Face mask exemptions for respiratory patients not ‘evidence based’: experts


By Nicola Garrett

7 Oct 2020

Professor Sinthia Bosnic Anticevich

People with respiratory conditions should not be exempt from wearing face masks in public, a team of international respiratory experts say.

Writing in a paper published in the European Respiratory Journal, the Respiratory Effectiveness Group, which includes Professor Sinthia Bosnic Anticevich from the Woolcock Institute of Medical Research, Sydney, note that some countries and jurisdictions have exempted people with respiratory diseases from the compulsory use of face masks during the COVID-19 pandemic.

“It must be strongly stated that such exemption is not evidence-based, and it may carry increased risk of personal infection to the estimated 544·9 million people worldwide suffering a chronic respiratory disease,” they write.

The group warn that exempting respiratory patients from the obligation to wear masks could be highly deleterious for them, since by definition those patients with respiratory conditions who cannot tolerate face masks are at higher risk of severe COVID-19.

“Although face masks undoubtedly enhance breathing resistances, the degree of discomfort experienced by some patients is influenced by its affective component. Dyspnea is a sensation, and supratentorial affects such as anxiety and claustrophobia might cause the added sensation of ‘being unable to breathe’ with a mask,” they say.

However, the WHO states that face masks of breathable material, worn properly, will not lead to health problems, they add.

In Victoria it has been mandatory since 2 August for everyone to wear a face covering when leaving the home, with a $200 fine for those who do not comply. But the rules provide an exemptions for a person “who is affected by a relevant medical condition, including problems with their breathing, a serious condition of the face, a disability or a mental health condition.”

Asthma Australia advises people to wear a face mask where possible but acknowledges that they can restrict breathing for those with existing respiratory conditions.

“In a recent Asthma Australia survey of 236 people, 69% of those who had used a face mask before said that it made it harder for them to breathe. If you have asthma and masks make it difficult for you to breathe and speak to your doctor or specialist before using a mask be extra vigilant with your other hygiene and self-protection practices.”

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