To wear a mask or not to wear a mask, this is the problem. Here’s what the WHO recommends

Should we all wear masks? What can we do if masks are not available? Should we all get used to go out with our nose and mouth covered? In Italy the debate is open: a couple of regions have ordered all the citizens to wear a mask or a scarf when out, but health authorities still say that only infected people and health care workers should always wear masks. Similar discussions are ongoing all over the world, especially after the publication of some evidence that show a longer persistence of the virus in the air. That’s why the World Health Organisation today released some advice on the use of masks in the context of Covid-19.

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«The use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted – states the WHO -. Whether or not masks are used, maximum compliance with hand hygiene and other IPC measures is critical to prevent human-to-human transmission of Covid-19».

According to the WHO, «the use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take masks away from those in health care who need them most, especially when masks are in short supply».

Regarding the use of nonmedical masks, «there is no current evidence to make a recommendation for or against their use» in the community setting.

In any case, where masks are worn in accordance with local customs or with advice by national authorities, the World Health Organisation recommends authorities to provide best practices about how to wear, remove, and dispose of them, and for hand hygiene after removal.

READ: THERE ARE NOT ENOUGH MASKS FOR HEALTH WORKERS: PROTESTS ALL OVER THE WORLD

Addressing decision makers, the WHO then underlines what should be considered when dealing with the use of masks for healthy people in community settings:

• Purpose of mask use: the rationale and reason for mask use should be clear– whether it is to be used for source control (used by infected persons) or prevention of Covid-19 (used by healthy persons).
• Risk of exposure to the Covid-19 virus in the local context: ­The population: current epidemiology about how widely the virus is circulating (e.g., clusters of cases versus community transmission), as well as local surveillance and testing capacity (e.g., contact tracing and follow up, ability to carry out testing). ­The individual: working in close contact with public (e.g., community health worker, cashier).
• Vulnerability of the person/population to develop severe disease or be at higher risk of death, e.g. people with comorbidities, such as cardiovascular disease or diabetes mellitus, and older people.
• Setting in which the population lives in terms of population density, the ability to carry out physical distancing (e.g. on a crowded bus), and risk of rapid spread (e.g. closed settings, slums, camps/camp-like settings).
• Feasibility: availability and costs of the mask, and tolerability by individuals.
• Type of mask: medical mask versus nonmedical mask.