The WHO is wrong. Face masks work and here’s why we should work towards universal face mask use

Wilfred Chan. The far left option is ironic; you probably have interacted with the outside world in the past 14 days.

Some solutions to new pandemics are old ones.

The information from the World Health Organization and other health bureaus, such as the Center for Disease Control in the United States, has recommended against wearing masks in community settings because of lack of evidence.

Unlikely to contradict official health recommendations, journalists have ignored face masks as one of the successful lessons from past outbreaks in their reporting, and in different articles, questioned why people who were wearing face masks disregarded advice from authorities.

Others have now questioned the real motive of the official recommendations for face masks in community settings. Authorities seemed afraid of rampant stockpiling of face masks if they recommended universal face mask usage, and therefore told people that they were not necessary.

Yet, there is ample evidence that face masks work. When researchers conducted a systematic review of a variety of interventions used during the SARS outbreak in 2003, they found that wearing a surgical mask is more effective in stopping virus transmission than washing hands alone — at about 68 percent versus 55 percent. N95 masks were given 91% effectiveness, but when surgical mask-wearing was combined with hand-washing and protective gear, intervention effectiveness was similar.

Chi Chiu Leung, Tai Hing Lam, and Kar Keung Cheng from Hong Kong wrote the article ‘Mass masking in the Covid-19 outbreak — people need guidance’ for The Lancet in the beginning of March, declaring that “Masking, as a public health intervention, would probably intercept the transmission link and prevent these apparently healthy infectious sources.”

Although places like Hong Kong, South Korea, Singapore and Taiwan have been battling the spread of coronavirus for months, their citizen-led containment strategies have not been widely reported in Western media.

Media coverage has focused on government response, and not on community response and collective behavior. But community response and collective behavior are far more crucial to combatting the spread of a pandemic than we understand. Face masks prevent virus transmission for everyone — from doctors to grocery store workers to people leaving their quarantine for a walk around the block — and their utility has been grossly obscured.

Community response and collective behavior are far more crucial to combatting the spread of a pandemic than we understand.

Masks are particularly useful for people who are asymptomatic or presymptomatic infections, who will not know that they are infected. If they are wearing face masks, then they can prevent spreading droplets that will infect others.

“People who don’t wear face masks are making a big mistake,” is the latest from the director of the Chinese Center for Disease Control, Gao Fu said in an interview with Science Magazine. In its public advisory issued on March 22, the Chinese CDC said that people need not wear face masks when they are at home, in the open air, or in an environment where there is good airflow and no crowds. However, they should still wear them in the office, meeting rooms, lifts and on public transport.

Official communication discouraging and stigmatizing face mask use has other consequences. In a context of rapidly increasing violence and racism towards Asians in the West, open distrust of China, Asians who have been wearing masks to protect themselves and their communities have been targeted.

Universal mask usage in countries outside of Asia will not occur until the stigma of using face masks is effectively removed. Stigma will only disappear once they are universally used, effectively normalizing a behavior. Finally, universalizing mask usage will also prevent racism and acts of violence against those who are already wearing masks, especially Asian-Americans and Asians who already practice wearing masks in order to prevent spreading colds and flu, survived SARS or have families who have lived through infectious outbreaks.

Here are three ways to work towards universal mask protection during a global mask shortage.

  1. Homemade masks that cover the nose and mouth and fit adequately.

The Czech Republic is the first country in Europe to explicitly mandate that residents are not allowed to leave the house with their nose and mouths uncovered. Citizens were outraged that government officials delayed this official announcement, and have largely led country-wide DIY mask movement themselves. The Czech Republic’s Vietnamese community has especially been active in making face masks for the community.

2. Mutual aid networks to bring surgical and N95 masks to hospital workers and frontline workers.

Although suffering from an uptick in racism, xenophobia and violence, Asian-Americans and Asians living in the United States have been on the forefront of mutual aid efforts focused on protective gear for hospital workers.

Mutual aid for crowdfunding for PPE for medical staff is critical when governments have failed to ensure adequate supply of masks for their medical workers. However, many fundraisers and mutual aid efforts are focused on medical staff and not all frontline, essential workers — which include farmers, taxi drivers, grocery clerks, delivery personnel, and many more.

3. Official governments and health organizations should change their official recommendations on face mask use.

Governments and health organizations around the world are facing a crisis of legitimacy due to their failure to prepare for this pandemic, despite having ample time, warning, and experience of handling previous infectious disease outbreaks in Asia and Africa.

This is their opportunity to correct for their mistakes and double down on universal face mask use, based on scientific studies of previous pandemics. Not only will this prevent the spread of coronavirus, but this will also remove stigma from mask-wearing individuals and allow communities to develop signal response.

Universal face mask use would make full lockdowns unnecessary. If the WHO hadn’t ignored Taiwan’s experience, which adopted universal face mask use early and avoided a lockdown, then there would be less lockdowns all over the world. Lockdowns are now proven to increase domestic violence for women.

Universal face mask needs to be recommended by governments and health authorities, but ultimately relies on citizens to support and protect each other by adhering to this practice. This necessitates a stronger collective identity and responsibility. This is what has been happening in places like Hong Kong — where citizens credit each other, and not the government, for flattening the curve by adhering to universal face masking. This is what could happen in other places as well.

Finally, it is not possible for journalists to do their job properly and publish accurate, peer-reviewed, scientific information about face masks (such as this article) if official governments and public health authorities recommend against face masks in community settings due to a lack of evidence. WHO, CDC, and other official governments and health organizations around the world need to change their public health orientations ASAP about face masks.

Face masks work.

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