Fikile Mbalula. Picture: THE TIMES
Fikile Mbalula. Picture: THE TIMES

Transport minister Fikile Mbalula was, characteristically, both right and wrong at the same time.

On Wednesday afternoon, the transport minister gave into taxi union Santaco, which had been fuming that the Covid-19 lockdown restrictions prevented taxis from being more than 70% full to ensure social distancing guidelines were adhered to. So Mbalula backed down, saying that taxis would be able to travel without any passenger number restrictions, as long as everyone in the vehicle was wearing either a surgical or N95 mask.

Just imagine where that would have led: taxis owners, who have been known to wage deadly wars with competitors, now in a fight to stockpile masks with doctors, nurses and physiotherapists who are at the frontline of treating Covid-19 patients.

And, as the SA Medical Association (Sama) has pointed out in recent days, there is a shortage of N95 masks, which are also needed by doctors treating tuberculosis.

Thankfully, someone powerful enough who was aware of the severe mask shortage must have called Mbalula because, just a few hours later, he backtracked. Again, he reiterated that taxis can be a maximum of 70% full – but he casually added that the government will help source masks.

Still, even that 70% occupancy is too much, say Sama and the College of Public Health Medicine, if you want to limit infections.

And yet, Mbalula was actually right in one sense: the evidence increasingly shows that masks may help to reduce the spread of the disease. It’s something that health minister Zweli Mkhize keeps saying publicly.

At the very least, masks should stop people touching their face, which is the easiest way in which the coronavirus transfers from their hands into their mouth or eyes, from where it can then travel to their lungs.

In the middle of January, when the outbreak began, Taiwan mandated 15 manufacturers to begin ramping up the production of masks. Taiwan limited the quantities of masks that people could buy and today the country is producing 10-million masks per day.

The conventional thinking on masks has shifted. Initially, the US Centers for Disease Control & Prevention (CDC) said masks should only be kept for the sick, their caregivers and doctors and nurses. Now, the CDC is thinking on changing its guidance to suggest that everyone wear masks. It makes sense: it can keep a sick person, who is unaware they have Covid-19, from spreading it when sneezing or spitting.

Fabric masks, however, don’t work as well as surgical masks. Much depends on the weave and the layers of fabric.

Still, the Western Cape department of health, which consulted with a number of top scientists and doctors including Prof Shaheen Mehtar and Dr Kerrin Begg, suggests that fabric masks may just be a partial solution to protect the public, while keeping the surgical masks for health professionals.

The department argues that masks will reduce the inhalation of a large number of droplets from others; they reduce exposure in overcrowded areas such as taxis, shops or government buildings; they create awareness of Covid-19; and they aren’t expensive.

The Western Cape, under premier Alan Winde, has led the way of much of SA’s response to Covid-19. Not only was the province the first to cancel large events, like the Cape Epic cycle race, it’s now ahead of the country in evaluating mask evidence and giving clear guidance to all those out there with a sewing machine.

Of course, as any scientist will tell you, wearing a fabric mask doesn’t replace the need for social distancing, staying at home if you’re sick, or washing your hands. It’s no panacea, it’s just another tool to help stay safe.

So here’s a compromise for Mbalula: suggest fabric masks. It would not only keep taxi bosses happy, it would ensure that doctors and nurses aren’t pitched into a battle with them for the short supply of surgical masks.

GUIDE TO WEARING A MARK

Make sure the mask covers your nose and mouth. Move it around to get the best fit but never touch the cloth part. Once you have put on the mask, do not touch your face again until you take it off;

You must have at least two cloth masks per person, so you will be able to wash one and have a clean one ready for use; and

Wash the mask daily in soap and hot water (tolerated during hand wash), rinse thoroughly and dry. Ironing is the best way to disinfect a mask.

Note: for further reading on masks, see here.