Covid19 Part XVIII-25,473 in ROI(1,736 deaths) 5,760 in NI (551 deaths)(30/06)Read OP

Away With The Fairies wrote: »

Do you think we'll get masks mandatory this week? People are getting busier already.

I think masks on public transport, where at least there is a reasonable logic given confined space for a period of time with others, will still only happen if the WHO change advice from recommended to mandatory. If they do that, they'd really want to distinguish between shops and transport which are entirely different situations in terms of continued proximity to others.

But the Govt uses same language as WHO to the word normally.

Here is the full text of the new WHO advice in relation to wearing of masks in public. It's quite clear in terms of what it advises, though I do accept that they are prone to changing their minds a lot, and that boards certified epidemiologists may disagree. (My highlighting of what I considered important)

Guidance on the use of masks for the general public

Available evidence

Studies of influenza, influenza-like illness, and human coronaviruses (not including COVID-19) provide evidence that the use of a medical mask can prevent the spread of infectious droplets from a symptomatic infected person (source control) to someone else and potential contamination of the environment by these droplets.

There is limited evidence that wearing a medical mask by healthy individuals in households, in particular those who share a house with a sick person, or among attendees of mass gatherings may be beneficial as a measure preventing transmission. A recent meta-analysis of these observational studies, with the intrinsic biases of observational data, showed that either disposable surgical masks or reusable 12–16-layer cotton masks were associated with protection of healthy individuals within households and among contacts of cases.

This could be considered to be indirect evidence for the use of masks (medical or other) by healthy individuals in the wider community; however, these studies suggest that such individuals would need to be in close proximity to an infected person in a household or at a mass gathering where physical distancing cannot be achieved, to become infected with the virus.

Results from cluster randomized controlled trials on the use of masks among young adults living in university residences in the United States of America indicate that face masks may reduce the rate of influenza-like illness, but showed no impact on risk of laboratory-confirmed influenza. At present, there is no direct evidence (from studies on COVID- 19 and in healthy people in the community) on the effectiveness of universal masking of healthy people in the community to prevent infection with respiratory viruses, including COVID-19.

WHO regularly monitors all emerging evidence about this important topic and will provide updates as more information becomes available.

Guidance
1) WHO recommends that persons with any symptoms suggestive of COVID-19 should:
• wear a medical mask, self-isolate, and seek medical advice as soon as they start to feel unwell with potential symptoms of COVID-19, even if symptoms are mild. Symptoms can include: fever, cough, fatigue, loss of appetite, shortness of breath and muscle pain. Other non-specific symptoms such as sore throat, nasal congestion, headache, diarrhoea, nausea and vomiting, have also been reported. Loss of smell and taste preceding the onset of respiratory symptoms have also been reported. Older people and immunosuppressed patients may present with atypical symptoms such as fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium, and absence of fever. It is important to note that early symptoms for some people infected with COVID-19 may be very mild and unspecific;
• follow instructions on how to put on, take off, and dispose of medical masks and perform hand hygiene;
• follow all additional measures, in particular respiratory hygiene, frequent hand hygiene and maintaining physical distance of at least 1 metre (3.3 feet) from other persons.
In the context of the COVID-19 pandemic, it is recommended that all persons, regardless of whether they are using masks or not, should:
• avoid groups of people and crowded spaces (follow local advice);
• maintain physical distance of at least 1 metre (3.3 feet) from other persons, especially from those with respiratory symptoms (e.g. coughing, sneezing);
• perform hand hygiene frequently, using an alcohol based hand rub if hands are not visibly dirty or soap and water;
• use respiratory hygiene i.e. cover their nose and mouth with a bent elbow or paper tissue when
coughing or sneezing, dispose of the tissue immediately after use, and perform hand hygiene;
• refrain from touching their mouth, nose, and eyes.


2) Advice to decision makers on the use of masks for the general public

Many countries have recommended the use of fabric masks/face coverings for the general public. At the present time, the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence and there are potential benefits and harms to consider (see below).

However, taking into account the available studies evaluating pre- and asymptomatic transmission, a growing compendium of observational evidence on the use of masks by the general public in several countries, individual values and preferences, as well as the difficulty of physical distancing in many contexts, WHO has updated its guidance to advise that to prevent COVID-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear masks in specific situations and settings as part of a comprehensive approach to suppress SARS-CoV-2 transmission (Table 2).

WHO advises decision makers to apply a risk-based approach focusing on the following criteria when considering orencouraging the use of masks for the general public:

1. Purpose of mask use: if the intention is preventing the infected wearer transmitting the virus to others (that is, source control) and/or to offer protection to the healthy wearer against infection (that is, prevention) 2. Risk of exposure to the COVID-19 virus - due to epidemiology and intensity of transmission in the population: if there is community transmission and there is limited or no capacity to implement other containment measures such as contact tracing, ability to carry out testing and isolate and care for suspected and confirmed cases; - depending on occupation: e.g., individuals working in close contact with the public (e.g., social workers, personal support workers, cashiers).

3. Vulnerability of the mask wearer/population: for example, medical masks could be used by older people, immunocompromised patients and people with comorbidities, such as cardiovascular disease or diabetes, mellitus, chronic lung disease, cancer and cerebrovascular disease.

4. Setting in which the population lives: settings with high population density (e.g. refugee camps, camp-like settings, those living in cramped conditions) and settings where individuals are unable to keep a physical distance of at least 1 metre (3.3 feet) (e.g. public transportation).
5. Feasibility: availability and costs of masks, access to clean water to wash non-medical masks, and ability of mask wearers to tolerate adverse effects of wearing a mask.

6. Type of mask: medical mask versus non-medical mask

Based on these criteria, Table 2 provides practical examples of situations where the general public should be encouraged to wear a mask and it indicates specific target populations and the type of mask to be used according to its purpose. The decision of governments and local jurisdictions whether to recommend or make mandatory the use of masks should be based on the above criteria, and on the local context, culture, availability of masks, resources required, and preferences of the population.



In my understanding, Ireland is not an area with "widespread transmission" with "no capacity to implement any of the other measures" - but for countries where there IS widespread transmission, then they recommend in shops, at work, mass gatherings, etc. etc. So no advice to wear in shops in Ireland.

In settings where physical distancing cannot be achieved, they recommend masks on public transportation. So, advice to wear masks on public transport.

The Government has stated "It is recommenced that face coverings be worn in public places, such as shops, and on public transport" - which combines both situations, which appear to distinguished by WHO. But they have gone further than WHO in recommending both situations.


Edit - benefits and risks:

Potential benefits/advantages
The likely advantages of the use of masks by healthy people
in the general public include:
• reduced potential exposure risk from infected persons before they develop symptoms;
• reduced potential stigmatization of individuals wearing masks to prevent infecting others (source control) or of people caring for COVID-19 patients in non-clinical
settings;
• making people feel they can play a role in contributing to stopping spread of the virus;Advice on the use of masks in the context of COVID-19: Interim guidance
• reminding people to be compliant with other measures (e.g., hand hygiene, not touching nose and mouth).
However, this can also have the reverse effect (see below);
• potential social and economic benefits. Amidst the global shortage of surgical masks and PPE, encouraging the public to create their own fabric masks may promote individual enterprise and community integration.
Moreover, the production of non-medical masks may offer a source of income for those able to manufacture masks within their communities. Fabric masks can also be a form of cultural expression, encouraging public acceptance of protection measures in general. The safe re-use of fabric masks will also reduce costs and waste and contribute to sustainability.


Potential harms/disadvantages
The likely disadvantages of the use of mask by healthy people in the general public include:
• potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands;
• potential self-contamination that can occur if nonmedical masks are not changed when wet or soiled. This can create favourable conditions for microorganism to amplify;
• potential headache and/or breathing difficulties, depending on type of mask used;
• potential development of facial skin lesions, irritant dermatitis or worsening acne, when used frequently for long hours;
• difficulty with communicating clearly;
• potential discomfort;(41, 51)
• a false sense of security, leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene;
• poor compliance with mask wearing, in particular by young children;
• waste management issues; improper mask disposal leading to increased litter in public places, risk of contamination to street cleaners and environment hazard;
• difficulty communicating for deaf persons who rely on lip reading;
• disadvantages for or difficulty wearing them, especially for children, developmentally challenged persons, those with mental illness, elderly persons with cognitive impairment, those with asthma or chronic respiratory or breathing problems, those who have had facial trauma or recent oral maxillofacial surgery, and those living in hot and humid environments.

Full text of WHO document here: https://apps.who.int/iris/rest/bitstreams/1279750/retrieve