea.

Studies of mask use to prevent the spread of respiratory illnesses, including severe acute respiratory syndrome, another form of coronavirus, can lower risk of infection. The effect is best when masks are used with hand hygiene and social distancing.

“Vast amounts of data would suggest that the coronavirus is an airborne infection carried by respiratory droplets, and it also can be passed on by direct contact,” said Dr Siddhartha Mukherjee, assistant professor of medicine at Columbia University, who recently wrote an article about how the coronavirus behaves inside patients. “The mask works two ways: not only to protect you from me, but me from you.”

While we don’t have a lot of research on the effectiveness of homemade masks in preventing the spread of infection, scientists who study airborne diseases can offer some guidance. A mask sewn from a pattern or an improvised face covering made with a T-shirt probably offers some protection.

The thicker the fabric, the better, said Linsey Marr, a Virginia Tech scientist and an expert in the transmission of viruses in the air.

While some people have suggested using a bandanna, the fabric is so thin and flimsy that it would likely offer little protection. Double or triple the bandanna fabric if that’s all you have.

“I’ve been saying some protection is better than none,” said

Marr, who noted that local health departments have been asking aerosol scientists for guidance on potential mask materials to deal with supply shortages. She said her team would have results soon with more specific recommendations for materials to use in masks.

Marr emphasised that most people do not need the high level of protection offered by a medical mask. “The potential for exposure is so much lower in a grocery store compared to working in a hospital close to patients,” she said.

Soe-lin said she believed an added benefit of a mask was that it served as a constant reminder against touching your face, a major way the virus is spread. But no face covering, homemade or a medical mask, makes you invincible. Pulling a mask on and off or fidgeting with it will lessen its effectiveness. And in theory, fiddling with your mask could contaminate it. Always remove a mask by the ear loops or the tie – never the part that covers your face.

Soe-lin said she has used cloth masks for three weeks and washes and dries them regularly. If a mask gets wet or damp while you are wearing it, it’s less effective, she said.

“I don’t think there is any evidence that this is going to make things worse, but there is evidence that it provides some additional good,” said Robert Hecht, professor at the Yale School of Public Health, who was the co-author of the face mask article with Soe-lin.

“It seems, in our view, hard to argue against covering your face. We have large numbers of infections occurring which don’t need to happen if people were to use the masks.”

Questions about durability, reuse and sanitising masks, as well as the best fabric for a homemade mask, still need to be answered. If you decide to start wearing a mask, you should know that it takes some getting used to. A mask can be hot and uncomfortable and fog your glasses. But pulling it up and down defeats the purpose of wearing it.

“I still believe masks are primarily for healthcare workers and for those who are sick to help prevent spreading droplets to others,” said Dr Adit Ginde, a professor at the University of Colorado School of Medicine. “However, I do believe that for limited circumstances when individuals must be in close quarters with others, a correctly positioned mask or other face cover for a short duration could be helpful.”

-The Citizen


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