Behind the Mask

In the era of COVID-19 there was never any doubt that frontline medical staff dealing with infected patients needed to wear gowns, gloves, a face mask and some form of eye protection. The argument for the general population wearing face masks has, up till now, been much more contentious. There seems little doubt that the British Government has not done well so far regarding the provision of personal protective equipment (PPE). They have been slow to recommend that the general public wear masks, saying that the scientific evidence was not in favour. You really wonder if this advice was intended to prevent diversion of masks from frontline staff, whom the Government has failed.

In America over 100 experts, including a Nobel laureate virologist and the editors in chief of Nature and The Lancet, have written an open letter asking all US governors to require cloth masks in public places such as shops, transportation systems and public buildings. A group convened by the Royal Society has published a paper making a similar recommendation for the UK.

The evidence suggests that the main role of masks is to reduce the likelihood of an infected individual (who may be asymptomatic) spreading the virus to someone else. It appears that to make a difference masks would need to be worn in the situations stated above by at least 80%, and without compulsion less than 50% (in my locality much less) wear one.

Political leadership in the UK and the US has not been particularly helpful in producing behavioural change. Boris Johnson’s cavalier attitude at the start of the outbreak regarding infection control almost certainly led to his infection with Coronavirus. In America both Donald Trump and Mike Pence have refused to wear face masks in public, flouting the advice of their own public health officials.

If we are not to see a resurgence of infections in Europe as lockdown restrictions are relaxed, it seems that masks should form part of the infection control strategy, while we await a vaccine or effective drug treatment of COVID. The point has also been made that the economies of affected countries cannot rebound until people feel safe, and people will not feel safe until the outbreak is under control. Social distancing, mass testing, isolation and contact tracing have a major role in this, but face masks would contribute too.

Today I wore a face mask in my local supermarket. I thought it would feel odd and that my glasses would keep steaming up. In fact, it felt pretty normal, if the current times can be described in any way as such, and my glasses didn’t steam up too much.

If this awful virus continues to plague us, I am sure the wearing of masks in public places will become very much the norm. They could even become a fashion accessory, with Kim Kardashian West sporting a diamond-encrusted face mask on Instagram. Give it a bit longer, and Apple will bring forth the iMask, complete with temperature and moisture sensors synchronised with your iPhone and your Apple Watch. Every cloud has a silver lining, doesn’t it?

Medicine

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