Wearing surgical face masks in public may have helped slow the coronavirus crisis – despite Britons being repeatedly told they were pointless.
Experts say a full-scale outbreak in the UK could have been prevented if millions of masks had been issued – which has been the case in South Korea and Japan.
The British Government has long held the view that the cheap paper masks offer little protection against catching COVID-19.
This is because they are thin, loose-fitting and porous – which make it easy for the tiny viral particles to pass through.
But experts have always maintained that, while the masks may not shield someone from contracting the illness, they stop the wearer from infecting others.
As well as on surfaces, the virus can be transmitted via droplets that are released when a patient talks, breathes, coughs or sneezes.
This may have been more important than initially thought now that researchers know infected people are contagious for several days before they have symptoms.
Professor Ian Jones, a virologist from the University of Reading, said the mass-issuing of masks ‘should now be considered’ in the UK.
Warning that the crisis is spiralling rapidly, he told MailOnline: ‘Anything that reduces the rate of transmission will bring it under control sooner.’
South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent large outbreaks, despite being in such close proximity to China.
Wearing surgical face masks in public may have helped slow the coronavirus crisis, it has been suggested. But the UK Government has long held the view that the cheap paper masks offer little protection against catching COVID-19
South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent full-scale outbreaks, despite being in such close proximity to China. Critics say masks don’t work because China still suffered more than 80,000 cases
The current official guidance from the CDC (above) urges people who are healthy to avoid using masks due to the ongoing shortage for doctors and nurses. The UK’s Department of Health recommends the same thing
The World Health Organization has a list of recommendations for safely wearing and removing masks to avoid the risk of infection
Professor Jones told MailOnline: ‘For me it’s very simple, the epidemic is currently running [rampant] and anything that reduces the rate of transmission will bring it under control sooner.
‘On the basis that correct mask use would do no harm and potentially some good it should be considered.’
Dr Stephen Griffin, associate professor of infection and immunity at the University of Leeds, said masks prevent asymptomatic people spreading the disease by catching tiny droplets they exhale.
He added: ‘They are also useful for people that are themselves symptomatic in stopping coughs and sneezes.
‘They also reduce the propensity for people to touch their faces, which happens many more times a day than we all realise and is a major source of infection without proper hand hygiene.’
George Gao, director-general of the Chinese Center for Disease Control and Prevention, this week said the ‘big mistake’ in the US and Europe was that ‘people aren’t wearing masks’.
He told Science magazine: ‘This virus is transmitted by droplets and close contact. Droplets play a very important role – you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.
‘Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.’
People around the world have been using scarves as makeshift masks (like this woman in Lisbon) because they can’t get access to them
Other have resorted to crafting masks out of household items. A man is seen using a nappy as a makeshift face mask in Brooklyn, New York City
The US Centers for Disease Control (CDC) is now reportedly considering switching its stance and recommending surgical masks should be worn.
The agency initially told Americans they didn’t need to wear masks and that anything other than a high-grade N95 medical mask would do little to prevent infection any way.
But experts are now increasingly leaning toward the notion that some form of protection is better than nothing as the crisis spirals out of control.
Whether or not the UK’s Department of Health and Social Care will switch its stance remains to be seen. MailOnline has contacted DHSC for comment.
It’s thought British experts will need to see hard evidence that issuing face masks on a nationwide scale can slow the spread before going ahead.
They may point to the fact China suffered a devastating outbreak despite mass-issuing masks.
A University of Oxford study published on Monday concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers.
It’s too early for there to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks.
The difference between surgical or face masks and N95 masks lies in the size of particles that can – and more importantly, can’t – get though the materials.
N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous.
This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose.
Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny – in fact, they’re about 20-times smaller than bacteria.
For this reason, a JAMA study published this month still contended that people without symptoms should not wear surgical masks, because there is not proof the gear will protect them from infection – although they may keep people who are coughing and sneezing from infecting others.
But the Oxford analysis of past studies – which has not yet been peer reviewed – found that surgical masks were worth wearing and didn’t provide statistically less protection than N95 for health care workers around flu patients.
However, any face mask is only as good as other health and hygiene practices.
Not all masks are created equal: Single-use masks and surgical masks have larger pores which the coronavirus can easily slip through. A more expensive N95 mask is the gold standard for healthcare workers fighting infectious diseases
Experts universally agree that there’s simply no replacement for thorough, frequent hand-washing for preventing disease transmission.
Some think the masks may also help to ‘train’ people not to touch their faces, while others argue that the unfamiliar garment will just make people do it more, actually raising infection risks.
If the CDC does instruct Americans to wear masks, it could create a second issue: Hospitals already face shortages of masks and other PPE.
The agency may recommend regular citizens use alternatives like cloth masks or bandanas.
‘Homemade masks theoretically could offer some protection if the materials and fit were optimized, but this is uncertain,’ Dr Jeffrey Duchin, a Seattle health official told the Washington Post.
A 2013 study found that next to a surgical mask, a vacuum cleaner bag provided the best material for a homemade mask.
After a vacuum bag, kitchen towels were fairly protective, but uncomfortable. Masks made of T-shirts were very tolerable, but only worked a third as well as surgical mask.
The Cambridge University researchers concluded that homemade masks should only be used ‘as a last resort.’
It comes amid a row over a shortage of masks and other personal protective equipment (PPE) for frontline NHS staff.
NHS workers have been sharing shocking images of the damage caused by prolonged use of face masks. Anaesthetic registrar Natalie Silvey (left), from London, showed her face covered in red and purple marks after a gruelling shift. Emma Sterba, a critical care nurse from Kent also shared an image, with red marks across her face
More than 10,000 healthcare workers have written to the Prime Minister to demand PPE amid growing anger that a lack of supplies is putting lives at risk.
It comes after the Royal College of Nursing (RCN) yesterday revealed there are medical staff working to save lives and turn the tide in Britain’s war with coronavirus that have no access to basic protective clothing at all.
Dame Donna Kinnair, chief executive and general secretary of the RCN, has blasted the ‘unacceptable’ levels of masks, gloves and aprons in some hospitals and care homes.
Whistleblowers in the NHS say they have been ‘hiding’ safety equipment for their next shifts and others have gone off sick fearing they will fall ill if they don’t get away from work.
Dame Donna’s warning based on worried emails and phone calls from nurses came as horrifying pictures of unprotected staff on the frontline emerged today despite new Government guidance making it clear that anyone within 3ft of coronavirus victims must wear full PPE.
She said: ‘I am hearing from nurses who are treating patients in Covid-19 wards without any protection at all. This cannot continue. They are putting themselves, their families and their patients at risk.
‘Every minute we wait is a minute too long. All nursing staff, no matter where they work, must feel safe. We need action, we need equipment, we need it now’.
She added: ‘The Government is finally prioritising Covid-19 testing for NHS staff, including social care, but it is completely unacceptable that weeks into this crisis there are colleagues in all settings – hospitals, community or care homes – who have not been provided with personal protective equipment.
‘As the professional trade union representing potentially the largest group of affected workers, the RCN has said repeatedly that we will not accept anything less than aprons, gloves and masks for all staff, in all settings. But this is a minimum – and that is why we are so disappointed even that level of protection has yet to be provided’.
NHS medics must wear full protective equipment if they come within three feet of a coronavirus patient, the government warned today, as shortages of the gear saw a brave nurse forced to dress in just an apron and gloves.
Wear a SCARF: Donald Trump tells people to cover their faces ‘if they want to do it’ as he acknowledges there are NOT enough masks to recommend that everyone wear one when they go outside
President Trump floated during Tuesday’s briefing that Americans can wear scarves ‘if they want to do it’ if they’re concerned about contracting coronavirus.
‘And just about masks, you could get a mask, but you could also – but most people have scarves and scarves are very good and they can use a scarf and we’re only talking about a limited period of time,’ the president said.
Health officials who have previously urged Americans not to wear face masks unless they’re ill are in the process of deciding if the public should wear them as a way to prevent the coronavirus from spreading.
At the White House Tuesday, Dr. Deborah Birx – known for wearing colorful scarves as she briefs the press – said a decision hasn’t been made yet. So it’s still under discussion.’
The coronavirus outbreak has prompted Americans to don surgical, cotton or even makeshift masks when they leave the home to buy groceries or exercise with the majority of the US now in various stages of lockdown due to the pandemic.
Presdident Trump floated the idea Tuesday that Americans could wear scarves if they’re worried about contracting the coronavirus – as the administration wants the flow of masks to go to the medical community
Dr. Deborah Birx, known for her colorful scarves, said the White House is still considering whether to advise all Americans to don masks when they go outside to stop the spread of the virus
Despite the CDC and the World Health Organization recommending that healthy people don’t need masks, some health experts are advocating for the need to wear some form of mask out in public to reduce the risk of asymptomatic spreading.
They argue that people who have no idea they are infected are spreading the virus because they either have no symptoms or have not begun to experience symptoms.
Healthcare workers, however, are currently facing shortages of personal protective equipment – including N95 respirator masks and surgical masks – as they treat the onslaught of highly contagious patients.
Dr Anthony Fauci, the nation’s top coronavirus expert, said on Tuesday that when the US gets into a situation where there are enough masks there would be very serious consideration about broadening the recommendations of face masks.
The possible shift in guidance comes as the virus continues spread rapidly across the country with more than 189,000 cases and over 4,000 deaths as of Wednesday morning.
It has prompted questions as to who should actually be wearing masks out in public and what to do if a person can’t actually find one due to the current shortages.
The coronavirus outbreak has prompted Americans to don surgical, cotton or even makeshift masks when they leave the home to buy groceries or exercise with the majority of the US now in various stages of lockdown due to the pandemic. Pictured above is the New York subway on Tuesday
Who should be wearing masks?
The current official guidance from both the CDC and the World Health Organization urges people who are healthy to avoid using masks due to the ongoing shortage for doctors and nurses.
Out the healthcare setting, people who are healthy are urged to wear masks if they are caring for a person who has or is suspected of having coronavirus.
Others are asked to wear masks out in public if they are coughing or sneezing – given they are some of the symptoms of having the coronavirus.
How to wear masks to protect against coronavirus?
The WHO says that masks are only effective for the general public when used in combination with frequent hand-cleaning, including with alcohol-based sanitizer or soap and water.
Health officials say that if people choose to wear a mask, it is important to know how to use it and dispose of it correctly.
The US Surgeon General Jerome Adams has previously warned that healthy people who don’t know how to wear a mask correctly can actually increase their risk of being infected.
The risks increase because people wearing masks are likely to touch their face more often than others to make adjustments.
The WHO has a list of recommendations for safely wearing masks, including putting it on with clean hands.
They advise to make sure the mask is covering both the mouth and nose and to make sure there are no gaps between the face and mask.
People are urged not to touch the mask while wearing it and, if they do, to immediately wash their hands.
To remove the mask, health officials warn that people should avoid touching the front of the mask and should instead take it off from the side closest to the mouth. People are advised to throw single-use masks away immediately and to then wash their hands.
What to do if there are no masks available?
The CDC currently has advice on its website for healthcare professionals to help them deal with situations where face masks are not available. The same advice can be implemented by the public.
Heath officials say that when masks are unavailable, homemade masks should be used as a last resort.
Homemade masks include a bandana or scarf covering a person’s mouth and nose.
Officials do, however, warn that homemade masks are not considered personal protective equipment and caution should be used when using this option.
There are also cases across the country where people have opted to sew their own DIY masks with a t-shirt or kitchen towel due to the shortage.
Past studies have also shown that vacuum cleaner bags can be used to make homemade masks.
When masks aren’t available, the CDC also advises health professionals to use some form of face shield that covers the entire front and sides of the face.
Is there any evidence that face masks actually work?
Research on how much protection face masks provides varies but, recently, experts are increasingly leaning toward the notion that something is better than nothing.
Research published by the University of Oxford published on March 30 concluded that surgical masks were just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers.
While it is too early to tell if those masks can prevent infection in relation to coronavirus, the study found that thinner, cheaper masks worked in flu outbreaks.
The difference between surgical or face masks and the N95 masks lies in the size of particles that are able to get through the material.
N95 respirators are made of thick, tightly woven, molded material that fits over the face and can stop 95 percent of all airborne particles. Surgical masks are thinner, fit more loosely and have more holes – meaning they are less effective at stopping small particles from entering the nose and mouth.
Research on how much protection face masks provides varies but, recently, experts are increasingly leaning toward the notion that something is better than nothing. A man wearing a face mask jogs in Venice Beach, California on Saturday
A crowd of people lined up wearing face masks outside a Whole Foods in Harlem, New York on Tuesday
A Pat’s Farms grocery store worker wears a mask and plastic visor on Tuesday in Merrick, New York. When masks aren’t available, the CDC has advised health professionals to use some form of face shield that covers the entire front and sides of the face
Will health officials change the guidance for face masks amid the coronavirus pandemic?
US health officials said on Tuesday they are discussing whether to recommend that the general public wear face masks as a way to prevent transmission of the new coronavirus but that it was too soon to take that step.
Fauci, the nation’s top infectious disease experts, said the use of masks outside the healthcare setting is under active consideration by the CDC and that the White House coronavirus task force would discuss it on Tuesday.
‘The thing that has inhibited that bit is to make sure that we don’t take away the supply of masks from the healthcare workers who need them,’ Fauci, who is the director of the National Institute of Allergy and Infectious Diseases, said on CNN.
When the country gets into a situation where there are enough masks, Fauci said, there will be very serious consideration of broadening the recommendation on face masks.
‘We’re not there yet but I think we’re coming close to some determination, because if in fact a person who may or may not be infected wants to prevent infecting someone else, one of the best ways to do that is with a mask,’ Dr Fauci said.
The consideration of wider use of masks stems from the likelihood that people who have no idea they are infected are spreading the virus because they either have no symptoms or have not begun to experience symptoms.
US Surgeon General Jerome Adams cautioned that wearing surgical-type cotton masks may not protect healthy Americans from contracting coronavirus and may even put them more at risk.
‘Wearing a mask improperly can actually increase your risk of getting disease. It can also give you a false sense of security,’ Adams told Fox News, adding that the CDC was looking at data involving the cotton masks.
‘The data doesn’t show that it helps individuals,’ he said. ‘If you’re sick, wear a mask. If you have a mask and it makes you feel better then by all means wear it. But know that the more you touch your face the more you put yourself at risk.
‘There may be a day when we change our recommendations – particularly for areas that have large spread going on – about wearing cotton masks… But again, the data’s not there yet.’
Who is pushing for the guidance to change?
The idea is being pushed by some health experts, including Scott Gottlieb, a former commissioner of the US Food and Drug Administration.
In a pandemic roadmap for the conservative American Enterprise Institute think tank published on Sunday, Gottlieb advocated for people, even those without symptoms, to wear non-medical masks during this initial phase of rapid community transmission.
He called for the public to ‘initially be asked to wear fabric nonmedical face masks while in the community to reduce their risk of asymptomatic spread’.
Gottlieb told CBS on Sunday that the CDC should be issuing guidelines on how people can make adequate DIY masks so it would take away from the healthcare workers on the front line.
On the issue of face masks, President Donald Trump said at the White House coronavirus briefing on Monday that ‘it’s certainly something we could discuss’.
‘After we get back into gear, people could – I could see something like that happening for a period of time, but I would hope it would be a very limited period of time,’ Trump said.
But numerous medical staff including doctors and nurses have expressed serious concerns about a lack of PPE in NHS hospitals.
One described how staff are ‘hiding’ equipment out of sheer desperation.
Some workers are saying they are sick as they fear the provisions are inadequate, another said.
Another doctor compared the situation to sending a soldier to war without the necessary equipment while a junior doctor said it feels like it is ‘inevitable’ that they will contract the virus due to a lack of PPE
Public Health England has issued stricter guidance on personal protective equipment (PPE), making it a requirement to wear a face mask, gloves, an apron and eye-protection as a shield against infectious airborne droplets.
A global shortage of the equipment medics and carers need to protect themselves against Covid-19 have led to shortfalls in the UK, with warnings the lives of thousands of NHS staff are being put at risk.