Should an asymptomatic person wear a mask to prevent COVID-19?

Nope.

This article had the potential to be on record as my shortest blog and I was tempted to end it at ‘nope.’ But the topic of the mask, something that has become so precious, deserves elaboration. In particular, we need people to stop buying masks so there are enough left for hospitals and clinics.

The world is in chaos. Arguably, we are in the midst of the biggest global event since 9-11. A pandemic has disrupted the life we so recently knew. Economically, socially and physically. And let’s not forget emotionally.

Emotions are running high. One emotional response you may be feeling is panic. The Merriam-Webster dictionary defines panic as a sudden overpowering fright. It is this societal panic that has led to stockpiling of unnecessary goods. For many, buying toilet paper was a reassuring act of preparation for the unknown (and probably deserves its own blog). But let’s focus on masks. People are buying them in large quantities.

This is despite the fact that there is currently a world-wide shortage of something called Personal Protective Equipment (also known as PPE). PPE is worn by health care workers to prevent us from getting infections and transmitting infections to our patients. Masks are a form of PPE.

Medical face masks were first invented in the 1890s. Initially, they were worn by surgeons for the purpose of preventing bacteria from entering the surgical field (in turn preventing infection). The popularity of the mask increased during the SARS outbreak in China in 2002.

Masks have been worn for other purposes in recent years, like protection from city smog, as a symbolic measure by protestors against climate change or even as an accessory in the fashion industry. This article recently published in the New York Times reviewed the cultural and societal implications of the mask in more detail.

Back to my first statement. A mask does not prevent a healthy person who is walking down the street from becoming infected. In fact, the World Health Organization stated that wearing a mask could create a false sense of security:

“For asymptomatic individuals, wearing a mask of any type is not recommended. Wearing medical masks when they are not indicated may cause unnecessary cost…and create a false sense of security that can lead to the neglect of other essential preventive measures.”

The World Health Organization

The situation is different for front-line health care workers. Depending on the setting, we could be constantly exposed to patients who are coughing and sneezing. The virus that causes COVID-19 is transmitted through droplets.

For example, if I am looking in a patient’s mouth, and the patient coughs, a droplet from their cough could land in my eyes, nose or mouth. If my eyes, nose and mouth are exposed, I could get the infection and pass it on to someone else. If I’m not wearing a gown, and a droplet from the cough lands on my clothing, I could also get the infection. The virus that causes COVID-19 can live on surfaces for hours, or even days. If I later touch my clothing, then touch my face, I could get infected, and again, infect others.

This is why the PPE is needed when we work closely with patients with infections. The recommendation for PPE for COVID-19 includes wearing a mask with an eye shield, a gown and gloves, according to the Public Health Agency of Canada, the World Health Organization and the Center for Disease Control. Also, if you are at home providing care for a loved one who is positive for COVID-19 or another infection, it is appropriate to wear PPE.

The shortage of PPE, including masks, is a global one. Doctors, nurses and care-takers need to be protected from becoming ill. If you are healthy and not in close contact with people who have an infection, please refrain from stockpiling masks, gloves and gowns as these are needed in our precious health care system.

Should an asymptomatic person wear a mask to prevent COVID-19?

Again-nope.

Dr. Sarah Fraser is author of Humanity Emergency, a collection of medical-themed poetry.

One comment

  • Faye McLean says:

    Thank you Dr Fraser. I agree the panic from the general public is bordering insanity. Keep up the great work. I read your info but do not always respond. I miss you as a doctor -any plans to come back to Dartmouth ?

    Faye McLean

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