29th April 2020 – The Westminster Government Procrastination on Face Mask Use is Irresponsible.

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

29th April 2020

Yet More on Face Masks

The failure of the Westminster government to recommend face mask use by the general public in public and work spaces is being seen by many doctors, scientists and public health workers as a misguided dereliction of responsibility. We continually hear from them in the daily No 10 briefing that the evidence for their use is weak when in reality it is the reasons and excuses they present for not recommending their use that are weak.

There seem to be two favorite government excuses for not recommending face mask use by the public.

  • The first is that they will give the wearer a false sense of security which they calculate will cause the wearer to neglect carrying out other preventative measures such as social distancing, hand washing and face touching.
  • The second, even weaker related excuse is that people might infect themselves from masks that are contaminated externally if they are exposed to infectious droplet spray from infected individuals in their immediate vicinity.

These are all hollow reasons easily addressed through simple education on proper use, basic do’s and don’ts to the public. The second excuse is even more deeply flawed; if everyone is wearing a mask then infectious droplet emissions from those individuals who are infected (whether they know it or not) would be attenuated and therefore the risk of contaminating the exterior of masks worn by others would be minimised.

Think about it, if nobody was wearing masks then those infected individuals in the community would be spreading their infectious spray around everywhere, onto hard surfaces, peoples clothing, hair, bags and in some cases directly into their faces. Then there’s the question of people with symptoms driving to drive in centres for testing. Without clear guidance and without wearing a mask who’s to say that they won’t cross infect someone else if stopping to visit the toilet or buy some paracetamol on the way?  Look how easy it is to demolish the government and their adviser’s weak reasoning.

What is more, the evidence actually is not that weak, there is clear cut evidence that in influenza epidemics, face mask use can reduce transmission rates by as much as 75% in some community settings. Consequently there are an increasing number of loud voices ranging from the British Medical Association (BMA) to frontline health workers to the public themselves, all calling for face mask use in public spaces once lockdown is eased as just another potentially valuable strategy to effectively reduce transmission in the community and contribute to the prevention of a second wave of infection. Look around the world UK government to see who is doing exactly this (France and Germany for starters) and ask why are we (Scotland excluded) out of step with almost everybody else?

Well we think we know. It is our judgement that the Westminster government’s stance on this is for political and not for any meaningful scientific reason. We believe that the Westminster government is fearful that if they recommend general face mask use this will result in a depletion of stocks for health care workers and exacerbate further their mismanagement of PPE supplies that we’ve all heard so much about recently (see the recent BBC Panorama programme “Has the Government Failed the NHS? for an expose on this).

And yet there is a simple solution to this issue if only our government and its advisers would start thinking outside the box a little and plan for an alternative solution. Firstly they should designate a separate supply chain for medical grade surgeon’s and high grade FFP3 respirator type masks (see our blog Unmasking the Myths) for exclusive use only by front line healthcare workers from existing stocks and supply chains. This would ensure that none of these supplies could be taken for general public consumption.

If they’re not already doing so, the government should actively seek out manufacturers in the UK, or abroad if absolutely necessary, to supply either simple paper face masks or preferably washable, reusable face masks which could exclusively be supplied to the general public through a household distribution system based on the electoral register, possibly using the Royal Mail high volume handling capabilities.

The best face mask solution in our opinion would be washable, reusable masks that could be used over and over and for which we have identified at least one supplier abroad but which it would be relatively easy to transfer to domestic production through the re-purposing of existing factory facilities here. Education on how to use such masks as exemplified in the image above would ensure that individual users would not inadvertently infect themselves.

As we’ve already said, we ourselves have identified companies both at home and abroad who would be able to meet at least some of the demand for face mask supply. But time is short and we know that some of these manufacturers of PPE will be in great demand elsewhere as market forces determine who they sell to. Once again we in the UK may miss that critical window of opportunity. If, when we do begin to come out of lockdown, there is no face mask use policy in place and there follows a second wave of infection then fingers will point to the failure to use face masks as being one of the possible contributory factors.

Why take that risk when the solution is so simple and so low tech to implement?

Ministers and their advisers, try explaining that to the British public.

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