WASHINGTON (NYTIMES) – Should healthy people be wearing masks when they’re outside to protect themselves and others?

Both the World Health Organisation and the Centres for Disease Control and Prevention have repeatedly said that ordinary citizens do not need to wear masks unless they are sick and coughing.

And as health care workers around the world face shortages of N95 masks and protective gear, public health officials have warned people not to hoard masks.

But those official guidelines may be shifting.

On Monday (March 30) during the coronavirus task force briefing, President Donald Trump was asked whether Americans should wear nonmedical masks.

“That’s certainly something we could discuss,” he said. “It could be something like that for a limited period of time.”

Dr Robert Redfield, director of the CDC, confirmed in an interview with WABE in Atlanta, a National Public Radio member station, on Monday that the agency was reviewing its guidelines on who should wear masks.

Citing new data that shows high rates of transmission from people who are infected but show no symptoms, he said the guidance on mask wearing was “being critically re-reviewed, to see if there’s potential additional value for individuals that are infected or individuals that may be asymptomatically infected”.

The coronavirus is probably three times as infectious as the flu, Redfield said. Some people are infected and transmitting the virus probably as long as two days before showing any symptoms, he said.

“This helps explain how rapidly this virus continues to spread across the country, because we have asymptomatic transmitters and we have individuals who are transmitting 48 hours before they become symptomatic,” Redfield said in the interview.

“That’s important, because now you have individuals that may not have any symptoms that can contribute to transmission, and we have learned that in fact they do contribute to transmission,” Redfield said.

A federal official said on Tuesday that the CDC’s review of mask wearing for the public stemmed from a request by the White House coronavirus task force, which is leaning towards recommending it.

One concern, which Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, voiced in an interview with CNN, is that such a recommendation could cause even worse shortages of N95 and other medical masks for health care workers, who need them most.

“You don’t want to take masks away from the health care providers who are in a real and present danger of getting infected,” Fauci, a member of the task force, said on CNN on Tuesday morning.

Nonetheless, Fauci said: “The idea of getting a much more broad communitywide use of masks outside of the health care setting is under very active discussion at the task force. The CDC group is looking at that very carefully.”

Masks work by stopping infected droplets spewing from the wearer’s nose or mouth, rather than stopping the acquisition of the virus from others.

Both medical grade N95 masks and flat face masks are made of a special melt-blown fabric, which is able to stop infectious particles even finer than a micron in diameter.

But in many Asian countries, where everyone is encouraged to wear masks, the approach is about crowd psychology and protection.

If everyone wears a mask, individuals protect one another, reducing overall community transmission. And places like Hong Kong and Taiwan that jumped to action early with social distancing and universal mask wearing have gotten their cases under much greater control.

There have been troubling reports that indicate the coronavirus may be able to travel farther in the air and stay in the environment longer than is possible by respiratory droplets, which have so far been assumed to be the primary mode of transmission of the virus.

One study in Singapore found traces of the virus in air vents in patient isolation rooms. In another study, researchers at the University of Nebraska Medical Centre detected extensive contamination in patient rooms as well as in air samples collected from the hallways outside rooms.

Dr Scott Gottlieb, former commissioner of the Food and Drug Administration, said in an interview Sunday that the CDC should put out designs for cloth masks for the public.

“The value of the mask isn’t necessarily to protect you from getting sick, although it may offer some protection,” he told CBS News.

“It’s to protect you from other people. So when someone who’s infected is wearing a mask, they’re much less likely to transmit infection.”

He said studies involving the flu suggested that you could reduce your ability to spread the flu by about 50 per cent if you wore a mask.

This is what the CDC’s guidelines currently say: “If you are sick: You should wear a face mask, if available, when you are around other people (including before you enter a health care provider’s office). If you are caring for others: If the person who is sick is not able to wear a face mask (for example, because it causes trouble breathing), then as their caregiver, you should wear a face mask when in the same room with them. Visitors, other than caregivers, are not recommended. Note: During a public health emergency, face masks may be reserved for health care workers. You may need to improvise a face mask using a scarf or bandanna.”

In the radio interview, Redfield also emphasised that social distancing, staying at least 6 feet away from others in public spaces, and staying home, were important measures to keep in place for now.

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