While it is probable that we have reached the peak of Covid-19 infection in the UK, the descent will be protracted and lockdown measures will remain in place for the foreseeable future. In this update, we will again attempt to cover some of the emerging issues and questions relating to the coronavirus outbreak.
In our last communication, we explored some of the details and difficulties around testing for Covid-19, especially the ‘pin-prick’ antibody testing kits that have been much reported in the media.
As things currently stand, we will continue to advocate that attendance at a medical clinic or facility especially when travelling to a city, or inviting a health professional to your home, where the sole purpose is to undertake testing, is putting you and your family at an increased risk of infection.
The use of face masks
After testing, probably one of the more common queries we receive is whether we should all be wearing face masks. As with many other questions during this epidemic, the simple answer is that we just do not know for sure. Science will aim to provide us with further evidence in due course, but we will try and offer advice based on our current thinking.
It is important to consider various scenarios, your own personal health and circumstances, and even the type of mask to wear. Of very real importance to us as a nation is the current supply chain difficulties that health and social care workers are experiencing. Whilst scientific evidence should guide public health policy, practical considerations are also needed.
National guidance is continually updated, but we do not anticipate a situation where the population as a whole is advised to wear face masks without significantly more convincing evidence as to their effectiveness. The guidance and recommendations across the world also varies widely, only adding to the confusion, as this recent review in The Lancet highlights.
The WHO offers the following recommendations of when to wear a mask:
- If you are healthy, you only need to wear a mask if you are taking care of a person with Covid-19
- Wear a mask if you are coughing or sneezing
- Note that masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water
So should I consider wearing a mask? The evidence is probably more robust in suggesting that you are less likely to be affording yourself additional personal protection, but that you are more likely to be helping avoiding spread of infection to others – not necessarily a bad goal. However the picture is extremely confusing. A recent review conducted by Oxford University, of all the trials conducted on the topic, can be found here. The simple conclusion – ‘we just don’t know’!
We will, however, try and give some practical guidance.
Firstly, given that social distancing and lockdown measures still persist, one should first assess whether it is appropriate to be leaving your home in the first instance. If you are showing any symptoms, then you should be self isolating for the recommended period, and if you are in a vulnerable category, then staying at home is also the correct course of action.
We would make the following suggestions:
- Those working in high risk environments should wear surgical masks – i.e.. health care facilities, carers, nurses etc.
- If you are displaying respiratory symptoms, yet still have to care for, or be in contact with other family members, we recommend you wear a mask during these ‘contacts’. You should still adopt distancing protocols whenever possible
- If you are in a vulnerable group (underlying health conditions or immunosuppression) and will (through necessity) be in contact with others, then wear a mask
- If you have to travel in confined spaces, e.g. public transport, there may be some marginal advantage to wearing a mask by reducing the spread of droplets
It is currently difficult to advocate mask wearing if you are well, and simply paying a necessary visit to pick up some groceries.
On a final note, outside of healthcare settings, if you have decided to wear a mask, then the type of mask is probably not that important. Certainly, wearing medical grade respirators is unnecessary – paper masks are more than adequate.
Updated information from the government can be found at GOV.UK.
Dr Simon Gillson – Medical Director
Dr Karl Braine – Medical Director