Confusion about face masks deepens amid coronavirus

So should we be wearing face masks? Health Secretary Matt Hancock says advice on the masks hasn’t changed – but US officials advise ALL Americans to wear them when they are outside

  • Mr Hancock said UK was still advising health people not to wear the face masks
  • Comes despite US dramatically switching its stance on mask wearing overnight 
  • It now advises all Americans make their own if they can’t get access to real mask
  • World Health Organization (WHO) also said to be switching its stance on masks

Britons are still being told face masks do not protect them from coronavirus despite the US dramatically switching its stance overnight and advising all Americans to wear them.

Health Secretary Matt Hancock today said the UK would not change its approach because he claims there is little evidence to show the masks help, and they would be better used by healthcare workers and patients who test positive.

The World Health Organization (WHO) – which currently does not recommend that healthy people wear them – is also said to be reconsidering its guidance on masks.

But Mr Hancock told Good Morning Britain today that the scientific advice has ‘been very clear since the start’ and maintained that they are not effective at shielding people from catching the virus.

The British Government says surgical masks – the most popular and widely available kind – are too thin, loose-fitting and porous, which make it easy for the tiny viral particles to pass through.

But experts have always maintained that, while the masks may not shield someone from contracting the illness, they stop the wearer from infecting others.

As well as on surfaces, the virus can be transmitted via droplets that are released when a patient talks, breathes, coughs or sneezes.  

This may have been more important than initially thought now that researchers know infected people are contagious for several days before they have symptoms.

Wearing surgical face masks in public may have helped slow the coronavirus crisis, it has been suggested. But the UK Government has long held the view that the cheap paper masks offer little protection against catching COVID-19

South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent full-scale outbreaks, despite being in such close proximity to China. Critics say masks don’t work because China still suffered more than 80,000 cases

How to make your own coronavirus face mask: Online DIY tutorials detail method for vacuum cleaner bag or T-shirt to create protection that leading scientists say is effective against bug

Speaking on Good Morning today, Mr Hancock said: ‘I haven’t been advised that we should do that. I’ll follow the scientific advice on that, which was very clear when we went through it at the start.

‘Masks are very important to protect healthcare workers who might have a lot of incoming virus but that (public being advised to wear face masks) isn’t something that we’ve done here because we’ve followed the advice and we’ve followed the medical and scientific advice and the whole basis of our response has been making sure that we follow the science. 

Research on how well various types of masks and face coverings varies but, recently, and in light of the pandemic of COVID-19, experts are increasingly leaning toward the notion that something is better than nothing. 

A University of Oxford study published on March 30 concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers. 

It’s too early for their to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks. 

The difference between surgical or face masks and N95 masks lies in the size of particles that can – and more importantly, can’t – get though the materials. 

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous. 

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose. 

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny – in fact, they’re about 20-times smaller than bacteria. 

For this reason, a JAMA study published this month still contended that people without symptoms should not wear surgical masks, because there is not proof the gear will protect them from infection – although they may keep people who are coughing and sneezing from infecting others. 

But the Oxford analysis of past studies- which has not yet been peer reviewed – found that surgical masks were worth wearing and didn’t provide statistically less protection than N95 for health care workers around flu patients. 

However, any face mask is only as good as other health and hygiene practices. Experts universally agree that there’s simply no replacement for thorough, frequent hand-washing for preventing disease transmission. 

Some think the masks may also help to ‘train’ people not to touch their faces, while others argue that the unfamiliar garment will just make people do it more, actually raising infection risks.  

If the CDC does instruct Americans to wear masks, it could create a second issue: Hospitals already face shortages of masks and other PPE.

Professor Ian Jones, a virologist from the University of Reading, told MailOnline the mass-issuing of masks ‘should now be considered’ by health bosses in the UK.

Warning that the crisis is spiralling rapidly, he added: ‘Anything that reduces the rate of transmission will bring it under control sooner.’ 

Dr Stephen Griffin, associate professor of infection and immunity at the University of Leeds, said masks prevent people with no symptoms spreading the disease by catching tiny droplets they exhale.

He added: ‘They are also useful for people that are themselves symptomatic in stopping coughs and sneezes.

‘They also reduce the propensity for people to touch their faces, which happens many more times a day than we all realise and is a major source of infection without proper hand hygiene.’

South Korea, Japan, Singapore and Hong Kong have issued millions of masks to their people and managed to prevent large outbreaks, despite being in such close proximity to China.  

George Gao, director-general of the Chinese Center for Disease Control and Prevention, this week said the ‘big mistake’ in the US and Europe was that ‘people aren’t wearing masks’.

He told Science magazine: ‘This virus is transmitted by droplets and close contact. Droplets play a very important role – you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth.

‘Many people have asymptomatic or pre-symptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others.’

It comes as the Centers for Disease Control and Prevention is expected to advise all Americans to wear cloth masks or other face coverings if they go out in public. 

The policy marks a profound change in messaging as both the CDC and World Health Organization previously said people don’t need to wear masks unless they are sick.

The new guidance has not been officially announced but it is in the works, according to multiple reports, which comes as more than 1million people globally have been infected with the coronavirus.

President Trump confirmed it was on the way but said it would not be mandatory to wear a mask in public.

Vice President Mike Pence noted it would be coming out ‘in the days ahead’.

Health officials believe wearing masks would reduce the risk of people not showing symptoms from spreading the virus.

Dr. Deborah Birx, who coordinates the day-to-day administration response to the virus for the US Government, cautioned people should not consider masks as a guarantee of protection.

‘We don’t want people to feel like I’m wearing a mask, I am protected, and I’m protecting others. You may be protecting others, but don’t get a false sense of security that that mask is protecting you exclusively from getting infected because they were other ways that you can get infected because the number of asymptomatic and mild cases that are out there,’ she said at the White House briefing.

She advised people to continue social distancing practices and to wash their hands. The new guidance will make it clear that N95 surgical masks should be saved for health care workers and others on the front lines, who have been in dire need of them.

Simple cloth masks – or scarves or bandannas – will be the recommendation for when people go to the grocery store, for a walk or are outside.

‘In light of these new data, along with evidence of widespread transmission in communities across the country, CDC recommends the community use of cloth masks as an additional public health measure people can take to prevent the spread of virus to those around them,’ according to a copy of the guidance obtained by The Washington Post.

Meanwhile, the World Health Organization (WHO) is mulling a decision to recommend healthy people to wear the masks if they can. 

A recent study found that coughs and sneezes can spread virus particles up to 27ft (8m) in a cloud around an infected patient.

The WHO currently does not recommend that people without the illness wear face masks because there is little evidence they help and they would be better used by healthcare workers and patients who test positive.

But it might be about to change its mind, according to a former infectious disease director at the organisation.

Professor David Heymann, now an in-house expert at the London School of Hygiene & Tropical Medicine, said the WHO was reopening its discussions about masks today.

He said officials could decide to advise people that masks are beneficial – but people would have to wear ones with a proper seal around the nose and wear them all the time.

Professor Heymann said: ‘There is right now a debate about the usefulness of masks because Hong Kong has provided some evidence that masks may be useful in protecting individuals from infection. It’s not clear yet whether or not that’s true.

‘WHO, the group that I work with, is debating that with a group of experts around the world tomorrow, to understand whether there is evidence which would call for a change in what WHO is recommending now for masks.

‘[What is recommends] is that they really don’t have a major role in protecting people from infection except in healthcare workers where they also wear eye protection and they also have a role from protecting others from coughs or sneezing.’

He added: ‘But as the evidence becomes available, it seems there will be a debate trying to decide whether masks play a role at some point in the outbreak.

‘And believe me, if they do, there is a private sector healthy enough to begin producing those masks in quantities necessary.’

He made the comments in a briefing at British think-tank Chatham House in London yesterday.

The WHO currently says healthy people only ought to wear a mask if they’re looking after a COVID-19 patient, or if they are coughing and sneezing themselves.

The coronavirus is thought only to spread through close contact with others – defined as being within 6’6″ (2m) of someone.  

But a study by the Massachusetts Institute of Technology (MIT) in Boston found that infected patients can create a cloud of virus particles around them with coughs and sneezes.

This can stretch out up to 27ft (8m) and could carry enough of the virus to infect someone, the researchers said.

Droplets from people’s lungs could also linger in the air and be blown about, they added.

The study – from one of the US’s most prestigious universities and published in the Journal of the American Medical Association (JAMA) – was done in lab conditions rather than the real world.

But it could change the way health authorities look at protective equipment like masks, which are currently being stockpiled for health workers.

In France, for example, the government banned wholesalers from selling masks to the public so it could save them for medical staff.

Although scientists say the vast majority of masks do not have fine enough filters to stop viruses getting through, there is a growing school of thought that they could be useful.

Even if they don’t stop viruses in their tracks they could redirect air flow which might be carrying them into people’s mouths or noses.

A smaller initial dose of the virus has been linked to less severe symptoms in some coronavirus patients.

How to make your own coronavirus face mask: Online DIY tutorials detail method for vacuum cleaner bag or T-shirt to create protection that leading scientists say is effective against bug 

The worldwide coronavirus pandemic has led to a shortage of protective face masks, leading to a deluge of online tutorials ion how to make your own using a t-shirt or pillowcase.

Homemade masks offer significantly less protection than the N95 medical masks, which are made of a thick, tightly woven material that fits over the face and can stop 95 per cent of all airborne particles. 

Public Health England still does not recommend Britons wear face masks, unless in a medical setting. 

But there are good reasons to think DIY masks could be effective in tackling the pandemic, as they have been widely used in Hong Kong,Mongolia and South Korea -countries that largely have the disease under control.

The World Health Organisation also currently does not recommend that people without the illness wear face masks, but it could be about to reverse its decision due to evidence from Hong Kong that they may be effective in fighting the virus.

And in a further sign that attitudes about masks are changing, LA’s mayor, Eric Garcetti, yesterday told all four million of the city’s residents that they must wear face masks at all times to slow the spread of the deadly pandemic. 

MailOnline has investigated how you can make your own face mask using everyday household items such as a t-shirt, kitchen towel or vacuum bags. 

How to make a face mask from a t-shirt

A YouTube tutorial by Runa Ray shows how to make a face mask without any need for sewing, using just a plain t-shirt. 

First of all you need scissors, pencil and a ruler, and a t-shirt you don’t mind being used to make a face mask. 

Cut out a 16″ by 4″ rectangle from the middle of the t-shirt, then fold it in half, and measure four inches on either side.

Then mark the t-shirt with an even number of tassels on each side and use scissors to cut them.

Turn the t-shirt inside out and separate the corner tassels, but tie the remaining ones in-between.

Then with the remaining t-shirt material cut some ear straps using the hem of the shirt. 

Attach the straps to the remaining outer tassels and you have yourself a face mask, with no sewing involved, and using an old t-shirt.

A slightly more complicated method has been perfected by researchers from the University of Pittsburgh  also managed to design a face mask that could be used if ‘commercial masks’ are not available during a virus outbreak.

A woman wearing a mask walks past a closed shop window display during the pandemic lockdown in Manchester

They used a regular cotton t-shirt, which was boiled for 10 minutes and then air-dried to sterilise the material, but also to shrink it.

The researchers used a marker and ruler to measure out what they wanted to cut and then formed the mask using an outer layer and then eight inner layers covering the nose and mouth.

The mask does not require any sewing, and instead involves it being tied multiple time around the face. 

How to make a face mask from vacuum cleaner bags 

By following the simple steps in the graphic, you can create your own face mask from a T-Shirt or vacuum cleaner bag, 

Even UK politicians have got in on the act,  with Gillian Martin, who is MSP for Aberdeenshire East, describing how she made a face mask from vacuum cleaner bags and elastic. 

She told the Daily Record: ‘I live in a small village and have been here for over 20 years. I don’t want to worry or offend people when I go out.

‘I started researching what other countries have been doing and came across a chart with the best materials to use to make a mask out of just about anything.’

‘Just below medical material was a hoover bag. I have loads of them lying around and found Hepa-Flow bag that just goes on your Henry hoover’. 

The chart the MSP is referring to from a University of Cambridge study which shows the materials that work the best against virus sized particles.

The top three are a surgical mask, vacuum cleaner bag and tea towel.

She added: ‘I cut it up the bag and secured it with elastic. I live with my family of three who have all been self-isolating so I made one for each of us’.

Gillian Martin posted about her mask that she made from a vacuum cleaning bag

‘I made it because I’m nervous of people coming up to me when I’m out walking the dog. I don’t want to have to run away from them.’

Another popular YouTube method shows how to fold up a scarf, using hair ties at either end, to make a simple and easy no-sew mask. The same method can be used with a handkerchief and doesn’t involve any sewing.  

How to make a face mask from kitchen towel

For this you need two layers of kitchen towel and one of tissue.

You cut it in half, and then use masking tape on each end to ensure the mask is stiff.

Then you punch holes through either end of the mask and thread elastic bands through the holes. 

Some Japanese women have even been posting instructions about how to make a face mask from a bra.

The method is simple and involves cutting off one cup with scissors and then sewing the bra straps on, so they can be attached to your face.

Do masks have to be complex to be effective?

The idea that masks do not have to be complex to be effective does have some support from recently published studies. 

A University of Oxford study published this week concluded that surgical masks are just as effective at preventing respiratory infections as N95 masks for doctors, nurses and other health care workers.

It’s too early for there to be reliable data on how well they prevent infection with COVID-19, but the study found the thinner, cheaper masks do work in flu outbreaks.

Two elderly women wearing protective face masks walk in Westminster on Wednesday

The difference between surgical or face masks and N95 masks lies in the size of particles that can – and more importantly, can’t – get though the materials.

N95 respirators are made of thick, tightly woven and molded material that fits tightly over the face and can stop 95 percent of all airborne particles, while surgical masks are thinner, fit more loosely, and more porous.

This makes surgical masks much more comfortable to breathe and work in, but less effective at stopping small particles from entering your mouth and nose.

Droplets of saliva and mucous from coughs and sneezes are very small, and viral particles themselves are particularly tiny – in fact, they’re about 20-times smaller than bacteria. 

Experts universally agree that there’s simply no replacement for thoroug



What is the coronavirus? 

A coronavirus is a type of virus which can cause illness in animals and people. Viruses break into cells inside their host and use them to reproduce itself and disrupt the body’s normal functions. Coronaviruses are named after the Latin word ‘corona’, which means crown, because they are encased by a spiked shell which resembles a royal crown.

The coronavirus from Wuhan is one which has never been seen before this outbreak. It has been named SARS-CoV-2 by the International Committee on Taxonomy of Viruses. The name stands for Severe Acute Respiratory Syndrome coronavirus 2.

Experts say the bug, which has killed around one in 50 patients since the outbreak began in December, is a ‘sister’ of the SARS illness which hit China in 2002, so has been named after it.

The disease that the virus causes has been named COVID-19, which stands for coronavirus disease 2019.

Dr Helena Maier, from the Pirbright Institute, said: ‘Coronaviruses are a family of viruses that infect a wide range of different species including humans, cattle, pigs, chickens, dogs, cats and wild animals. 

‘Until this new coronavirus was identified, there were only six different coronaviruses known to infect humans. Four of these cause a mild common cold-type illness, but since 2002 there has been the emergence of two new coronaviruses that can infect humans and result in more severe disease (Severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) coronaviruses). 

‘Coronaviruses are known to be able to occasionally jump from one species to another and that is what happened in the case of SARS, MERS and the new coronavirus. The animal origin of the new coronavirus is not yet known.’ 

The first human cases were publicly reported from the Chinese city of Wuhan, where approximately 11million people live, after medics first started publicly reporting infections on December 31.

By January 8, 59 suspected cases had been reported and seven people were in critical condition. Tests were developed for the new virus and recorded cases started to surge.

The first person died that week and, by January 16, two were dead and 41 cases were confirmed. The next day, scientists predicted that 1,700 people had become infected, possibly up to 7,000. 

Where does the virus come from?

According to scientists, the virus almost certainly came from bats. Coronaviruses in general tend to originate in animals – the similar SARS and MERS viruses are believed to have originated in civet cats and camels, respectively.

The first cases of COVID-19 came from people visiting or working in a live animal market in Wuhan, which has since been closed down for investigation.

Although the market is officially a seafood market, other dead and living animals were being sold there, including wolf cubs, salamanders, snakes, peacocks, porcupines and camel meat. 

A study by the Wuhan Institute of Virology, published in February 2020 in the scientific journal Nature, found that the genetic make-up virus samples found in patients in China is 96 per cent identical to a coronavirus they found in bats.

However, there were not many bats at the market so scientists say it was likely there was an animal which acted as a middle-man, contracting it from a bat before then transmitting it to a human. It has not yet been confirmed what type of animal this was.

Dr Michael Skinner, a virologist at Imperial College London, was not involved with the research but said: ‘The discovery definitely places the origin of nCoV in bats in China.

‘We still do not know whether another species served as an intermediate host to amplify the virus, and possibly even to bring it to the market, nor what species that host might have been.’  

So far the fatalities are quite low. Why are health experts so worried about it? 

Experts say the international community is concerned about the virus because so little is known about it and it appears to be spreading quickly.

It is similar to SARS, which infected 8,000 people and killed nearly 800 in an outbreak in Asia in 2003, in that it is a type of coronavirus which infects humans’ lungs. It is less deadly than SARS, however, which killed around one in 10 people, compared to approximately one in 50 for COVID-19.

Another reason for concern is that nobody has any immunity to the virus because they’ve never encountered it before. This means it may be able to cause more damage than viruses we come across often, like the flu or common cold.

Speaking at a briefing in January, Oxford University professor, Dr Peter Horby, said: ‘Novel viruses can spread much faster through the population than viruses which circulate all the time because we have no immunity to them.

‘Most seasonal flu viruses have a case fatality rate of less than one in 1,000 people. Here we’re talking about a virus where we don’t understand fully the severity spectrum but it’s possible the case fatality rate could be as high as two per cent.’

If the death rate is truly two per cent, that means two out of every 100 patients who get it will die. 

‘My feeling is it’s lower,’ Dr Horby added. ‘We’re probably missing this iceberg of milder cases. But that’s the current circumstance we’re in.

‘Two per cent case fatality rate is comparable to the Spanish Flu pandemic in 1918 so it is a significant concern globally.’

How does the virus spread?

The illness can spread between people just through coughs and sneezes, making it an extremely contagious infection. And it may also spread even before someone has symptoms.

It is believed to travel in the saliva and even through water in the eyes, therefore close contact, kissing, and sharing cutlery or utensils are all risky. It can also live on surfaces, such as plastic and steel, for up to 72 hours, meaning people can catch it by touching contaminated surfaces.

Originally, people were thought to be catching it from a live animal market in Wuhan city. But cases soon began to emerge in people who had never been there, which forced medics to realise it was spreading from person to person. 

What does the virus do to you? What are the symptoms?

Once someone has caught the COVID-19 virus it may take between two and 14 days, or even longer, for them to show any symptoms – but they may still be contagious during this time.

If and when they do become ill, typical signs include a runny nose, a cough, sore throat and a fever (high temperature). The vast majority of patients will recover from these without any issues, and many will need no medical help at all.

In a small group of patients, who seem mainly to be the elderly or those with long-term illnesses, it can lead to pneumonia. Pneumonia is an infection in which the insides of the lungs swell up and fill with fluid. It makes it increasingly difficult to breathe and, if left untreated, can be fatal and suffocate people.

Figures are showing that young children do not seem to be particularly badly affected by the virus, which they say is peculiar considering their susceptibility to flu, but it is not clear why. 

What have genetic tests revealed about the virus? 

Scientists in China have recorded the genetic sequences of around 19 strains of the virus and released them to experts working around the world. 

This allows others to study them, develop tests and potentially look into treating the illness they cause.   

Examinations have revealed the coronavirus did not change much – changing is known as mutating – much during the early stages of its spread.

However, the director-general of China’s Center for Disease Control and Prevention, Gao Fu, said the virus was mutating and adapting as it spread through people.

This means efforts to study the virus and to potentially control it may be made extra difficult because the virus might look different every time scientists analyse it.   

More study may be able to reveal whether the virus first infected a small number of people then change and spread from them, or whether there were various versions of the virus coming from animals which have developed separately.

How dangerous is the virus?  

The virus has a death rate of around two per cent. This is a similar death rate to the Spanish Flu outbreak which, in 1918, went on to kill around 50million people.

Experts have been conflicted since the beginning of the outbreak about whether the true number of people who are infected is significantly higher than the official numbers of recorded cases. Some people are expected to have such mild symptoms that they never even realise they are ill unless they’re tested, so only the more serious cases get discovered, making the death toll seem higher than it really is.

However, an investigation into government surveillance in China said it had found no reason to believe this was true.

Dr Bruce Aylward, a World Health Organization official who went on a mission to China, said there was no evidence that figures were only showing the tip of the iceberg, and said recording appeared to be accurate, Stat News reported.

Can the virus be cured? 

The COVID-19 virus cannot be cured and it is proving difficult to contain.

Antibiotics do not work against viruses, so they are out of the question. Antiviral drugs can work, but the process of understanding a virus then developing and producing drugs to treat it would take years and huge amounts of money.

No vaccine exists for the coronavirus yet and it’s not likely one will be developed in time to be of any use in this outbreak, for similar reasons to the above.

The National Institutes of Health in the US, and Baylor University in Waco, Texas, say they are working on a vaccine based on what they know about coronaviruses in general, using information from the SARS outbreak. But this may take a year or more to develop, according to Pharmaceutical Technology.

Currently, governments and health authorities are working to contain the virus and to care for patients who are sick and stop them infecting other people.

People who catch the illness are being quarantined in hospitals, where their symptoms can be treated and they will be away from the uninfected public.

And airports around the world are putting in place screening measures such as having doctors on-site, taking people’s temperatures to check for fevers and using thermal screening to spot those who might be ill (infection causes a raised temperature).

However, it can take weeks for symptoms to appear, so there is only a small likelihood that patients will be spotted up in an airport.

Is this outbreak an epidemic or a pandemic?   

The outbreak was declared a pandemic on March 11. A pandemic is defined by the World Health Organization as the ‘worldwide spread of a new disease’. 

Previously, the UN agency said most cases outside of Hubei had been ‘spillover’ from the epicentre, so the disease wasn’t actually spreading actively around the world.

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