Face masks during the COVID-19 pandemic
In community and healthcare settings, the use of face masks is intended as source control to limit transmission of the virus and for personal protection to prevent infection.If worn properly, a surgical mask is meant to help block large-particle droplets, splashes, sprays, or splatter that may contain viruses and bacteria, keeping them from reaching the wearer's mouth and nose.[49] An N95 mask is a particulate-filtering facepiece respirator that meets the N95 air filtration rating of the US National Institute for Occupational Safety and Health, meaning it filters at least 95 percent of 0.3 μm airborne particles, while not resistant to oil like the P95.[67] For the COVID-19 response when supplies are short, the US CDC says contingency and crisis strategies should be followed: Each elastomeric respirator is issued for the exclusive use of an individual healthcare provider but must be cleaned and disinfected as often as necessary to remain unspoiled and sanitary.[79] According to #Masks4All, in September 2020, approximately 95% of the world population lived in a country where the government and leading disease experts recommend or require the use of masks in public places to limit the spread of COVID-19.[93] For children 6–11, they advise that mask usage should be decided in consideration of several factors including the intensity of local viral transmission, (the latest evidence about) the risk of infection for the age group, the social and cultural environment (which influences social interactions in communities and populations), the capacity to comply with appropriate mask usage, the availability of appropriate adult supervision, and the potential impact on learning and psychosocial development, as well as additional factors involving specific settings or circumstances (such as disabilities, underlying diseases, elderly people, sport activities, and schools).[128] In June 2020, the Norwegian Institute of Public Health said asymptomatic individuals wearing face masks were not to be recommended due to the low prevalence of COVID-19 in the country but noted that it should be reconsidered if cases rise.[3] The National Health Commission of China cited the following reasons for the wearing of masks by the public, including healthy individuals: In a comment to The Lancet, Kar Keung Cheng, Tai Hing Lam, and Chi Chiu Leung argued that a public health rationale for mass masking is source control to protect others from respiratory droplets and underscored the importance of this approach due to asymptomatic transmission.[147] In a perspective, Monica Gandhi, Chris Beyrer, and Eric Goosby posit that masking reduces the dose of the virus for the wearer and thus helps lower the severity of infection.[148] One example involved a comparison of outbreaks on cruise ships: the Diamond Princess had 18% asymptomatic cases among all the infected people, but this was 81% in the Greg Mortimer where masks were given to passengers and staff members.[153] According to Stephen Griffin, a virologist at the University of Leeds, "Wearing a mask can reduce the propensity for people to touch their faces, which is a major source of infection without proper hand hygiene.[158] One paper did not consider RCTs a "gold standard" of evidence, since most effective public health policies had never been evaluated through an RCT, but that, overall, there was "robust data" to support the use of face masks to reduce community transmission of COVID.A scientific review of research about the overall efficacy of face masks in terms of product design (such as thermal comfort and flow resistance) and ways of usage found that fluid dynamics and fabrication techniques have a significant impact on performance.[86] The European Centre for Disease Prevention and Control highlighted that the appropriate use of face masks in communities could be improved through education campaigns and is key for its effectiveness as a measure.[198] Thousands of French individuals and companies teamed up during the outbreak to form a decentralized network of Fab labs and ad-hoc retooled production facilities, producing more than a million face shields, masks and other kinds of PPE during the height of the pandemic.The Dutch health ministry issued a recall of 600,000 face masks from a Chinese supplier on 21 March which did not fit properly and whose filters did not work as intended despite them having a quality certificate.[215] Two government workers from the Federal Law Enforcement Training Center in North Charleston, South Carolina, were charged in October for conspiracy to steal PPE, obstruction of justice and lying to the FBI.[220] In March 2020, US President Donald Trump applied the Defense Production Act against the American company 3M, which allows the Federal Emergency Management Agency to obtain N95 respirators from 3M.He then said the 3M-authorized US distributors later told him the masks Florida contracted for never showed up because the company instead prioritized orders that came in later, for higher prices, from foreign countries (including Germany, Russia, and France).[233] In early April 2020, the Berlin politician Andreas Geisel alleged that a shipment of 200,000 N95 masks it had ordered from American producer 3M's China facility was intercepted in Bangkok, Thailand, and diverted to the United States.Many speculative manufacturers have been forced to quit due to changing export rules and tighter licensing requirements in China and weaker demand for lower quality products globally.[85] A May 2020 study surveying people in Spain showed that an individual's likelihood of voluntarily wearing a mask is positively correlated with the proportion of uptake in the surrounding area.[264] Clemens Eisenmann and Christian Meyer argue that the question, how the meaning of wearing face masks develops in society, depends on their practical and public uses within everyday social interactions.[278][280] Huang Yinxiang, a sociologist from the University of Manchester, described maskaphobia (negative prejudice, fear or bitter hatred against people wearing face masks) as making Asians in Western countries into targets for racists who want to legitimize xenophobia during the COVID-19 outbreak.[320][321] Although authorities, especially in Asia, have been recommending people to wear face masks in public, in many other parts of the world, conflicting advice has caused much confusion among the general population.[335][338][339] Matthew Facciani, a sociologist at Vanderbilt University, says the uncertainty from health experts during the early days of the pandemic paved the way for political leaders to become a prominent source of guidance and clarity.[257] In April 2020, health officials from Taiwan's Central Epidemic Command Center (CECC) pushed back on school bullying of boys in pink face masks.[356] Some people, including introverts and those with social anxiety, prefer using face masks because of the near-anonymity it provides, allowing them to easily blend in, feel psychologically protected, and be more open in talking to strangers.[357] In 2020, in the state of Utah, Christian clergy from the Lutheran, Catholic, Presbyterian, Anglican, Baptist, and Latter-day Saint traditions, as well as those from the Jewish, Buddhist, and Unitarian religions, implored people to wear masks by signing a letter sent out by Governor Gary Herbert's office.[363][364] Early in the pandemic, people and businesses from the fashion industry responded to official calls for help in overcoming the shortages of protective personal equipment including face masks.
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