As the UK moves into the next stage of the Coronavirus management, and schools start to open their doors mask guidance is confusing. Scotland now recommending face coverings in school and many English schools deciding coverings may help.
The Government’s advice relates to face coverings.
With more people returning to work, schools starting to re-open and the increased social interactions this will cause, the Government has now followed several other countries in advising that people should wear face coverings in spaces where social distancing is not possible. This change in policy is outlined in the Government’s COVID-19 recovery strategy, published some weeks ago. ‘Face coverings’ refers to homemade cloth coverings; the Government is still advising that surgical masks, respirators, and other Personal Protective Equipment (PPE) should be reserved for key workers. As of 15th June, face coverings will be compulsory for anyone travelling on public transport in England.
The World Health Organization (WHO) has already spoken about some of the benefits of wearing face masks. They published a report on the subject in April, stating that “wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral illnesses, including COVID-19”.
The WHO report outlines why masks are beneficial, as they can prevent the spread of infectious droplets from person to person, as well as contamination of an environment by these droplets, which it states are the two main routes of transmission of COVID-19. WHO recommends that medical masks should be worn by anyone showing COVID-19 symptoms, as well as anyone living with someone with symptoms.
Essentially, masks are good at stopping virus particles getting out from a person. This means the viral ‘loading dose’ (i.e. the amount of virus someone is exposed to) for other people may be reduced if someone wears a mask.
This has been proposed by the Royal Society’s Data Evaluation and Learning for Viral Epidemics (DELVE) group, which published a paper for the Government earlier this month.
The paper presented three main findings:
1) People who are infected with Coronavirus but do not show symptoms can pass the virus on.
2) Droplets from infected individuals are a major mode of transmission.
3) Face masks reduce droplet dispersal.
These findings suggest face masks help reduce the release of viral droplets by asymptomatic infected individuals, helping to control the spread of Coronavirus. The DELVE report argues this is consistent with the experience of countries that have adopted face masks.
What kinds of face masks are available?
There are three broad categories of masks.
The first are the loose-fitting, disposable 'surgical masks' consisting of a square covering and ear loops. These can be made of varying fabrics ranging from tight weft cottons to none woven material and should be either disposed of after every use or washed at 60 degrees depending upon the material. They help to protect others by reducing the droplets a person releases.
The second type are reusable, protective face masks. These may come with a respirator and may have a code such as KN95, N95, FFP2 or KF94. These all mean a mask is required to stop at least 94-95% of airborne particles >0.3 microns in size, helping protect the wearer against COVID-19. The different codes refer to the standard used in different countries. For example, N95 refers to the rating system of the American National Institute for Occupational Safety and Health (NIOSH) which states a mask must filter 95% of airborne particles. KN95, FFP2 and KF94 are the equivalent standards for China, Europe and South Korea respectively. These should be
Third are the plastic face shields. These fit on your head and are designed to stop splashes and liquid droplets.
....then there are basic fabric coverings, which should be triple layer and fit both nose and mouth.
How should masks be worn?
In its report, the World Health Organization issues some specific guidance on how masks should be worn, which it derives from practices in healthcare settings. This guidance is as follows:
- Place the mask carefully, ensuring it covers the mouth and nose, and tie it securely to minimize any gaps between the face and the mask.
- Avoid touching the mask while wearing it.
- Remove the mask using the appropriate technique: do not touch the front of the mask but untie it from behind.
- After removal or whenever a used mask is inadvertently touched, clean hands using an alcohol-based hand rub or soap and water if hands are visibly dirty.
- Replace masks as soon as they become damp with a new clean, dry mask.
- Do not re-use single-use masks.
- Discard single-use masks after each use and dispose of them immediately upon removal.
Provided this advice is followed, masks should be effective in helping to control the spread of Coronavirus.
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