13^th May 2020 – The British PM’s advice to use face coverings should go further.

 

A Blog by Dr David J Flavell PhD FRCPath & Dr Sopsamorn (Bee) Flavell BSc PhD

Scientific Directors of Leukaemia Busters

13^th May 2020

Mask Up!

• Face mask recommendation at last

• Does it go far enough?

• Will it work?

• A free high spec washable face mask for you!

 

After several weeks of indecision the British government has finally come down on the side of advising the public to use some form of face coverings in certain public settings such as on public transport and in shops. It has been quite a journey with government advisers telling us back in March that face masks were of little value in controlling COVID-19 transmission.

We’re very pleased that they’ve changed their minds but very disappointed that precious time has been wasted and resulted in more cases of transmission than there needed to be. These excess cases and deaths that went with them could have been avoided if face mask use had been the official line months ago.

Published studies have shown that face masks really do help reduce transmission of the influenza virus in some community settings and there’s every reason to believe that the same will be true for coronavirus. Now that we’ve finally arrived at the point where face mask use is recommended officially let’s not waste any more precious time and take things a step further to make sure that this low tech and relatively cheap solution is used to maximum effect when used alongside other measures such as social distancing, hand washing and clear instructions on how to behave safely.

For this to happen the government will have to shift from the current position where face mask use is only recommended to that of full scale mandatory use in the majority of public settings. It will be no good if half the community bother to wear and the other half don’t, it needs to be enforced for everyone otherwise this additional measure will only half succeed.

So what brought about this change of heart from the UK government after months of procrastination?

We have a suspicion that the British Prime Minister’s near death experience probably had something to do with it after he discovered first hand just how nasty and potentially deadly a disease COVID-19 actually is. As argued in all our previous blogs on this subject that extend back to the beginning of April (Unmasking the Myths, Facemask Dithering and More on Facemasks) any face covering is going to reduce the amount of droplet infection shed by those individuals who are carrying the virus whether asymptomatic or even moderately symptomatic and who do not adhere to the stay at home order.

From today there are likely to many of these potentially infectious individuals walking around freely in the community now lockdown has started to be eased off. Many will ride on buses and trains when travelling to work or will be buying goods in the supermarket and other stores. Scientifically scrutinised published work unequivocally shows that droplet infection can extend to 8 metres or even further from an infected individual who coughs or sneezes even in an open space, the range being determined by wind direction, relative humidity and temperature. This makes the current 2 metre social distancing rule inadequate and argues that an additional measure is urgently needed. Applying “common sense”, so lauded by the government recently, tells us that this additional measure should be a simple face mask to reduce this identifiable risk. It really is not a difficult concept, even a child can understand this principle.

So where does that leave us?

The argument has at long last been won, most now accept (including, so it seems,  the governments scientific advisers) that ordinary face coverings will indeed help in preventing infected individuals from spreading the COVID-19 virus to others around them. But common lore still continues to say that a face covering will not protect the wearer from becoming infected.

Personally we think this is probably wrong and it would be more accurate to say that a face covering decreases the amount of droplet infection reaching the wearers nose, mouth and lungs from an infected individual passing by in close proximity which in turn reduces the risk of the infection taking hold. Biomedical scientists are well familiar with this, it’s something called dose-dependency, simply put the fewer the number of viral particles to which any individual is exposed, the lower is the likelihood that the infection will become established. It’s all too obvious really and whilst we admit in the case of COVID-19 more work to confirm this experimentally is needed it would be just prudent “common sense” to do it ahead of formally proving this. There really is nothing to lose, only something to gain.

But there is an important caveat to all of this. For face mask use to be effective at controlling spread of COVID-19 in the community where social distancing alone might be inadequate, then everyone has to wear a face covering. But because face mask use has not yet been made mandatory in the UK, there is a real danger that many people will ignore government advice and go bare faced onto public transport and other community settings.

There is little doubt in our mind that face mask use by everyone in public places and where necessary in some work places, would substantially help to contain the spread of the COVID-19 virus and thereby reduce the time taken to ease lock down still further, thereby allowing us to return to some form of normality that much more quickly. So the advantages of one relatively small low tech solution could have enormous benefits for all of us, let’s keep that firmly in mind when we are asked to wear a face mask.

A recent survey showed that there were wide variations across the UK on how many people would voluntarily wear a face mask or covering, a figure that ranged from over three quarters in parts of the North East of England to less than half in places like Southampton. This is deeply disappointing and in our opinion demonstrates that many people just don’t appreciate the real dangers they face or the benefits that face mask use would bring to their and to others safety.

One thing is indisputable and it’s the plain fact that COVID-19 is an airborne infection and is transmitted largely through the air we breath. This needs to be driven home in a government sponsored educational campaign designed to persuade and not just some wishy washy suggestion that everyone should aim to wear a mask when out and about. If face mask use is not made compulsory then there will always be those macho types who refuse to comply. We therefore call on the UK government to do the right thing and make the wearing of face masks a mandatory requirement when in public spaces and other places that are high risk for community transmission. 

One perceived problem that compulsory face mask use might potentially create is that of availability and this has drawn criticism from those who oppose their general use in the community. The government, already concerned about PPE supplies for health and social workers, have stressed that PPE supplies for health workers must not be further compromised by the public attempting to buy up supplies. But this need not happen if some simple steps were taken to address this.

The government have offered an amateur solution by suggesting that everyone makes their own washable face covering from old items of clothing such as a T-shirt. A number of websites explaining how this can be done have sprung up with the Big Community Sew being one of the best. We have offered a more professional solution, the provision of high quality four layered washable (more than 100 times), shaped face masks from a supplier we have identified overseas.

It wouldn’t take much wit to repurpose a factory facility and an army of workers to churn out hundreds of thousands of masks a day together with a robust supply network to ensure that everyone in Britain receives one. The modest cost of doing this would be massively offset by the enormous economic benefits that more effectively bringing infection under control would offer by allowing an earlier return to some form of normality and thus economic activity.

In a small attempt to lead the way, we are importing a quantity of high quality multi-layered washable (more than 100 times) face masks from Bangkok as used by people in Thailand and other Far East countries where infection rates have been brought under control far better than here. We shall be distributing a mask to each government Cabinet member (in England, Scotland, Wales and Northern Ireland) together with a selection of other back bench MP’s as part of our campaign to persuade the necessity of mandatory face mask use for all the reasons outlined above.

How to claim your free mask(s).

To those of you reading these blogs in the UK we are pleased to be able to offer a limited number of face masks as illustrated above on a first come, first served basis, limited to a maximum of two masks per household (UK only). This is a personal initiative and does not use any Leukaemia Busters research funds.

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 the postage cost.

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.

If our modest little campaign is successful then this will position us more strongly to persuade the government and allow us to facilitate one way ahead for mass face mask distribution to the UK population. It is in all of our interests so we thank you for your support in this quest.

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

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