Face masks are one of the most debated topics surrounding the coronavirus pandemic. Disagreements as to the role masks should play in fighting the pandemic has led to a lot of confusion among the general public.

Why are masks important in the coronavirus pandemic?

Coronavirus is spread in two ways:

  1. People with the virus can infect others when droplets they exhale come into contact with another person’s eyes, nose and mouth. 
  2. Virus particles in droplets can also survive on surfaces, where they are later picked up by people who then touch their faces and infect themselves. 

Broadly, there are three different kinds of mask being used during the coronavirus pandemic.

  • Respirators (sometimes called FFP2, FFP3, or N95): masks which fit very tightly to the face and stop the wearer breathing in particles from the air. 
  • Surgical face masks: loose-fitting masks that cover the nose, mouth and chin. They are usually shaped like a rectangle. They create a physical barrier between the mouth and nose of the wearer and the virus, blocking large-particle droplets  that may contain germs. They do not block smaller particles, and have a less close fit, making them less effective protection against viruses than respirators. They are single-use only and only work for a few hours. 
  • Cloth face coverings: masks made from materials which are not designed to block particles in the air, such as clothing or towels. These are the least effective type of mask, although this varies with the material used. Studies show cloth masks can still provide a significant degree of protection, and importantly can stop the wearer infecting other people with the virus. They can be made at home, and also be washed and reused. 

As respirators and surgical face masks are the most effective in protecting the wearer from viruses, they are in high demand. Healthcare workers in hospitals and other settings are constantly exposed to the coronavirus, and most in need of masks to protect themselves. The public, who are far less exposed to the virus, should not be buying respirators or surgical masks, as shortages put healthcare workers at a very high risk. If many healthcare workers get sick and cannot work, healthcare systems will struggle even more to take care of people with coronavirus. It is in everybody’s interests to make sure doctors and nurses have the right protection. 

Should I wear a mask?

The World Health Organisation (WHO) recommends that you should wear a mask if:

  • You are taking care of someone suspected to have coronavirus OR
  • You are frequently coughing or sneezing

However, across the world there have been lots of different recommendations to the public about masks. This has caused a lot of confusion. For example:

  • In Austria face masks are only mandatory in shops, meaning you must wear one whilst in a shop.
  • In Rwanda and South Africa, face masks are mandatory whenever people leave their homes. 
  • In America, the Centre for Disease Control (CDC) initially discouraged wearing masks, but now advises people to wear homemade coverings. 
  • In the UK, the  government still doesn’t advise the general public to wear masks, although this is currently under consideration.

Densely populated countries like Nigeria, with about 200 million people spread across 36 states, may face additional difficulties enforcing physical (social) distancing. In Nigeria, President Muhammadu Buhari has been asked to make face masks compulsory in public. In such countries, the wearing of masks may be a more important measure in preventing coronavirus transmission because people live so closely together that they cannot do social distancing.

When deciding whether or not to wear a face mask, you should take into account what advice or compulsory measures your country or region’s government has decided on. If your country introduces compulsory measures, you must follow these. However, there is no harm in wearing a face mask as additional protection against the virus, as long as you wear it correctly. It is especially useful if you are unable to take part in physical distancing for whatever reason. However, you will still not be completely safe even if you are wearing a mask – and you must bear this in mind.

One of the strongest cases for masks is to think of them as a way to protect other people.  Rather than seeing them as a method to protect people from getting infected, they should be seen as a way to stop people with the virus from infecting others. Coronavirus can be transmitted by a person who has it but does not show symptoms (someone asymptomatic). It can also be transmitted by pre-symptomatic people, people who have coronavirus but do not yet have symptoms of it. If they were wearing masks, these people would be less likely to accidentally spread the virus. A study published in Nature Medicine showed that without face masks, 30% of droplets exhaled by participants with coronaviruses contained virus particles, whereas when they wore masks it was 0%.

Why aren’t masks recommended by all public health bodies? 

There are lots of reasons:

  1. Their effectiveness depends on people’s ability to use them. Healthcare professionals are trained to handle masks so they don’t infect themselves by removing them incorrectly. Masks also need to be fitted properly, and changed regularly as they accumulate moisture, which much of the general public do not know. 
  2. There are concerns that widespread mask-wearing will mean people stop being careful about physical (social) distancing – which could cause the virus to spread more easily. We know that social distancing (staying 2 metres away from other people) is one of the most important ways of stopping the spread of the virus.   Face masks that are suitable for use in hospitals are in short supply all over the world. Already in February it was reported that Kenya and Tanzania were facing massive demand from China for supplies, leading people to worry that those countries would be left without enough masks for at-risk healthcare workers. As a result, many countries are not recommending masks in order to prevent or minimise shortages caused by the public stocking up.