The issue of the beneficial effect of face masks is much in the news at the moment. Whenever you hear people clarifying the position on masks you come away slightly more confused than when you started. The “science” has moved from, they have no beneficial effects, to they don’t stop you catching Covid-19 but they may reduce substantially the chance of you spreading it if you have caught it.

But even the latter “science” is followed by advice that the general public should still not use masks. Why? Accepting that the mask does not stop you getting the disease, surely if it reduces substantially your chance of spreading Covid-19 it is worth people wearing masks. I thought the whole point was to break the chain of infection and surely it does not matter whether it is the getting or the giving which breaks the chain.

Usually, when the discussion has got to this point the government spokesperson talks about the mask becoming a source of infection if you do not take it off properly or dispose of it properly. However, I guess if the mask is infected that is because it has stopped something that would otherwise be infecting your face.

The next argument is masks promote a misplaced feeling of security and undermines the commitment to social distancing and hand washing. I suspect the contrary is true and that the face mask is a constant reminder of the risk of infection. However, that is just a hunch based on observing those with masks who seem, at least to me, to be more conscious of strict social distancing than those without. Of course that is just anecdotal, but I suspect it is the same evidence base as the “undermining commitment” theory.

Finally, they point to the advice of the World Health Organisation. That is definitely worth a look. There is a very interesting vides explaining “When to use a mask.” The video like much of the communication on Covid-19 requires close attention. 

It starts with a very clear statement that masks cannot protect against Covid-19 but then qualifies this with “when used alone”. It goes on to say you need to combine with hand washing and social distancing. Which sort of suggests it does have some benefit. This seems to be clarified when it goes on to say that WHO only recommend you wear a mask if you have symptoms of Covid-19. This would seem to support the prevention of spreading theory. The “giving” bit of the chain.

But then it goes on and says “There is no evidence that they (masks) protect people who are not sick” A very clear statement on the lack of prophylactic benefit. But the very next sentence says “However, if you are healthy but you are taking care of a person who [may be infected] then you should wear a mask whenever you are in the same room as that person.”

So wearing masks does not prevent you from getting the disease from an infected person however if you are with such a person you should wear a mask. All clear?

I suppose you might say this is an example of the “precautionary principle”, i.e. we have no evidence that it works but we have no evidence that it does not work either so what’s the harm in wearing it. Or that the virus is more/less virulent inside than outside and therefore the advice differs by location.

What comes across from this advice and much of the information that comes out of the UK press briefings is the need to listen very carefully to every word. The statements made are very carefully crafted to enable alternative interpretations to be put on them. 

I have no idea why the Government has taken such a clear position on face masks for the general public. My suspicion is that in a situation where front line health and care staff cannot get the PPE they need the Government don’t want any calls on supply or production that might divert the short supply that exists from them.

That is a perfectly reasonable position that I am confident the vast majority of the public would respect. I am pretty confident once supply issues are no longer a constraint the “science” on masks will change. We may then get advice on the matter which does not sound like a G7 communique that has been all night in the negotiation and which says – black is white except in circumstances where it is white.Masking the future