Rational use of face masks in the COVID-19 pandemic

Rational use of face masks in the COVID-19 pandemic

Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that caused coronavirus disease 2019 (COVID-19), the use of face masks has become ubiquitous in China and other Asian countries such as South Korea and Japan. Some provinces and municipalities in China have enforced compulsory face mask policies in public areas; however, China's national guideline has adopted a risk-based approach in offering recommendations for using face masks among health-care workers and the general public.

We compared face mask use recommendations by different health authorities (panel). Despite the consistency in the recommendation that symptomatic individuals and those in health-care settings should use face masks, discrepancies were observed in the general public and community settings. For example, the US Surgeon General advised against buying masks for use by healthy people. One important reason to discourage widespread use of face masks is to preserve limited supplies for professional use in health-care settings. Universal face mask use in the community has also been discouraged with the argument that face masks provide no effective protection against coronavirus infection.

Recommendations on face mask use in community settings

WHO

 

  • If you are healthy, you only need to wear a mask if you are taking care of a person with suspected SARS-CoV-2 infection.
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China

 

  • People at moderate risk * of infection: surgical or disposable mask for medical use.
  • *People at moderate risk of infection include those working in areas of high population density (eg, hospitals, train stations), those have been or live with somebody who is quarantined, and administrative staff, police, security, and couriers whose work is related to COVID-19.
  • People at low risk † of infection: disposable mask for medical use.
  • †People at low risk of infection include those staying in areas of high population density (eg, supermarket, shopping mall), who work indoors, who seek health care in medical institutions (other than fever clinics), and gatherings of children aged 3–6 years and school students.
  • People at very low risk ‡ of infection: do not have to wear a mask or can wear non-medical mask (such as cloth mask).
  • ‡People at very low risk of infection include those who mostly stay at home, who do outdoor activities, and who work or study in well-ventilated areas.

 

Hong Kong

 

  • Surgical masks can prevent transmission of respiratory viruses from people who are ill. It is essential for people who are symptomatic (even if they have mild symptoms) to wear a surgical mask.
  • Wear a surgical mask when taking public transport or staying in crowded places. It is important to wear a mask properly and practice good hand hygiene before wearing and after removing a mask.

 

Singapore

 

  • Wear a mask if you have respiratory symptoms, such as a cough or runny nose.

 

Japan

 

  • The effectiveness of wearing a face mask to protect yourself from contracting viruses is thought to be limited. If you wear a face mask in confined, badly ventilated spaces, it might help avoid catching droplets emitted from others but if you are in an open-air environment, the use of face mask is not very efficient.

 

USA

 

  • Centers for Disease Control and Prevention does not recommend that people who are well wear a face mask (including respirators) to protect themselves from respiratory diseases, including COVID-19.
  • US Surgeon General urged people on Twitter to stop buying face masks.

 

UK

 

  • Face masks play a very important role in places such as hospitals, but there is very little evidence of widespread benefit for members of the public.

 

Germany

 

  • There is not enough evidence to prove that wearing a surgical mask significantly reduces a healthy person's risk of becoming infected while wearing it. According to WHO, wearing a mask in situations where it is not recommended to do so can create a false sense of security because it might lead to neglecting fundamental hygiene measures, such as proper hand hygiene.