In its most recently updated guidelines, the World Health Organization (WHO) now says that covering your face will not stop the virus from infecting healthy people. This creates a lot of confusion and contradicts the previous recommendations by the Centers of Disease Control and Prevention (CDC) and WHO that everyone should cover their face with a mask or cloth, especially in public. Now, WHO has stated that there was no evidence suggesting that wearing masks in public prevents healthy people from developing respiratory infections such as COVID-19.
The WHO and CDC offer conflicting recommendations about wearing masks in public during the coronavirus pandemic. https://t.co/VzicPzwgdI
— Durham Herald-Sun (@TheHerald_Sun) April 8, 2020
Initially, WHO did not support the use of face masks due to lack of evidence that they could help contain the spread of the virus. Later, they reviewed their guidelines in light of evidence from Hong Kong indicating a decrease in the spread of the coronavirus in certain regions due to people wearing masks. However, in updated guidance published on April 6, the organization reverted to their original stance, stating that while face masks could help control the spread of disease, they were insufficient on their own and should only be worn by sick people.
The CDC has updated their guidelines on proper use of face masks and reinforced the importance of social distancing. Get the latest updates on Sanford Health News. https://t.co/wPcmk0hoeg
— Sanford Health (@SanfordHealth) April 7, 2020
New Guidance: Wearing a Facemask Won’t Protect You against COVID-19
Prof. David Heymann of the London School of Hygiene and Tropical Medicine chairs the WHO’s Scientific and Technical Advisory Group for Infectious Hazards. He stated that unless people were involved in health care settings, masks are ‘only for the protection of others, not for the protection of oneself’.
Heymann further stated that the widespread use of masks could create a false sense of protection that could put people at a greater risk:
People think they are protected when they are not. Health care workers, in addition to the masks, wear visors too, to protect the eyes.
William Keevil, a professor of environmental health care at the University of Southampton, shared Heymann’s opinion. He stated that governments were under pressure and simply wanted to be seen doing something by forcing everyone to wear masks, even if the measure was a waste of time and valuable resources:
Cloth masks and poor quality surgical face masks will not filter fine respiratory droplets, and certainly not aerosols, which some are now claiming to be an infection risk. The major question that needs to be addressed is: what about protecting the eyes, a known route of entry?
The revised advice states that only individuals exhibiting symptoms should wear a face mask, should self-isolate and seek medical guidance the moment they begin to feel unwell, whereas those caring for the sick should only wear a mask when they are in close proximity. Asymptomatic people are also capable of transmitting the virus – every four out of five people who have the coronavirus are asymptomatic, and asymptomatic and pre-symptomatic individuals are the main reason for the spread of disease. However, the virus spreads via droplets or contaminated surfaces, for which social distancing and hand-washing are adequate preventive measures.
Previous Recommendations by WHO and CDC
At the beginning of the pandemic, the CDC clearly stated that viruses were microscopic particles that spread via contact or inhalation of droplets, hence wearing a mask won’t make any difference. The latter would only provide protection if someone is in close proximity of an infected person. The best approach is to maintain a distance of at least six feet from anyone exhibiting symptoms, such as coughing or sneezing, and to maintain proper hygiene. Even the US Surgeon General urged that people should not hoard face masks since they were not helpful: even the N95 masks recommended for avian viruses and influenza cannot filter virus particles properly.
After a surge in cases was registered in the US and around the world, WHO and CDC revised their earlier claim about face masks, suggesting that everyone should wear some form of face covering in public places. However, the masks were made a priority for health workers. Dr. Mike Ryan, WHO’s executive director of Health Emergencies Program, stated:
We must preserve medical surgical respirator masks for our frontline workers. But the idea of using respiratory coverings or mouth coverings to prevent coughing or sneezing projecting disease into the environment and towards others … that in itself is not a bad idea.
Update: The CDC is now reportedly considering updating its guidance on use of face masks. Read our latest story on the evidence surrounding face masks here: https://t.co/21kwbs4ezS
— Vox (@voxdotcom) March 31, 2020
With coronavirus cases skyrocketing, the CDC may start encouraging Americans to wear face masks to cut down on asymptomatic spread. https://t.co/pbKC078esK
— NPR (@NPR) March 31, 2020
This update was followed by another upgrade in recommendations by the CDC, which then suggested that everyone should wear a cloth mask or face covering, contradicting the previous stance of only wearing a mask when visiting public places such as pharmacies and grocery stores where physical distancing was hard to follow.
Take action to slow the spread of #COVID19 by wearing a cloth face covering in public spaces, keeping at least 6 feet of physical distance, & frequently washing your hands.
Make a cloth face covering from a t-shirt, scarf or cloth napkin. Learn more at https://t.co/bihJ3xEM15. pic.twitter.com/IVZklVYUtS
— CDC (@CDCgov) April 5, 2020
The CDC recently recommended that Americans begin wearing cloth masks when in public. https://t.co/rWcXdBDAHD
— Newsy (@Newsy) April 6, 2020
Why the Sudden Shift in Guidelines?
As described, the latest update by WHO does not support the use of face masks by healthy people in a community setting since existing evidence is uncertain and carries critical risks. In their revised report, WHO outlined various reasons for this sudden change of stance: masks were not significantly protective against cross-contamination between individuals; people did not know how to wear masks properly; masks would provide a false sense of security and people would not be careful about social distancing and hand-washing; most masks needed to be accurately fitted to work properly; masks were in shortage and health care professionals needed them the most; people would contaminate themselves while adjusting, removing or disposing of their masks.
Despite the guidelines, WHO has asked individuals who still choose to wear face masks to follow its advice on how to safely wear them. It also suggests setting up studies to evaluate the effectiveness of using face masks. Dr. Elaine Shuo Feng, an epidemiologist at Oxford University, supports the use of face masks, saying it would be practical approach for people who might have been exposed to the virus because of the risk of transmitting the virus to healthy people:
It would be helpful if high-risk people – elderly, people with chronic conditions – wear a face mask if they can’t avoid crowed areas, because these people have the highest risk of severe outcomes such as ICU/death if infected.
Meanwhile, CDC is pleading with the public to leave professional face masks for nurses, doctors and medics who are exposed to COVID-19 patients every day, and instead use homemade face coverings if they opt to do so.
Nevertheless, using a medical/surgical/homemade mask is among the preventive measures to limit the spread of respiratory viral diseases. However, this method alone isn’t sufficient to provide adequate protection. Whether you chose to wear a mask or not, factors such as hand-washing and social distancing simply cannot be ignored and play a major role in minimizing human to human transmission of SARS-CoV-2. Until any change in the current situation is registered, WHO continues to closely monitor the situation and will issue another update if needed.