Tuesday, July 21, 2009

Unmasking: A Public Health Problem

 

 

# 3521

 

 

As I stated yesterday (and often in the past), I am generally very sympathetic to the plight of public health officials who are charged with dealing with a pandemic crisis.  

 

Most, I believe, are doing the best they can with the resources they’ve been allotted. But good intentions don’t always produce the best of results.

 

Overnight the Belfast Telegraph ran the following article, which I’ve excerpted just the opening paragraphs.   I’ve underlined and bolded the section of greatest interest to today’s blog.

 

After the article, a few comments. 

 

 

Swine flu: Don’t bother with masks

By Lisa Smyth
Tuesday, 21 July 2009

Members of the public should not wear protective facemasks as it could increase their risk of contracting swine flu, health experts have warned.

 

While medical facemasks could prove vital in protecting healthcare workers from catching the virus, ordinary members of the public have been warned against such a precaution as it could make them more susceptible to swine flu.

 

At a press conference in Belfast yesterday, the Department of Health, Social Services and Public Health Agency stressed the best way to avoid catching swine flu is to follow good hygiene practice, particularly regular hand washing, and the use of tissues when coughing or sneezing.

(Continue . . . )

 

The use of masks by the general public during a pandemic is problematic for many governments, since supplies are likely to be very limited over the fall and winter.

 

The science behind whether they are effective for `casual wear’ in public is iffy at best. 

 

But studies in the home have suggested (see Study: Facemasks Reduce Transmission Of Respiratory Viruses) they are likely to be at least somewhat protective

 

Of course, that doesn’t do much good if you run out of masks.

 

Which would happen in short order if the populace, en mass, decided to start wearing them when they are in public.  Millions of disposable masks – good for only a few hours use – would be `burned’ each and every day.

 

There are high risk groups of people – such as first responders and HCWs (Health Care Workers) – who will obviously need them much more than the general public.  

 

 

If they run out of protective gear, they may either decide it is too dangerous to work, or will fall ill at a greater rate – either way badly degrading the essential services they work for.

 

Even if the supply of masks wasn’t a problem, governments would like – as much as possible – for things to appear `normal’ in a pandemic.  Having the populace wearing facemasks would be, many fear, detrimental to the economy.

 

So governments are faced with a dilemma.   They need to conserve precious safety resources for those who will need them the most, while discouraging their use by others. 

 

Which is why we get announcements like the one above. 

 

A murky, and frankly, difficult to swallow claim that somehow wearing a mask could make the public more susceptible to swine flu. 

 

Even if true, this statement was apparently just tossed out there, with no rationale behind it reported.

 

 

I’m unaware of any scientific studies to back this assertion up, although I recently heard a WHO official try to explain some of the the reasoning behind it.  

 

The operative word is `could, by the way.

 

The concern is that people – if they wear maskscould become overconfident in their protection, and could neglect to wash their hands or social distance, or they could infect themselves removing a mask, or they could infect others by improperly discarding contaminated masks.

 

All of which are plausible, if not exactly proven risks. 

 

But whether they actually increase the odds of getting swine flu . . . well, I’m certainly not convinced.   And I doubt that the general public would be, either.  

 

I’m not entirely sure what is wrong with simply stating that officials believe that facemask usage by the general public is probably of `limited value’.

 

That serious shortages of facemasks are anticipated over the coming months, and that as much as possible, masks need to be reserved for high risk groups.

 

People might not like that reality, but it has the advantage of being the truth.  

 

Most people, I believe, would accept it.

 

In a pandemic, the one commodity that will be in shorter supply than facemasks is governmental credibility.  It is something terribly difficult to gain, and so very easy to lose.

 

Something for all risk communicators to keep in mind as they try to find the right words to inform the public during this, and any other crisis.