The acute shortage of medical-grade masks and respirators in the United States is a crisis. Doctors, nurses, and emergency responders are in desperate need of masks to prevent their own infection as they tend to the ill.
But the general public, too, should be protecting itself with masks. This doesn’t mean that we should be fighting with public-health frontline soldiers for limited supplies. Instead, civilians can use scarves, bandanas, and other makeshift masks to protect themselves and others.
It’s been widely noted that Japan, South Korea, and Taiwan have done a remarkably effective job of containing the spread of Covid-19. These countries may have rolled out testing protocols more quickly than the U.S., which enable them to engage in proactive tracking and quarantining of positive cases. East Asia’s experience with previous infectious respiratory-disease epidemics has prepared it to deal with this one in a way that Europe and the U.S. have failed to do.
But those same East Asian countries also have a deep cultural acceptance of wearing masks as a means of preventing disease transmission; in these countries, it’s standard for people to don masks when they are sick, or to avoid becoming sick. A study of influenza outbreaks in Japan demonstrated that 80 percent compliance in wearing masks was sufficient to eliminate transmission of the disease. Another meta-analysis determined that “mask and/or respirator use was independently associated with a reduced risk of severe acute respiratory syndrome (SARS).” At the same time, since East Asian nations prioritized the production and stockpiling of masks, they don’t have the shortage that we’re seeing in places like New York City, where wearing surgical masks is viewed as eccentric.
It’s true that doctors and nurses need high-quality N95 masks, which block up to 95 percent of particles no smaller than 0.3 microns, and which studies show are capable of blocking much smaller particles and can protect users from exposure to the virus. Most of us, though, don’t need that level of protection, because we aren’t intubating sick people—but that doesn’t mean that we should do nothing. While practicing social distancing—keeping six feet away from other people outside of our homes—scarves or bandanas are at least partially effective, and public-health authorities should encourage their use.
Just wrapping a cotton tee shirt around your mouth and nose is a surprisingly effective method for filtering out even tiny, virus-sized particles. A vacuum cleaner bag, pillowcase, or a piece of silk are also good substitutes. The CDC and other U.S. health agencies typically report that wearing masks is not indicated for the general public, but the reasons they offer tend to be unspecific and based on the assumption that the average user will wear masks “improperly.”
It’s probably true that most Americans are not up to speed on proper mask and hygiene protocol for, say, entering an infectious-disease ward and interacting with seriously contagious patients. But for general public use, an imperfect solution is better than nothing. When it comes to going to the grocery store, riding a city bus, or walking down the street, let’s not make the perfect the enemy of the good: go ahead and wrap a scarf, bandana, or even pillowcase around your mouth and nose.
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