At first the answer seemed simple—only those who were sick needed to wear a mask. This testified both to the fact that a normal face mask isn’t proof against viral particles, and concerns that existed even then about the possibility that nurses and doctors wouldn’t be able to get all the medical-grade masks needed if they were having to fight against the whole populace for protective gear. So unless you were out there spreading droplets with every cough … don’t wear a mask.
That original message from the Centers for Disease Control and Prevention (CDC) is still out there on their official site, and closely matches the information provided by the World Health Organization (WHO). But over time that advice has seemed to get more shaky, and in just the last few days it seems that the call for everyone to don at least some kind of face covering is growing stronger.
For some in America, the advice to not wear a mask has become a sign of “yet another thing we were told that was wrong.” After all, it seemed that everyone in South Korea, Singapore, and Japan has been wearing a mask, and all those countries have so far avoided the kind of explosive growth and heartbreaking predictions of fatalities that are hanging over the United States. On the other hand, mask-wearing is a longtime part of culture in many Asian communities, including within the United States. Even though people in China started wearing masks very early on—and many were already wearing masks because it was flu season there, just like here, when this all began—it didn’t stop them from piling up 80,000 cases.
As CNN reports, when it comes to masks the official advice from the CDC has only become more confusing. Word from within the agency is that they’re considering changing their advice to the general public, but they haven’t. Only now everyone knows they are considering it … which makes it seem like the agency may not be acting to give the best advice.
The position at WHO continues to be that only health care professionals, those caring for someone known to be infected, and those who are showing symptoms need to cover their faces. And on Tuesday, President Donald Trump did what he has done throughout this crisis: deliver the worst possible advice by standing on both sides of the issue, appearing to both scoff at and recommend the practice in the space of a sentence. And the CDC … still hasn’t spoken.
At the heart of the possible change seems to be the elusive “asymptomatic carriers.” These are most definitely a real thing. Not only have the best “Human Petri dish” situations we’ve had—like the gosh-that-seems-like-a-long-time-ago-now Diamond Princess—suggested that somewhere around half of all people infected with the novel coronavirus have light symptoms that might not get much notice, but studies have also indicated that those infected with 2019 novel coronavirus are most contagious not only in the days immediately after symptoms begin, but in the period right before those symptoms appear.
So there are definitely people in the population who are not coughing or sneezing, but who could pass along the novel coronavirus. Which makes a pretty good case that anyone who might possibly have been exposed should be wearing a mask. And since none of us can be absolutely certain that we haven’t been exposed … having everyone wear a mask of some kind does not seem like a bad idea.
Why, then, does WHO insist that masks aren’t necessary? As The Atlantic reports, it comes down to the definition of the word “airborne.”
Just about any disease can be spread if someone coughs or sneezes at another person from close range. In that case, droplets carrying millions or billions of virus particles can make a warm, wet trip from person to person and get on about their replicating business. WHO doesn’t dispute this. Neither does the CDC. But droplets have a limited range. That’s why we’re all supposed to be standing six feet apart, so those virus-bomb droplets can crash and burn on the street.
But in medical-speak, just traveling by droplet doesn’t make a disease airborne. To earn that moniker, a disease has to be capable of surviving in tiny droplets that dry out to leave viral particles floating in the air. It’s only when a disease can be spread by these tiny, invisible, inhale-able particles that it’s considered airborne.
COVID-19 is not airborne. Because … yeah, that’s a good question. Because as the expert quoted in The Atlantic piece notes, it’s really too early to make a definitive statement about whether or not COVID-19 can make a more-than-six-feet, more-than-immediate-cough trip from person to person by air. We simply don’t know, and saying that it’s not happening is “really irresponsible.” Does this mean that you can definitely catch COVID-19 just from passing someone on the street, even if they are not coughing, sneezing, or otherwise hurling droplets into your open orifices? Maybe. But it’s also the kind of situation where anything less than a medical mask, properly fitted, is ineffective.
So that circles back to the original question: Should we all be wearing masks? And the answer is … it’s a good idea. Yes, your homemade two layers of T-shirt construction will not protect you if you are in an environment where live COVID-19 is simply floating through the air in virus-sized bits. But you’re probably not in that place anyway. The most likely location for this kind of aerosol, if it exists, is in the spaces where health care workers are working. So leave the N95 masks they need to them.
What an ordinary cloth mask will definitely do is cut down on the travel of those droplets, in both directions. It may also reduce the number of times you touch your nose or mouth while out and about—assuming you don’t get into a habit of adjusting your mask every 10 seconds. Because you don’t know who is sick, and because you can’t be sure that you’re not sick, and because at this point it probably makes other people simply feel a little better … why not wear a mask? If nothing else, pull a bandana up over your nose, or wrap a scarf around your face. Just don’t throw away a mask in public, and don’t reuse it without washing. And definitely leave the professional masks to the professionals who desperately need them.
If this is the crisis where just staying away from other people makes you a hero, what happens when you add a mask? Hm.