20th February 2021 –   Face Masks –  Time to Upgrade. 


A Blog by Dr David J Flavell PhD FRCPath & Dr Sopsamorn (Bee) Flavell BSc PhD
Scientific Directors of Leukaemia Busters

20th February 2021

Face Masks – Key in the Fight Against COVID-19

At the beginning of the pandemic the UK government deemed face mask use as of unproven benefit and therefore unnecessary. Time has shown that they could not have been more wrong.

They were wrong

You’ll very likely remember a time, not so long ago, when the UK government and even the World Health Organisation (WHO) were decrying the use of face masks during the pandemic as unproven or absurdly claiming that they might even pose a hazard for the control of COVID-19. They could not have been more wrong, a realisation that came too late allowing the first wave of the epidemic to run rampant in the UK and other countries.

Now all the scientific evidence points to small virus laden droplets and aerosols in the air as being the main source of person to person transmission and whilst social distancing of two metres helps reduce this, it does not eliminate the risk completely, particularly for indoor settings with poor ventilation.

The SARS-CoV-2 virus that is the cause of the COVID-19 illness was always recognised as respiratory virus whose main mode of transmission was strongly suspected to be via airborne transmission from the outset. So you may well ask why the procrastination and indecision about face mask use by the UK government during the early months of the first wave of infections in the UK? There is no easy answer to this that we can think of other than it was the government’s nervousness on face mask availability at the height of the PPE crisis.

The purpose of today’s blog is to argue in favour of the more widespread use of medical-grade face masks as a certain way of reducing transmission in the community and how this will make a vital difference to avoid the necessity for a catastrophic fourth lockdown.

Acceptance at Last

Now that it is known and accepted by scientists and politicians alike that face masks have an important part to play in helping control COVID-19 transmission in the community, what might be done to further improve their effectiveness?

The first thing to understand is that not all face masks are equal, some are highly effective at blocking the virus from either leaving or entering an individuals airways whilst others offer only very minimal protection. Watch the excellent BBC news video below for an explanation of the various types of face coverings and the levels of protection that each offers.

Which kind of mask is best?

The major problem with face coverings used presently in the UK  is one of inconsistency, a problem that has arisen because the UK (and many other) governments have not formally set a minimum specification for face coverings. As a consequence individuals have devised their own solutions that can range from a simple scarf around the mouth to a fully sealed FFP3-type respirator mask.

Not only this, there is also a general lack of public instruction on how and when face coverings should be used in different settings. Put plainly some people are not always using the face coverings they possess in the correct or safest possible way, an issue which we see as being due to a lack guidance from the top and something that needs addressing urgently as we come out of this third lockdown in the weeks and months that lie ahead.

Improving Face Mask Use

Knowing what we know now, how can face coverings and their use be improved to increase their effectiveness at preventing transmission of SARS-CoV-2? In light of the new coronavirus variants and their increased infectivity this is in everybody’s interest to help avoid the potentially disastrous consequences of a fourth lockdown.

Firstly there has to be some form of standardisation with levels of performance set for face coverings. It’s no longer sufficiently good enough to allow individuals to design and make their own face coverings. Some will be good but equally some will be poor. The use of home-made face coverings should therefore be discouraged/disincentivised and effective commercially produced medical-grade face masks made readily available through a government led scheme.

There is a growing wealth of commercially available face masks (none of them are cheap it seems as some cash in on this new demand). There should however be standard set by the government to ensure that what is on offer commercially does an effective job. Here the layers of material used in construction, the ability of the mask to form an effective seal against the face and its reuse-ability are amongst the most important factors.

The UK government should also seriously consider a scheme to provide the most highly effective type of medical FFP2 face mask to those who are most vulnerable in society. The German government has already devised such a scheme where high quality FFP2 face masks are provided for free to 27 million people over the age of 60 or have certain pre-existing conditions. Other European countries are following suit with France considering banning some home-made masks.

German Chancellor Angela Merkel dons her FFP2 face mask.

Secondly there has to be an education campaign alongside the mask supply issue to ensure that people are using the masks they have correctly, effectively and safely. This has largely been lacking in the UK at least. How often have we seen people wearing a mask that fails to cover their nose or who even remove their mask to speak directly to someone and by so doing defeat their entire purpose. This is a public health issue and the whole population needs educating fully and constantly reminding about the important aspects of safe and effective mask use.

Thirdly there needs to be an expansion of face mask use to outdoor public places in addition to indoor settings. Whilst it is probably true that transmission occurs inefficiently out of doors this doesn’t mean that it never happens, it almost certainly does but to a lesser extent than it does indoors.

It has been shown in a considerable number of scientific studies, long before COVID-19 appeared, that a sneeze, a cough or even loud talking can carry aerosolised droplets for up to and possibly further than eight metres. This makes the current two meter social distancing rule somewhat inadequate under certain conditions. Those circumstances will be dictated by a variety of factors ranging from how many viral particles a particular individual is shedding, the wind direction and even the direction that the infected individual or unsuspecting victim is facing.

For this reason we advocate for a mandatory use of FFP2 or similar well fitting four layer face masks out of doors in all public places both indoors and outdoors, particularly in those settings where people are relatively crowded together on public transport, in stores, restaurants, bars, theatres, places of worship, on the street or in parks to name a select few.

If this approach to face mask use is applied vigorously then we are of the opinion that this will make a significant contribution, possibly the most important contribution to controlling transmission rates next to an effective vaccination programme and will bring the COVID-19 epidemic under control once and for all. It is vitally important that this is put in place before the third lockdown we are currently in begins to be eased later this year.

See our previous related blogs:-

A Free High Spec Washable Face Mask for You!

We have obtained specific funding for a supply of high quality reusable/washable 4-layer face masks that we are offering to people in limited numbers for free.

To claim your mask please do all of the following things:

  • Email contact@leukaemiabusters.org.uk using the wording “Mask Request” in the subject heading.
  • Give your name, address and telephone number in the body of the email.
  • State whether you require 1 or 2 masks.
  • Send a £1.29 stamped self addressed envelope using large C5 size envelope (162 x 229 mm) to Leukaemia Busters, MP3, Southampton General Hospital, Southampton SO16 6YD or send a cheque payable to Leukaemia Busters for postage costs.

Please note a maximum of two masks per request. Allow up to a week for delivery from when we receive your stamped self addressed envelope.We will not retain your personal details without your permission other than for the purpose of mailing your face mask to you. We do not have the resources to be able to reply to everyone who might apply so if you do not hear from us it means that the full quota of masks has been used up.

Whilst we are offering face masks free of charge, if you feel able, a small donation to Leukaemia Busters would be much appreciated. Click here to make a donation

Note: None of Leukaemia Busters research funds have been used in the supply of these masks.

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