Journal Pioneer

Fit folks hogging surgical masks are sabotaging frontline health care

- DR. SARAH FRASER GUEST OPINION

Should an asymptomat­ic person wear a mask to prevent COVID-19?

Nope.

This article had the potential to be on record as my shortest blog and I was tempted to end it at “nope.” But the topic of the mask, something that has become so precious, deserves elaboratio­n. In particular, we need people to stop buying masks so there are enough left for hospitals and clinics.

The world seems to be in chaos. Arguably, we are in the midst of the biggest global event since the terrorist attacks of 9-11. A pandemic has disrupted our lives. Economical­ly, socially and physically. And let’s not forget emotionall­y.

Emotions are running high. One emotional response you may be feeling is panic. The Merriam-Webster dictionary defines panic as a sudden overpoweri­ng fright. It is this societal panic that has led to stockpilin­g of unnecessar­y goods. For many, buying toilet paper was a reassuring act of preparatio­n for the unknown (and probably deserves its own blog). But let’s focus on masks. People are buying them in large quantities.

This, despite the fact there is a worldwide shortage of Personal Protective Equipment (also known as PPE). PPE is worn by health-care workers to prevent us from getting infections and transmitti­ng infections to our patients. Masks are a form of PPE.

Medical face masks were first invented in the 1890s. Initially, they were worn by surgeons for the purpose of preventing bacteria from entering the surgical field (in turn, preventing infection). The popularity of the mask increased during the SARS outbreak in China in 2002.

Masks have been worn for other purposes in recent years, like protection from city smog, as a symbolic measure by protesters against climate change or even as an accessory in the fashion industry. This article recently published in the New York Times reviewed the cultural and societal implicatio­ns of the mask in more detail. Back to my first statement. No, a mask does not prevent a healthy person who is walking down the street from becoming infected. In fact, the World Health Organizati­on stated that wearing a mask could create a false sense of security: “For asymptomat­ic individual­s, wearing a mask of any type is not recommende­d. Wearing medical masks when they are not indicated may cause unnecessar­y cost and a procuremen­t burden and create a false sense of security that can lead to the neglect of other essential preventive measures.”

The situation is different for frontline health-care workers. Depending on the setting, we could be constantly exposed to patients who are coughing and sneezing. The virus that causes COVID-19 is transmitte­d through droplets.

For example, if I am looking in a patient’s mouth, and the patient coughs, a droplet from their cough could land in my eyes, nose or mouth. If my eyes, nose and mouth are exposed, I could get the infection and pass it on to someone else. If I’m not wearing a gown, and a droplet from the cough lands on my clothing, I could also get the infection. The virus that causes COVID-19 can live on surfaces for hours, or even days. If I later touch my clothing, then touch my face, I could get infected, and again, infect others.

This is why the PPE is needed when we work closely with patients with COVID-19. The recommenda­tion for PPE for COVID-19 includes wearing a mask with an eye shield, a gown and gloves, according to the World Health Organizati­on and the Centers for Disease Control. Also, if you are at home providing care for a loved one who is positive for COVID-19 or another infection, it is appropriat­e to wear PPE.

The shortage of PPE, including masks, is a global one. Doctors, nurses and caretakers need to be protected from becoming ill. If you are healthy and not in close contact with people who have an infection, please refrain from stockpilin­g masks, gloves and gowns, as these are needed in our precious health-care system.

Should an asymptomat­ic person wear a mask to prevent COVID-19?

Again: nope. Dr. Sarah Fraser is a Nova Scotia physician who blogs about medicine. Her book of poetry and other writings can be found at www.sarahfrase­rmd.com

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