Wear a mask in public, respiratory societies advise

By Michael Woodhead

7 Jul 2020

The world’s peak respiratory groups have joined with the World Health Organization in recommending that people wear masks in public if there is an ongoing risk of COVID-19 community transmission.

As countries including Australia face a second wave of COVID-19, the Forum of International Respiratory Societies (FIRS) is urging people not to get complacent.

“Face masks or coverings should be worn at all times in public. If everybody is wearing them, including infected and asymptomatic people, this will help stop the spread,” says Professor Stephanie Levine, President of FIRS.

“It is vital that we all continue with everyday preventive measures such as wearing masks, maintaining social distance, and washing hands, which can substantially curtail the spread of the virus. Continuing these actions is the number one thing we can all do to reduce our chances of catching and spreading COVID-19,” says Professor Levine, a respiratory physician at UT Health, San Antonio, Texas.

FIRS says self isolation is also very important for anyone who has symptoms of the virus, or might have been exposed to it, to reduce potential transmission to others.

FIRS is an organisation comprised of the world’s leading international respiratory societies including the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR, European Respiratory Society (ERS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The WHO has also recently updated its advice to recommend wearing of masks in public, although it concedes “the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence and there are potential benefits and harms to consider.”

“However, taking into account the available studies evaluating pre- and asymptomatic transmission, a growing compendium of observational evidence on the use of masks by the general public in several countries, individual values and preferences, as well as the difficulty of physical distancing in many contexts, WHO has updated its guidance to advise that to prevent COVID-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear masks in specific situations and settings as part of a comprehensive approach to suppress SARS-CoV-2 transmission.

In its examples of situations where the general public should be encouraged to wear a mask, the WHO suggests public settings, such as grocery stores, at work, social gatherings, mass gatherings, closed settings, including schools, churches, mosques, etc.

This advice applies to areas with community transmission and limited capacity to implement other containment measures such as physical distancing, contact tracing, appropriate testing, isolation and care for suspected and confirmed cases.

Australia’s  Australian Health Protection Principal Committee does not recommend the use of masks for preventing transmission of COVID-19, saying they may provide a false sense of security and may result in neglect of more important measures.

“Wearing a mask in public is not recommended as it adds little if any protection,” it said.

But some infectious disease specialists have recommended public wearing of masks, at a time when Melbourne is going back into Stage 3 restrictions to try control community transmission of COVID-19.

“It’s time we adopted community mask-wearing and provided people with positive and constructive messaging on using masks,” said Professor Raina MacIntyre, Head of the Biosecurity Program at the Kirby Institute at the University of NSW.

“In states that are not affected, it may make the difference between needing a lockdown versus not, in the near future,” she said.

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