Taking a closer look at mask mandate

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When the Covid-19 pandemic began over two years ago, wearing a facemask was the first measure of defence against the virus spread, alongside hand washing and practicing physical distancing. But later on, as the countries witnessed a steep decline in Covid-19 positive cases, several states have now announced that wearing facemasks is no longer mandatory.

The Covid-19 pandemic has begun in March 2020 in Sri Lanka and it is not over yet. Globally, over 6.1 million have died so far due to the Covid-19 as of April 2022. Also, the world is identifying new variants of viruses and people need to be vigilant enough to protect themselves and others. 

Despite the drop in Covid-19 cases reported in the countries including
Sri Lanka, there are new strains circulating (Omicron BA.4 and BA.5 in South Africa) in different regions of the world, with the potential to cause another wave of infections.  

Recent Gazette

On Monday (18), a Gazette Notification has been issued to end the mandatory use of facemasks in most indoor spaces. Director-General of Health Services (DGHS), Dr. Asela Gunawardena added that checking body temperature when entering premises and obtaining details of customers or visitors entering the premises as a measure of preventing Covid-19 was also not necessary.

Though it was said that a facemask is not mandatory in the enclosed spaces, still it is advised to wear it in public transportations and in crowded public places such as malls, markets, theatres and others.

Why Facemasks?

Facemasks are protective devices that are used to cover a part of the face. They are designed to protect the person who wears them from breathable pollutants such as respiratory poisons or bacterial or viral pathogenic organisms. Different types of masks can be used and the breathing resistance varies proportionally to the density of the mask material.

Prior to Covid, the efficacy of wearing facemasks to reduce the spread of respiratory infections was controversial because there were no solid relevant data to support its use. However, during the pandemic, the scientific evidence has increased and compelling data now demonstrate that wearing a mask is an effective non-pharmacologic intervention to reduce the spread of infection, especially as source control to prevent the spread from infected persons, but also as protection to reduce wearers’ exposure to infection.

Experts Advices

Meanwhile, the Government Medical Officers’ Association (GMOA) it is more advisable to wear a mask when leaving home in view of the prevailing situation in the country. GMOA Secretary, Dr. Senal Fernando noted that the facemasks including cloth and surgical masks largely helped to prevent respiratory infections as well as Covid.

“With the present drug shortage in hospitals and other health institutions, we will not be able to treat patients properly if they get infected with any kind of disease. With the ongoing protests and demonstrations, the risk of getting infected with communicable diseases is high, and taking precautions to prevent them will be helpful,” he said.

Further, the President of the Association of Medical Specialists (AMS), Dr. Lakkumar Fernando urged the decision on masks to be rescinded, especially at outdoor gatherings. “People should be advised to take all measures to prevent contracting the Covid-19 infection. While walking alone without a mask may be justified, there is a substantial risk of contracting Covid in mass outdoor gatherings too,” he said. The association added that there is a scarcity of medicines and other medical reagents in Sri Lanka, stressing that an increase of Covid infections coupled with the inability to provide medical support for those in need would cause havoc, further undermining the deteriorating economic situation in the country.

Therefore, the AMS urges that the decision on masks be rescinded, especially in outdoor gatherings, and the people are advised to take all measures to prevent Covid infection.

In addition, to ensure that vulnerable people are able to travel safely, everyone is still advised to wear a facemask as wearing a facemask helps to protect you and the people around you.

Prof. Suranjith Seneviratne, Consultant in Clinical Immunology and Allergy Institute of Immunity and Transplantation and Health Service Laboratory, London, noted that though several Covid-19 restrictions and health guidelines have been removed in several countries, not every country can get adapted to it by copying the other country and countries need to check their status before lifting the restrictions.

“If still there is a risk of virus spread, then the guidelines should be followed accordingly in order to protect the nation. Generally, respiratory viruses are transmissible, cause severe diseases and sometimes it affects treatments. Due to this concern, we will not be able to curtail the Covid-19 virus and its variants, similar to other pandemics. Respiratory viruses are a huge threat to society as they are transmissible and people need to be more precautious and careful in protecting themselves,” Prof. Seneviratne said.

Meanwhile, some countries have started giving the fourth dose of Covid-19 vaccine to all, whereas some countries have identified the low-immune people or people with diseases and given them the fourth dose. However, it cannot be done every three to four months and proper systems need to be planned in controlling the risks, he added.

“There will be no risk at all to be unmasked if walking alone on a street. However, despite the very low number of cases and hospitalisations due to Covid-19 in Sri Lanka right now, it would be advisable to wear masks in large outdoor gatherings,” Professor and Head, Department of Immunology and Molecular Medicine, Neelika Malavige tweeted, recently.

Responsibility of citizens

It is now up to the individual to decide on whether to wear a mask or not, according to their level of vulnerability to the virus or other infectious diseases. Mostly, the vulnerable group includes the over-60 population, pregnant women, children, and the immune-compromised. Individuals under these categories are recommended to continue wearing facemasks in small or poorly ventilated crowded indoor spaces, especially if spending significant time there.

In addition, the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) have recommended the use of facemasks, either surgical or cloth, to protect themselves from respiratory transmissible viral diseases including Covid-19.

Reversal of the Gazette

However, by considering the large public gatherings including protests taking place in the country, on Thursday (21), the Health Ministry has reversed the recently issued Gazette and wearing facemasks was made mandatory as before. Dr. Gunawardena said other measures stipulated by the release namely; checking of body temperatures and documenting details of customers and visitors had been waived as previously mentioned in the Gazette issued on 18 April 2022.

By Eunice Ruth