Should I be wearing a face mask when I leave my home?!

Will masks prevent us from speaking moistly on others?!

Myth: Only those who have symptoms of COVID-19 should be wearing a face mask in public. 

There has been a lot of confusion about whether or not the general population is supposed to be wearing masks in public if they don’t have symptoms of COVID-19, and rightfully so. The stance of public health officials on facial coverings for the general public has changed numerous times over the course of the pandemic as we learn more about COVID-19, so it has been difficult to keep track of what’s happening. It’s also confusing because different countries seem to be taking a variety of approaches to public mask use, so understandably, many aren’t sure whether or not they should be wearing a face mask when they leave their home. Where do we currently stand on mask use for the general public in Canada?

Why has the opinion around wearing masks changed?

As we learn more about COVID-19, our public health recommendations evolve. There’s a lot more that we now know about COVID-19 transmission compared with what we knew at the beginning of the pandemic. At the start of the pandemic, widespread mask use was not encouraged to the same degree that it is now, at least not in Canada.

What we do currently know is that the novel coronavirus is spread through respiratory droplets. Droplets may come from symptomatic individuals currently infected with COVID-19 or from those who are infected, but who have no symptoms (and therefore don’t know they carry the virus).1 Although we don’t yet fully understand the role of asymptomatic and pre-symptomatic individuals in the transmission of COVID-19, we do know that it does occur.1 Therefore, one may wear a mask to protect others from their respiratory droplets.1,2

What is the current recommendation of public health officials in Canada?

The current official recommendation of the Public Health Agency of Canada (PHAC) on wearing masks is for Canadians to wear non-medical masks while in public when physical distancing is not possible.2 We want to reserve medical masks (like N95 masks) for health care workers! It is now recommended to wear a non-medical mask/face covering especially in crowded public spaces, such as stores and public transportation, where maintaining physical distancing can be challenging.2

Importantly, the use of masks is considered complementary to physical distancing and hand hygiene. Now that we know that people who are asymptomatic can spread COVID-19 via droplets from “speaking moistly” (shout out to Prime Minister Justin Trudeau),3 wearing masks can be a way to prevent or reduce the likelihood of transmitting the virus to others when we can’t keep six feet apart.

Pitfalls of wearing a mask

However, it’s also important to be aware of the potential pitfalls of mask-wearing. Firstly, wearing a mask is in no way a substitute for physical distancing and washing our hands – these should continue to be practiced regularly, mask or no mask! Secondly, wearing a mask could actually increase the risk of COVID-19 transmission if you repeatedly touch your mask with contaminated hands, or if you keep your mask on other parts of your face, like your chin, and then put it back over your nose and mouth.4  So remember – if you’re going to wear a mask, please make sure you’re not cutting a hole out of it to drink your iced coffee!

Also – not everyone can wear a mask! Masks should not be used for people who have difficulty breathing and for children under two years of age.2 They may also be harmful in that they can potentially increase the risk of an asthma attack in those with asthma. Moreover, mask-wearing may make it more difficult for the deaf to read lips.5 So, although wearing masks can help reduce the transmission of COVID-19, this intervention cannot be practiced by everyone.

What does the research show about mask use?

The Royal Society of the United Kingdom Data Evaluation and Learning for Viral Epidemics (DELVE) Initiative, a group of data-scientists and experts, recently published a report that outlines some of the evidence around mask use.7 This report, which focused on the use of masks in infected but asymptomatic wearers,  concluded that face masks could contribute to reducing viral transmission in the general population if correctly used.7  

Although it has been shown in a previous study that cloth masks are not as effective at filtering out particles as surgical masks, they can still filter up to 50% of airborne particles!8 Another study showed that cloth masks were able to filter viral particles during coughing, although not quite at the same efficacy as surgical masks.9 So although cloth masks may not be as effective as surgical masks, there is still evidence that they work to a degree! It’s also important to note that these studies were published several years ago and are not specific to COVID-19.

If I wear a mask, does that protect me from getting sick as well? Or does it only prevent others from my respiratory droplets?

As of right now, there is no evidence that wearing a non-medical mask as a member of the general public is going to protect you from getting sick.6 The emphasis around wearing a mask in public has really been around protecting others, since you can be infected with COVID-19, spread it to others, and not even know it. However, with that being said, if someone coughs near you, a mask could theoretically help prevent some of the other person’s droplets from getting into your mouth or nose. However, the use of non-medical masks should not give us a false sense of security — homemade masks are not medical devices: they are not regulated, and they have not been tested.2 They may not be effective at providing complete protection against virus-sized particles that come with someone coughing or sneezing because the fabric may be inadequate, and the fit may be too loose.2

Summary

Non-medical masks may be helpful in reducing transmission of COVID-19, but only if they are worn properly and accompanied by proper hand hygiene and physical distancing. In Canada, it is not mandatory to wear a mask in public, although you may be required to do so to enter certain establishments, such as some grocery store chains. Mask use for the general public has been recommended by Canadian public health officials at times where physical distancing is not possible.

Importantly, these changing recommendations around masks does not discredit public health agencies; they make recommendations with the information that is available to them at the time. It is important to keep following public health updates on the use of masks for the general public, as they may change moving forward as we learn more about COVID-19, economies continue to open up, and things start to move towards a new normal!

BUST OR NO BUST:

Myth: Only those who have symptoms of COVID-19 should be wearing a mask. 
Results: Bust. Myth-meter = 30/100 truthfulness.

Written by Christina Blagojevic.

For more information:

https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html#_Appropriate_non-medical_mask

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

References

  1. “Canadians Should Wear Masks as an ‘Added Layer of Protection,’ Says Tam | CBC News.” CBC News, CBC/Radio Canada, 20 May 2020, www.cbc.ca/news/politics/masks-covid-19-pandemic-public-health-1.5576895.
  2. Public Health Agency of Canada. Government of Canada. “COVID-19: About Non-Medical Masks and Face Coverings” – Canada.ca, Government of Canada, 22 May 2020, www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/about-non-medical-masks-face-coverings.html#_Appropriate_non-medical_mask.
  3. Elliott, Josh K. “Trudeau Cringes at His Own ‘Speaking Moistly’ Tip for Coronavirus Masks.” Global News, Global News, 8 Apr. 2020, www.globalnews.ca/news/6792967/coronavirus-trudeau-speaking-moistly/.
  4. “Q&A: Masks and COVID-19.” World Health Organization, World Health Organization, www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-on-covid-19-and-masks.
  5. Spencer, Donna. “Face Masks Can Be Problematic, Dangerous to Health of Some Canadians: Advocates.” Global News, Global News, 21 May 2020, www.globalnews.ca/news/6967625/coronavirus-canada-face-masks-disabilities/.  
  6. Government of Alberta. “COVID-19 Information: Guidance for Wearing of Non-Medical Face Masks for the General Public”, May 2020, https://www.alberta.ca/assets/documents/covid-19-guidance-for-wearing-non-medical-masks.pdf
  7. Royal Society DELVE Initiative. “Face Masks for the General Public.”, 4 May 2020, https://rs-delve.github.io/reports/2020/05/04/face-masks-for-the-general-public.html
  8. van der Sande, Marianne, et al. “Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population.” PLoS ONE, vol. 3, no. 7, Sept. 2008, doi:10.1371/journal.pone.0002618.
  9. Davies, Anna, et al. “Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?” Disaster Medicine and Public Health Preparedness, vol. 7, no. 4, 2013, pp. 413–418., doi:10.1017/dmp.2013.43.