United States officials are actively discussing recommending masks to people who are not in hospitals or sick, two top officials said this week.
“The idea of getting a much more broad, community-wide use of masks outside of the healthcare setting is under very active discussion,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, during an appearance on CNN on Tuesday.
Both the White House Coronavirus Task Force and a group at the Centers for Disease Control and Prevention (CDC) are looking at broadening the recommendations, Fauci said. There are concerns about the number of masks currently in circulation not being enough for healthcare workers.
“When we get in a situation where we have enough masks, I believe there will be some very serious consideration about more broadening this recommendation of using masks,” according to Fauci. “We’re not there yet, but I think we’re close to coming 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, so perhaps that’s the way to go.”
Mask shortages prompted the approval of a sterilizing technology that can clean each mask up to 20 times.
Dr. Robert Redfield, director of the CDC, told a reporter on Monday that new data showing there’s significant asymptomatic transmission of the virus has prompted researchers to re-review recommendations on wearing masks “to see if there’s potential additional value for individuals that are infected or individuals that may be asymptomatically infected.”
President Donald Trump told reporters in Washington on Monday that suggesting everybody wear a mask in public was something officials could discuss.
“We’re not going to be wearing masks forever, but it could be for a short period of time,” Trump said.
Only healthcare workers and people with confirmed COVID-19 cases are currently advised to wear masks. The CDC and the World Health Organization (WHO) have both resisted recommending other people wear them, despite what some experts describe as ample evidence masks help prevent the transmission of illnesses.
The WHO says healthy people only need to wear a mask if they’re taking care of a person with a suspected case of the CCP (Communist Chinese Party) virus, commonly known as the novel coronavirus. which causes COVID-19.
“There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit. In fact, there’s some evidence to suggest the opposite in the misuse of wearing a mask properly or fitting it properly,” said Dr. Mike Ryan, executive director of the WHO health emergencies program, at a press conference in Geneva on Monday, also highlighting the “massive global shortage” of masks and other person protective equipment.
CDC recommendations also only include sick people or healthcare workers and the agency over the weekend disputed a report that claimed the agency would soon advise Americans to wear masks in everyday life.
“During a public health emergency, facemasks may be reserved for healthcare workers. You may need to improvise a facemask using a scarf or bandana,” the agency states on its website.
Officials have struggled to explain why masks work for healthcare workers but wouldn’t be useful for healthy people to wear. Masks are used widely in Asia and have been credited by some for slowing the spread of the virus in China, Japan, South Korea, and Taiwan.
‘Doesn’t Make Sense’
Benjamin Cowling, an epidemiologist at the University of Hong Kong, told Science Magazine “it doesn’t make sense” that surgical masks would be important for healthcare workers “but then not useful at all for the general public.”
If wearing masks properly is an issue, then people can be advised on how to do so.
“It’s really a perfectly good public health intervention that’s not used,” added KK Cheng, a public health expert at the University of Birmingham. “It’s not to protect yourself. It’s to protect people against the droplets coming out of your respiratory tract.”
One group compiled 41 papers they say show masks would be useful in slowing the spread of the CCP virus, including multiple studies showing that even home-made masks can reduce exposure to respiratory infections.
The new virus from China is believed to spread primarily through respiratory droplets produced by an infected person coughing or sneezing, the CDC says. That method of transmission would be blocked by masks. Another suspected source of transmission is aerosolized particles, which remain suspended in the air longer than respiratory droplets.
‘Protect You From Other People’
Tom Inglesby, director of the Johns Hopkins Public School of Health’s Center for Health Security, argued over the weekend that medical masks like N95 respirators should be reserved for healthcare workers and emergency personnel but that other masks would be beneficial to the general public to wear to the slow the spread of the virus.
“While past studies have shown no evidence that wearing a mask in public is protective to an individual, given the spread of COVID, there is conceptual basis for covering the mouth/nose of members of the public w/ non-medical masks to lower risk of asymptomatic transmission,” he wrote on Twitter, referring to people with the new virus transmitting it before they show symptoms.
Dr. Scott Gottlieb, former director of the Food and Drug Administration, said over the weekend that people should consider wearing masks.
“We should be putting out guidelines from the CDC on how you can develop a mask on your own. It might create a secondary market on Etsy or other sites for selling those kinds of masks,” he said during an appearance on CBS’s “Face the Nation.”
“The value of the mask isn’t necessarily to protect you from getting sick, although it may offer some protection. It’s to protect you from other people. So when someone who’s infected is wearing a mask, they’re much less likely to transmit infection. And studies demonstrating this come out of evaluations with the flu.”
Many experts tout the N95 respirators, which are widely used in hospitals, but some say conventional surgical masks don’t do well against the new virus.
“We study the efficiency of face masks and various respirators on human subjects and breathing mannequins and in terms of penetration of particles through a conventional surgical mask, it may be as much as 50 percent or even greater,” said University of Cincinnati scientist Sergey Grinshpun.
Such masks are “useless” to protect people, the researcher said, adding, “These masks may filter out very large droplets, but not tiny aerosolized particles.”