Ministers know which masks offer the best Covid protection – why not tell the British public? | Claire Horwell


IIt is now unequivocally accepted that the virus responsible for Covid-19 is airborne, traveling for meters on the breath of an infected person within liquid microdroplets and aerosols. One of the most important measures to prevent the transmission of an airborne respiratory virus is the use of masks. Any face covering is better than nothing, but in the UK the government has failed to educate people about the most effective protection, nor to ensure that they have access to it.

Almost two years after the start of the pandemic, official guidelines remain unclear. The government continues to discourage non-medical workers from obtaining PPE, including certified respiratory protection, saying it is used in a limited number of industrial and healthcare settings.

As a result, high-quality masks are not a standard issue even among healthcare workers. Very few teams beyond intensive care received effective respiratory protection. This despite studies showing that they could reduce infections among hospital staff. This week, the British Medical Association and other medical organizations called for all frontline NHS staff to receive effective respiratory protection.

The government does not hesitate to hide regulations in general. In England, the wearing of face coverings on public transport became law on June 15, 2020 and a second law, covering indoor public spaces, such as commercial spaces and places of worship, came into force five more weeks late. Both laws were repealed on July 18, 2021, on the eve of “Freedom Day”. In response to the Omicron threat, a new law imposing face coverings on public transport and in certain interior spaces entered into force on November 30. Similar laws are in place in decentralized nations.

However, the regulations say little about the best type of protection. Laws for the public require the use of “face covers” and not “face masks”. The government defines a face covering as “something that securely covers the nose and mouth.” It can be made of fabric; the government recommends a comfortable and breathable material, such as cotton. The guide says that by covering the nose and mouth, these coverings protect the wearer and others from the spread of infection.

This is only partially true. The guidelines date back to a time when this coronavirus was thought to spread mainly in large droplets, emitted when someone sneezed or coughed. The idea was that a cotton liner would capture these blood cells, as surgical masks are designed to do, thus protecting others from infection. Such coatings can also provide limited protection if droplets from other people land on you.

This is good advice when fabric is all you have available, and government guidelines then recommend that the fabric be at least two layers thick and fit well around the mouth and nose. But almost two years after the start of the pandemic, we should be doing better.

Many coatings on the market, or made at home, do not have features such as a moldable nose clip that helps secure them to the face. As a general rule, if you feel air blowing into your eyes and your glasses mist up quickly, or if you can feel your breath escaping around the edges of a mask, then contaminated air can also. enter.

There are masks designed to filter out tiny particles and aerosols that have been shown to be effective. So why isn’t the government just recommending these highly effective certified masks (called FFP2 or FFP3 in the UK and N95 or N99 in the US)? Initially, it was because there were not enough of them. It made sense at the start of the pandemic; The World Health Organization has said it is essential to keep limited stocks of personal protective equipment (PPE) for medical use.

There has been ample time to reuse UK factories to produce masks (as has been done elsewhere in the world) or order them from existing sources, and for these sources to step up their manufacturing and supply chains. .

But in most health and social care settings in the UK, such as GP surgeries and nursing homes, respiratory PPE has not been provided except for surgical masks which are not provided. not designed to form a face seal. This despite overwhelming evidence that standard surgical masks are not very protective against infection.

From a health and humanitarian perspective, it is ethically questionable not to inform people that more effective interventions are available. People also have a right to know that open weave fabric coverings may offer inferior protection against aerosol and microdroplet infections, especially if they are poorly fitted.

People need facts about high efficiency masks and need to be encouraged to use them. Many of the concerns expressed about the masks could easily be resolved. They can even be renewed – a fact little known to the public. Although manufacturers recommend discarding masks after eight hours, this advice is for highly contaminated environments, such as an infectious disease ward.

For the public, it is indeed good to reuse FFP masks until they break or become visibly unsanitary. Having several masks that you wear alternately, wearing a different mask each day, and then letting it “decontaminate” can allay concerns about the build-up of pathogens. This not only lowers costs, but also helps solve the problems with masks as plastic waste.

It’s time to revise the guidelines. The government must encourage people to wear better masks. Countries like Germany encourage the use of high-quality masks, making them widely available and even making their use mandatory on public transport.. It’s a simple intervention that can have a big impact, and the UK needs to catch up.

  • Claire Horwell has produced extensive information on the effectiveness and use of face masks, in the context of protecting communities from exposure to volcanic ash.


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