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'Masks for all' movement grows while medical officials still recommend targeted use

Jamie Martines
| Monday, March 30, 2020 6:07 p.m.
Shane Dunlap | Tribune-Review
Pedestrians wear masks Monday on Forbes Avenue in Pittsburgh’s Oakland neighborhood.

The debate over who should wear a face mask is continuing as some health experts and lawmakers urge the public to wear a mask when they go out to run an errand or visit a communal space.

The Centers for Disease Control and Prevention still recommends that anyone who is sick, particularly if they are showing symptoms of covid-19, should wear a face mask if they are around other people.

Healthy people, with the exception of health care workers or those caring for someone who is sick, don’t need to wear a face mask, according to the CDC: “Face masks may be in short supply and they should be saved for caregivers.”

In a video message posted to his Twitter feed Saturday, U.S. Sen. Pat Toomey of Pennsylvania praised initiatives calling for everyone — including those who are healthy or who are not showing symptoms of covid-19 — to wear some type of face covering in public.

This could include a homemade cloth face mask, bandana or T-shirt, he said. His video message told people not to seek out the surgical-grade masks needed by health care workers.

He posted the video with the hashtag #Masks4All, which has been linked to other posts calling for more Americans to start wearing face masks or coverings in public in order to slow the spread of the coronavirus.

A March 27 New York Times article, “More Americans Should Probably Wear Masks for Protection,” cited Dr. Robert Atmar, an infectious disease specialist at Baylor College of Medicine, to say that while mask-wearing doesn’t “replace important measures such as hand-washing or social distancing, it may be better than nothing.”

Many posts also praised the Czech Republic, where face masks are now mandatory for anyone out in public. Toomey noted in his video that the policy has been deployed “very successfully” in the Czech Republic.

“My mask will keep someone else safe, and their mask will keep me safe,” Toomey said. “I’m not suggesting that this is any kind of guarantee, and it probably doesn’t have tremendous value for the person wearing the mask. But it probably does significantly reduce the risk that people could inadvertently transmit it.”

The coronavirus is typically spread through respiratory droplets that are produced when an infected person coughs or sneezes, according to the CDC.

In some cases, it could be spread by someone who is not yet showing symptoms.

Different types of masks have different roles, and many of those available to the public are intended to prevent the spread of germs, said Dr. Gavin Harris, an infectious disease physician and critical care fellow with UPMC.

Many of those masks are not intended to be used to protect the wearer from infection, Harris said.

Furthermore, many of those masks could break down and become less effective or contaminated over time.

He stressed that social distancing is the only “tried and true, tested method,” combined with good hand hygiene, to prevent the spread of the coronavirus.

“There is a possibility that constructing homemade masks, or even to wear masks in public as a healthy person, can provide a false sense of security,” Harris said.

Recommending that people wear masks “could in fact lead to more people going out in public and actually putting more people at risk of contracting the virus — because they’ll be around more like-minded people,” Harris said. Restricting movements in public, he added, is the best “proven health care measure that we can take.”

Dr. Amesh Adalja, a Pittsburgh-based infectious disease and critical care physician, shared similar concerns.

“When the general public wears a mask, they may not wear it appropriately and gain a false sense of security and refrain from, for example, washing their hands as frequently as they should,” Adalja said. “If the average person chooses to wear a mask, a homemade one that doesn’t impact hospital supply chains is probably the best option. However, I am not convinced it is beneficial. I, personally, do not wear a mask outside of the health care setting.”

In an opinion piece published in The Washington Post on Saturday, Jeremy Howard, a research scientist with the University of San Francisco, argued that such concerns don’t outweigh the potential benefits of wearing a mask.

He referenced places like Hong Kong, Mongolia, South Korea and Taiwan, where covid-19 outbreaks are reported to be controlled and wearing a face mask in public is common.

“The reasons the World Health Organization cites for its anti-mask advice are based not on science but on three spurious policy arguments,” Howard wrote. “First, there are not enough masks for hospital workers. Second, masks may themselves become contaminated and pass on an infection to the people wearing them. Third, masks could encourage people to engage in more risky behavior. None of these is a good reason to avoid wearing a mask in public.”

The World Health Organization, like the CDC, recommends that healthy people only need to wear a mask if they are taking care of a sick person.

The WHO also recommends those who are coughing or sneezing also wear a mask.

In an interview with “Good Morning America” on Monday, National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci, the nation’s leading expert on the covid-19 outbreak, said that there could be a case for using masks more frequently but also warned that there could be drawbacks.

“There is some rationale that the person in the street, who may not know they’re infected, could actually prevent the spread to other people by wearing masks,” Fauci said. “This hasn’t been proven. We know the masks aren’t 100% effective. People might think, and get under the impression that if they wear a mask they’re completely protected, and they’re not. But even when you pull back and think about it, we’re starting to reexamine the possibility, that if there are enough masks, should everyone be wearing masks, those who are trying to protect themselves, and those who are trying to protect others?”

When asked about Toomey’s message during a press briefing Monday, Gov. Tom Wolf said masks could help prevent infected individuals from spreading covid-19, but he would continue to consult medical research.

“I haven’t spoken with Sen. Toomey about that,” Wolf said. “I think the jury is out, exactly what those masks do.”


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