Piet Streicher
The situation
At the time of writing, South Africa had 1 000 cases of the Covid-19 virus, and two deaths. The spread of the virus should slow down a lot if everyone wears a face mask in public or when caring for a relative with virus symptoms at home (we must also maintain physical distancing, hand washing, self-isolation and the rules of the 21-day shutdown).
Important facts about face masks
- Any barrier between your hands and your face is beneficial according to David Price (2020), an ICU Pulmonologist treating Covid-19 patients.
- Wearing a mask helps someone with the virus not to give it to others.
- Wearing a mask helps someone without the virus avoid being infected.
- All health workers in hospitals must have face masks as they are in close contact with coughing patients and at risk of contracting the virus – they should wear N95 masks (Price, 2020).
- Other South Africans can help make sure health workers have enough of these masks by wearing home-made masks instead.
- All countries without a lockdown that have the virus under control, have everyone wearing masks in public.
- Not wearing a face mask properly puts you at risk of infection.
How to make a home-made mask and wear it properly
Remember, people may have the virus even if they don’t look sick.
You can have the virus for up to 14 days before showing symptoms. We should all consider that we might already be infected and that we might be infecting others (Pueyo, 2020). It is a mistake to think that only those who are sick with the virus should wear a mask because any of us could have the virus but not know it yet.
Important: wearing a mask protects you from infection by hand:
Yes, you can breathe the virus in, but most people catch it by touching a surface the virus is on, then touching their face. The virus lives for up to 72 hours on plastic, 48 hours on stainless steel, 24 hours on cardboard and 4 hours on copper.
That is why we must wash our hands often and avoid touching our faces. But you could still touch a surface with the virus and forget not to touch your face. Wearing a mask will remind you not to touch your face.
Countries can contain this virus
Hong Kong, Singapore, Japan and Taiwan have all been able to contain it. In all of these countries, people have been wearing face masks for weeks (Myburgh, 2020). Public posters in Hong Kong remind people to wear their face masks when in public (see below). This measure has not been adopted in the USA, Italy, Germany, Spain, France or South Africa.
A poster used in Hong Kong – from the James Myburg article, “The coming winter flood”.
The infection rate difference between countries where people wear masks and countries where they don’t:
FT analysis of John Hopkins University, CSSE, Worldometers; FT research
Shortage of medical face masks for health workers
There are many South Africans who have wrongly been stock-piling the N95 masks,
which causes a shortage of these masks for health workers. Anyone who has these masks should give them to their nearest hospital immediately. This is what they look like:
How to make your home-made mask
Face masks can be made from variety of easily available materials. Both T-shirt and pillowcase materials are good enough, according to a scientific paper by Davies and others (2013).
#Tshirtfacemasks for South Africa
Anyone can wear a T-shirt as a mask:
- Pull the T-shirt on.
- Raise the T-shirt’s head opening to eye level, covering your mouth and nose, and tie the sleeves behind your head.
- Put a new, clean T-shirt mask on every time you leave the house.
- Remember not to touch your face while you are outside.
- When you get home, wash the T-shirt and your hands thoroughly with soap and water.
Misconceptions regarding face masks
Because health workers need the medical masks and have been running out of them quickly, this has resulted in a misleading message to the public, saying that face masks do not help the general public. While well-intended, this is not true.
Here are some false beliefs and true facts about masks:
| FALSE | TRUE |
| Masks are not effective unless you are sick or a health worker. | You may be sick and not know it. If worn properly, masks are effective for everyone. |
| Only health workers should wear masks. | Everyone should wear masks. Health workers should wear medical masks; everyone else should wear home-made masks. |
| The public doesn’t know how to wear masks properly, so we should not wear masks. | We must learn how to wear masks correctly. |
| Home-made masks can let the virus through. | So can medical masks but airborne infection is mainly a risk for health workers, which is why they need the medical masks.
Outside of hospitals, most infections occur from surface-to-hand-to-face and face masks reduce this danger. |
| If you can’t have a medical mask, don’t bother wearing a mask. | Any mask is better than no mask. |
| Even if I wear a home-made mask it won’t make much difference. | If everyone wears a home-made mask it will make a BIG difference. |
Most non-health-workers do not know how to handle and wear home-made face masks but there is no reason why they cannot learn the correct practices.
According to a medical expert:
“The evidence is that, as masks dampen with prolonged wear, they become quite good at conveying viral particles deposited onto their surfaces (both inside and out). Also, based on observation, most people do not use masks effectively. They also tend to touch the mask more often, to adjust it or for eating and drinking, potentially depositing virus onto the surfaces. Consequently, the authority view is that members of the public should not use masks because they will derive no benefit from them. They may even increase their own risk. Therefore, masks out in public really aren’t that helpful, unfortunately.
You are right to highlight the dangers of transmission in a care setting. The close and prolonged contact that such care necessitates results in significant risk escalation. We estimate that 80% of transmissions occur in the household settings.”
- To practice not touching your face, wear a home-made face mask at home #homemadefacemark (Price, 2020). This needs to be practiced long before you wear a home-made face mask in public, or long before you need to care for a Covid-19 patient in your household.
- During the lockdown period, only go out to buy food or medicine. This should be as short a trip as possible.
- There should be no eating or drinking during this trip.
- When returning home, assume your mask is contaminated, and wash it immediately.
Comparing the individual benefit to the group benefit
While there is a benefit to the individual from wearing a mask, we must remember the benefits of everyone following this practice. If everyone follows this practice, fewer surfaces will be contaminated and hand-to-face contamination will be reduced. As more people follow this practice, the benefits will be compounded exponentially for all of us. This benefit should be modelled mathematically in the same way that lockdown measures were modelled in the article by Harry Stevens, 2020.
In summary
By making it compulsory for all South Africans to wear home-made masks in public, the growth in Covid-19 infections will slow down dramatically, without putting medical staff at risk due to a shortage of medical masks.
Be a hero during the lockdown by wearing your home-made face mask and sharing your pictures on social media to encourage others to do the same. By doing this, good habits will spread faster than the virus itself.
References:
Davies, Anna & Thompson, Katy-Anne & Giri, Karthika & Kafatos, George & Walker, James & Bennett, Allan. (2013). Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?. Disaster medicine and public health preparedness. 7. 413-418. 10.1017/dmp.2013.43.https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic
FT analysis of John Hopkins University, CSSE, Worldometers; FT research.
Country by country: how coronavirus case trajectories compare
https://www.ft.com/coronavirus-latest
Myburg, James 2020. “The coming winter flood” https://www.biznews.com/undictated/2020/03/20/herd-immunity-control-covid-19-james-myburgh
Pueyo, Tomas 2020. “Coronavirus: The Hammer and the Dance”. Medium.com https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56
Price, David 2020. Empowering and protecting your family during the Covid-19 pandemic (video) https://vimeo.com/399733860?fbclid=IwAR1hEkGPhowvsaDtx5cUsCrtYbCcaCVAGLzMXaPDwh77ntPgmlHdZcbx_u8
Stevens, Harry 2020. Why outbreaks like coronavirus spread exponentially, and how to flatten the curve. https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?fbclid=IwAR2aAMsqhM1gz3rrAcGRQk2kL4MXre2w6aAI4yNfCGauWIZgn11-UsJ7LNw&utm_campaign=wp_main&utm_medium=social&utm_source=facebook
