The world is confused, anxious and concerned, people are getting mixed messages – what to do?
There is plenty of information out there debating on the issue except that it is all about assumptions, speculations and hypothesis but no facts or evidence either way. The only thing applies is your own sense. I don’t need to quote any citing or reference as there is no proven evidence to refer to.
Sometimes there are situations in life when doctors come second and common sense comes first, and it seems that is where we are now.
The face mask is a physical way to personal protection and not about a newly launched medicine or a surgical operation that will need hard core scientific evidence before public use. Sensible people will know whenever there is a risk of infection, one should use appropriate gloves, mask, gown, disinfectants and isolate. Whether a high street food handler or a local butcher or a supermarket baker all are using this kind of protection on a daily basis to be safe from any unknown adversities and why should this be any different for general public to realise their own risk with the same principle?
Yes, there are debates within the medical community, that masks may not protect, there is no supporting evidence, it can be source of infection itself, one type of mask is better than other, people wouldn’t know what to use, it can cause harm, it can spread the disease even more etc etc etc.
Ok, ok ,ok that’s no help, only confusing, depressing and undermining. Where is the evidence to prove all that? I would say, since you have no evidence, I don’t want to talk to you face to face, if you don’t wear face mask. And I will not talk to you face to face without wearing face mask, to protect you.
So, I will wear a face mask and avoid you until you wear the same that should be the principle. It doesn’t matter what type of mask you wear. Wear anything any cloth to cover your nose and mouth with, whatever you can. Yes, care of mask hygiene and disinfecting is your common sense exactly as you clean your kitchen or bathroom to keep them hygienic.
No one is saying it is 100% protective but some protection is better than no protection at all. And as far as the risk benefit balance is concerned, there is no evidence to show risk is higher than the benefit. If using a face mask is thought to be adding any further risk of spreading infection then I would challenge that there are many other things that a person normally carries like their own clothing, bags, coats, hats, mobile phone, files, folders, Laptops all their belongings would cause much higher risk of spreading the infection than a tiny face mask would do. Using a face mask is a practical sense protection as like as the public was advised to cough or sneeze into their elbow folded arm cloth, which could carry far more infection risk than a face mask, which is just an extra piece of garment that anyone can use regardless, as like as people wear cloths as they wish without the need for medical advice.
After all this is a virus and invisible and obvious that it will spread and circulate everywhere including the surrounding open air space and can easily enter the body through the nose, mouth, eyes, ears including any breach of skin or mucus contact and not just hand touch alone, so that hand washing alone will be enough protection. And indeed the reality showed hand washing was not enough and as a result complete isolation had to be adopted as a definitive measure, and that seems to be working gradually, because that’s avoiding virus entry to the body, exactly the same way a face mask should do.
The advisory authorities are very likely to have anticipated the risk of bottle-necking of sudden surge of huge demands of resources and political pressure on responsible bodies to provide masks to the entire population, but that was not necessary and all that was required was to tell the people to use common sense methods to cover the lower face. People can easily use any cloth or scarf etc hygienically to cover the face and protect themselves and others without using formal factory made masks, if they are not available. Many parts of the world are now doing this and early results are promising.
An appropriate look back analysis of the lessons learnt might offer better understanding about the appropriate protective methods policy for the future. Until then, let’s wear a face mask in whatever form we can to protect each other, with a hope to stop Covid-19.
Sish Chakrabarty, Consultant Cardiologist, London
Clinical Examiner, Medical Education Exam faculty, King’s college London University Medical School
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