Volunteers wear masks at the start of a Covid-19 awareness drive in densely populated Diepsloot in Johannesburg, March 21 2020. Picture: AFP/MARCO LONGARI
Volunteers wear masks at the start of a Covid-19 awareness drive in densely populated Diepsloot in Johannesburg, March 21 2020. Picture: AFP/MARCO LONGARI

The National Institute for Communicable Diseases (NICD) is reviewing its stance on discouraging members of the public from using masks to reduce the spread of Covid-19, it emerged on Thursday.

The World Health Organisation and the NICD, a government body that provides research and advice on infectious diseases, have until now consistently said that ordinary people do not
need to wear masks unless they are sick or caring for someone who is.

They have said that hygiene and social distancing offer people the best protection against getting infected by the SARS-Cov-2 coronavirus, which is spread largely through droplet infection, and that the global scarcity of masks means they should be reserved for frontline healthcare workers.

But more and more countries around the world are now following the example of Asian governments in advising people to use masks when they go out in public as concern mounts that infected people could transmit the virus before they show symptoms.

On Thursday, the NICD joined a growing number of health authorities, including the WHO and US Centers for Disease Control in confirming that it was reconsidering its position.

"Guidelines on the use of masks are currently under review," said NICD spokesperson Sinenhlanhla Jimoh, without elaborating.

In recent days, health minister Zweli Mkhize and Gauteng health MEC Bandile Masuku have indicated that they see a greater role for masks, such as when people are in crowded public transport or queuing at the shops.

"Sometimes it is not possible [to do social distancing] so you might need a mask," Mkhize told journalists on Wednesday evening.

The Western Cape went further, saying on Thursday that it was now advising ordinary citizens to use nonmedical masks when they are out in public. Acknowledging the shortage of masks and the need to prioritise limited stocks for healthcare workers, it recommends that people use cloth masks.

The provincial government posted detailed instructions on its website on how to make, use and clean masks. It called on households, the textile industry and civil society groups to make cloth masks.

The Western Cape said it devised its new guidance in consultation with independent scientists, including public health specialist Kerrin Begg of the Colleges of Medicine of SA.

"Given the global shortage of medical masks, a cloth mask, when used appropriately, can help," she said, emphasising that masks should not be considered a substitute for measures such as hand-washing, keeping a distance of two metres from other people and staying at home when ill with flu-like symptoms.

CDC medical officer Meredith McMorrow said scientists had been hesitant to make recommendations on the use of cloth masks as there was little data to guide them.

"Scientific research to date has mostly focused on the level of protection provided by N95 versus surgical mask or surgical mask vs cloth mask, but not cloth mask versus no mask," she said. McMorrow warned that wearing masks could provide a false sense of protection, and if they were used incorrectly could pose more of a risk to the user than not using one at all, not least of all because people wearing them tended to touch their faces more.

"The only potential benefit I see to a cloth mask is that it might prevent the person wearing it from spreading the virus by capturing droplet particles they expel when speaking, sneezing or coughing.

"The wearer wouldn’t be using the mask for personal protection, but to protect those around them. I believe that is why several scientists from Asia are encouraging the public to wear masks to reduce droplet spread from presymptomatic individuals," said McMorrow.

By Thursday, SA had 1,462 confirmed cases of Covid-19.

Western Cape head of health Keith Cloete said there was increasing community transmission in the province, which accounted for 164 of its 393 cases to date.

Altogether 22 patients were in hospital, seven of whom were in intensive care. The numbers were rising.


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