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As COVID-19 pandemic intensifies, guidance on public use of basic masks may be shifting
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COVID-19 | PERSONAL PROTECTION

As COVID-19 pandemic intensifies, guidance on public use of basic masks may be shifting

From the The COVID-19 pandemic hits home: Keep up with the latest local news on the coronavirus outbreak series
Dawn Helt, UW Health

UW Health workers, including imaging assistant Dawn Helt, wear surgical masks, face shields and gowns when screening visitors to UW Hospital. Health officials say surgical masks should be reserved for health care workers because they are in short supply, but guidance against the public wearing homemade masks may be shifting.

The growing COVID-19 pandemic is causing health officials to rethink their position that the general public should not wear masks — but basic masks are more likely to protect others, not the wearer, and shouldn’t replace handwashing and social distancing, doctors say.

If people wear a mask, it should be a homemade one, to conserve the limited supply of commercial masks for health care workers, doctors say.

Homemade masks might help keep people who feel well but are infected with the new coronavirus from spreading it to others, though there is not widespread proof of that. But such masks may not offer much protection for the wearer and can cause problems for people who are ill, who should instead stay home and avoid others as much as possible, doctors say.

Nasia Safdar

Safdar

“If you have any kind of symptoms, the moment you sneeze, that homemade mask is going to get soaked,” said Dr. Nasia Safdar, medical director of infection control at UW Health. “You take it off, you contaminate your hands and you contaminate the environment.”

Wisconsin on Wednesday reported 1,550 cases of COVID-19 and 24 deaths, and for the first time said how many people with confirmed infections have been hospitalized: 398, or 26%. Public Health Madison and Dane County reported 232 cases, including three deaths.

Patrick Remington

Remington

One reason health officials have discouraged broad use of masks is that people might think they can resume normal activity if they wear one, said Dr. Pat Remington, director of the preventive medicine residency program at the UW School of Medicine and Public Health and former associate dean.

Another reason is that people may touch their face and mouth more when putting on a mask or adjusting it. Social distancing and handwashing are more effective in protecting people from infection, doctors say.

COVID-19 cases and deaths

“Masks could allow people to break some of the social distancing rules,” Remington said.

Health officials are reconsidering their guidance because a fair amount of COVID-19, unlike many infections, appears to be spread before infected people develop symptoms. It also might be spread among people who never feel ill or have mild symptoms that appear to be something else, such as allergies, doctors say.

COVID-19 appears to spread mostly by droplets through coughs and sneezes, but there is some evidence it can be transmitted more broadly through the air, health officials say. That could bolster the argument for wearing masks, to reduce the chance that people who don’t know they’re infected will transmit it.

Entryway

The main entrance and exit for UW Hospital has become a screening zone for COVID-19, as workers check visitors for potential symptoms and exposure before allowing them inside.

The Centers for Disease Control and Prevention’s recommendation against broad use of masks “is being critically re-reviewed to see if there’s potential additional value for individuals that are infected or individuals that may be asymptomatically infected,” Dr. Robert Redfield, CDC director, told National Public Radio this week.

State guidance

Dr. Ryan Westergaard, chief medical officer for the Wisconsin Department of Health Services’ Bureau of Communicable Disease, said, “Federal guidance on this issue is evolving, and DHS is discussing how to approach this question here in Wisconsin.”

Dr. Ryan Westergaard

Westergaard

Commercially made masks, for which supply is currently inadequate, should be reserved for health care workers, Westergaard said. For the general public, he said it’s not clear if homemade masks are better than nothing.

Homemade masks can block respiratory droplets from people wearing them but can lead to hand contamination and have “unintended negative effects,” he said.

“Individuals should not assume that wearing such a mask will protect them from contracting COVID-19,” Westergaard said. But he said using a homemade mask is not harmful if people continue social distancing, handwashing and avoid touching their eyes, nose and mouth.

Face shields

Health care workers at UW Health are using face shields and masks to help stop the spread of COVID-19, but whether the general public should wear masks has become more of a topic for debate.

Some Asian societies where mask use is widespread, including South Korea, Hong Kong and Singapore, have reported lower levels of COVID-19 infection than the United States.

That could be from use of masks, but “there are so many other differences with those settings, with respect to testing, quarantine and isolation,” Remington said.

A watchful time

If the COVID-19 outbreak gets worse in the Madison area and begins to resemble the situation in New York City, it might make more sense for people here to wear homemade masks if they go out, such as to the grocery store, Remington said. If the supply of commercial surgical masks becomes adequate for the general public, those would be preferred, he said.

Safdar said homemade masks might also make sense now for well people using public transportation.

If the supply of commercial surgical masks was adequate for the general public, wearing them wouldn’t be a bad idea, she said. “But that isn’t the real world for masks now, with really any type of mask.”

Health care workers are scrambling to get commercial masks to protect themselves and others, so any broader public use of such masks only makes the problem worse, Safdar said.

Masks, respirators and ventilators

Photos: A look at how COVID-19 is affecting Wisconsin

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