WHO approves use of face masks by people without virus

On March 13, the first positive coronavirus case was reported in the country.

The Health Ministry maintained that only individuals with Covid-19 symptoms and health care workers were to wear masks, the same position held by the World Health Organisation.

The ministry however changed tune and directed that all Kenyans to wear masks when leaving their houses, while using public transport or when they visit shopping centres and markets.

The World Health Organisation has now retracted its earlier position on the use of face masks by a healthy population, a decision the agency says is based on scientific evidence.

In the updated guidelines published on Friday, the WHO now advises 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 transmission.

The global health agency advises that before encouraging the use of masks by the general public, policy makers should for instance consider the 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,” WHO says.

Another factor to be put into consideration is the occupation of the individuals. For instance those working in close contact with the public such as social workers, personal support workers and cashiers should wear a mask.

In addition, the vulnerability of the mask wearer/population should be put into consideration.

“For example, medical masks could be used by older people, immune-compromised patients and people with comorbidities, such as cardiovascular disease or diabetes mellitus, chronic lung disease, cancer and cerebrovascular disease,” WHO states.

The WHO also recommends the use of masks by the healthy population in settings with high population density like refugee camps, camp-like settings and settings where individuals are unable to keep a physical distance of at least 1 metre such as those using the public transportation.

Another factor is 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.

The agency however emphasised that that all persons, regardless of whether they are using masks or not, should adhere to transmission prevention measures put in place such as avoiding crowded spaces, maintaining social distancing, frequent hand washing and refraining from touching their mouth, nose, and eyes.

The WHO says the use of masks is likely to reduced potential exposure risk from infected asymptomatic persons, reduce potential stigmatization and make people feel they can play a role in contributing to stopping spread of the virus;

“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,” it states.

The WHO adds: “Moreover, the production of non-medical masks may offer a source of income for those able to manufacture masks within their communities. The safe re-use of fabric masks will also reduce costs and waste and contribute to sustainability.”

The agency however warns that the use of masks by healthy people in the general public is likely to lead to a potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands or when nonmedical masks are not changed when wet or soiled.

Other risk factors include 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.

The WHO also warns of waste management issues, poor compliance with mask wearing, in particular by young children, difficulty in communicating with the deaf persons who rely on lip reading and disadvantages for or difficulty wearing them, especially for children and those with mental illness.

The elderly persons with cognitive impairment, individuals with chronic respiratory or breathing problems, those who have had facial trauma or recent oral maxillofacial surgery, and those living in hot and humid environments might also be disadvantaged.