“I wear a mask to protect you and you wear a mask to protect me”
As the Government rethinks its guidance on masks, a public health expert tells StoryCode we should wear homemade masks to protect other people not just ourselves

Ministers are debating whether to advise people to wear homemade cloth masks having hesitated so far over fears that people might rush to buy the medical masks desperately needed by NHS staff. They are worried masks might give people a false sense of security causing them to relax on hand-washing and social distancing and that people might fiddle with them and transfer viral particles to their faces. Some question whether masks are a cultural stretch too far – before the outbreak many Londoners regarded mask-wearing tourists on the Tube with bemusement.

However, these concerns may be over-ridden by a growing consensus that even simple cloth masks could help slow the spread of the pandemic.

Public health experts have been lobbying the Government since the start of March to change the advice and a hundred senior doctors have written to The Times saying it is time for the public to wear homemade masks. The British Medical Association (BMA) has said it wants the public to wear their own cloth masks and doctors across the UK are supporting ‘Masks4allUK’, a campaign that was set up by healthcare workers to address the Government’s apparent reluctance to make masks compulsory.

There is an assumption in the West that a mask is worn to protect the wearer but this is an attitude that needs to change, according to a leading public health professor.

“I wear a mask to protect you and you wear a mask to protect me,” KK Cheng, professor of public health at the University of Birmingham, told StoryCode. “If everyone wears a simple DIY mask, everyone is protected. We must do it.”

Trish Greenhalgh, a professor of primary care at Oxford University, who recently completed a review on face masks, is also calling for the public to wear homemade cloth masks to reduce the spread of the disease.

Laura is the founder of StoryCode and a former Staff News Reporter at The Times and The Daily Mail.

Friday, 24 April 2020

Photos: Banner photo by Honey Yanibel Minaya Cruz on Unsplash; People wearing masks in Singapore by Victor He on Unsplash

The last time people routinely wore masks in London was the great smog of 1952. People also wore masks during the Spanish flu in 1918. By contrast, mask-wearing is commonplace in many parts of Asia due to the 2002 Sars outbreak. People in Asia wear them to protect other people from any pathogens they may be carrying and to protect themselves from infection and pollution.

Women covering their faces during the Great Smog (Daily Herald)

“There is almost universal mask-wearing in Hong Kong,” said Professor Cheng. “In January when things were bad in Wuhan and mainland China several hundred thousand people crossed the border every day. Hong Kong is one of the most densely populated cities in the world but as of Wednesday there were only 1,036 confirmed cases and only four deaths.”

Professor Cheng added: “We have known since February that there are asymptomatic or pre-symptomatic people who are infectious. Since then a lot of other countries – the US, Canada, Austria, the Czech Republic – have changed their guidance on mask-wearing but we have not.

“One reason for this is we focused on the protection of the wearer when we should have focused on protecting others. That is the mindset shift we need to make now.”

A basic barrier mask protects other people from the wearer by reducing the droplet spread that occurs when people exhale, talk, cough or sneeze. Masks may also encourage social distancing by providing a visual cue about the risk of contagion.

Efficacy of homemade masks

Cloth masks do also provide a degree of protection to the wearer, according to scientists at the University of Cambridge. They tested the efficacy of homemade masks after the H1N1 flu pandemic and found that a simple cloth mask made from old t-shirts or t-towels is around 50% better than nothing.

Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?. Disaster Medicine and Public Health Preparedness. 7. 413-418. 10.1017/dmp.2013.43.

Professor Cheng stressed that people must not buy medical masks needed by the NHS but should instead make their own or buy cloth masks.

When the US Government asked the public to wear masks on April 3, the Surgeon-General personally demonstrated how to make a cloth mask by using an old t-shirt and two elastic bands. There was no sewing involved and the mask took less than a minute to make.

“We need to appeal to people’s sense of social responsibility,” said Professor Cheng. “We need to ask them to wear masks to protect other people – it’s the same principle as covering our mouths when we cough.

“Of course wearing a mask is inconvenient but everyone has tasted inconvenience with lockdown – what could be more inconvenient than that? Wearing a DIY mask protects others, causes no harm and costs almost nothing – why are we not already doing it?”

“Social distancing and hand washing are of prime importance in the current lockdown. Mask wearing would complement these measures, especially for essential workers who cannot stay at home. As people return to work, mass masking might help to reduce a likely increase in transmission.”
– Professor Cheng