Rethink the use of masks

BOTH the World Health Organisation (WHO) and our Health Ministry have reiterated that people who are not sick need not wear face masks. They have advised that only people who are unwell or caring for the sick need to wear a mask. This is to enable the masks, which are currently in short supply, to be made available to the frontliners in the fight against Covid-19.

Infectious disease experts are also worried that masks could give people a false sense of security and make them less disciplined about the other preventive measures to ward off Covid-19, including social distancing and hand hygiene.

Nevertheless, it is common to see Malaysians wearing masks in public, and some supermarkets/hypermarkets are imposing the “no mask, no entry” rule. Furthermore, more health experts are now recommending the use of face masks by the public.

The virus that causes Covid-19 is spread by respiratory droplets and not through airborne transmission. Face masks work by stopping the droplets from an infected wearer’s nose or mouth from spewing into the environment. Since a Covid-19 patient may not show any symptoms, if those who come in contact with him or her wears a mask, they are less likely to be infected.

In short, if all wear face masks, they protect one another, thus preventing the community transmission of the coronavirus.

Hong Kong and Taiwan, which applied social distancing and universal wearing of masks early, have got their Covid-19 cases under better control. South Korea and Japan also distributed masks to the public.

Recently, the Czech Republic and Slovakia made the use of masks among the public mandatory. The Czech Republic has a slogan that promotes the wearing of masks: “My mask protects you, your mask protects me.”

George Gao, director of the

Chinese Centre for Disease Control and Prevention (CDC), supports the move by the Czech government. He believes that not wearing a mask is a big mistake.

Although a systematic review and meta-analysis may not provide evidence on the effectiveness of face masks in preventing the transmission of flu-like diseases, we should observe the progress made in countries like China, Hong Kong, Taiwan, South Korea and Japan in fighting Covid-19.

These countries recommended using face masks in areas of high population density such as supermarkets, shopping malls (China), when taking public transport or staying in crowded places (Hong Kong) or in confined and badly-ventilated spaces (Japan).

Lack of solid evidence supporting the effectiveness of masks in preventing the transmission of the coronavirus is not a good reason to dismiss its use because there may never be definitive scientific proof.

However, community use of masks alone is not the only method to stop the spread of Covid-19. Social distancing, staying at home, a rigorous system of contact tracing, testing and quarantine of people who are potentially infected are also very important.

It is time for our government to make rational recommendations on the appropriate use of face masks to complement our other public health measures. Older adults and those with comorbidities should wear masks if these are available.

Universal use of face masks should be considered if there is adequate supply. In addition, research on the effectiveness of cloth face masks, which are reusable after washing, should be encouraged. PROF DR MOY FOONG MING Department of Social and Preventive Medicine Faculty of Medicine Universiti Malaya