On the masks the chaos is total: do you have to wear them? And if so, how and when? Each country, not to mention each region, has decided to go its own way. There are no joint indications, nor a single line that makes citizens understand what to do.
In Italy, although in some territories such as Lombardy and Tuscany theobligation to use masks, finding them remains a feat and many citizens - on the advice of the Regions themselves - try to make up for it as best they can, using scarves or foulards, on the usefulness of which yet another debate has opened.
The scientific world has also been divided on the usefulness of protective devices, which however, unlike politics, seems for the moment - oriented towards following the old guidelines: the masks must be used by the sick, by the family members who take care of them and by hospital workers. Then come all the others.
So let us try to do some clarity on the use of masks: how to wear them? When to wear them? Here are the risks, benefits, and tips.
DOES THE CORONAVIRUS CIRCULATE IN THE AIR?
A few days ago in Italy the news – highlighted by all the main newspapers in the country – concerning a new study by MIT (MIT) of Boston published in Jama on March 26th. According to the analysis of US researchers, the droplets emitted by a subject through a cough or a sneeze or simply by speaking can travel in the air for very large distances, even exceeding six or eight metres. Although the source is absolutely authoritative, it is a study whose validity will have to be confirmed by further and precise evaluations. Despite this, the news had a huge resonance and was immediately correlated with con the use of masks and with the need (still to be tested, we reiterate it) to have them used by the entire population to protect individuals and slow the spread of the coronavirus. To further expand the media coverage of the study has also contributed a statement released to the BBC from a WHO consultant, the infectious disease specialist, David Heymann:
"WHO is reopening the discussion by examining the new evidence to see if there should be a change in the way it advises the use of masks."
Source: Bcc
However, the president of the Istituto Superiore della Sanità, Silvio Brusaferro, intervened to appease spirits, who said during a press conference:
"We have no evidence to say that the virus is airborne. The data we have at an epidemiological level tell us that the main transmission routes are by droplets and by contact".
Brusaferro summed up the official position of the ISS, which can also be read on the Institute's official website, where more detailed information can be found:
“The pre-eminent mode of contagion to date is related to the transmission of the virus through droplets of saliva given off by infected people when coughing, sneezing or talking. This established mode of transmission is exhausted in about one meter of distance. Stay at home or, if you are forced to go out, observe a safe distance from other people. Studies are currently underway on the ability of viruses to attach themselves to fine particles in the air and thus be transported by the wind for large distances or remain suspended in the air but to date there is NO scientific evidence of the permanence of the new coronavirus in the air beyond the safety distances mentioned above under normal conditions, i.e. in the absence of systems that produce aerosols which, on the other hand, can be found in a hospital environment in the care of COVID-19 patients".
Source: National Institute of Health
MASKS: SHOULD WE WEAR THEM? WHO'S ANSWER
Several days have passed since the publication of the MIT study and during a meeting with the press, the director general of the World Health Organization, Tedros Adhamon Ghebreyesus on April 6 announced the new guidelines of the organization, but first he made a premise:
“It appears that some countries have recommended or are considering the use of both medical and non-medical masks for the entire population to prevent the spread of COVID-19. It must be said first of all medical masks are recommended for patients, carers and hospital staff. We know that globally the availability of these masks is in short supply and we are concerned that the mass use of medical masks by the general population could exacerbate their shortage and seriously endanger the healthcare workers who really need them. In some places, these shortcomings are putting health workers at serious risk."
Source: WHO
Based on these analyses, WHO has issued new recommendations which, however, are not too different from the previous ones:
"In health care facilities, WHO continues to recommend the use of medical masks, respirators and other personal protective equipment for health workers. In the community, we recommend the use of medical masks by people who are sick and are caring for a sick person at home."
Source: WHO
The WHO then analyzed particular cases, giving some concrete examples:
“The generalized use of masks must be taken into consideration by those countries in which other measures, such as washing hands or keeping distance, are more difficult to apply due to “water shortages or overcrowded conditions”.
Source: WHO
The WHO director stressed that the masks are not able, by themselves, to stop the ongoing pandemic. What can it do? The increase in swabs, the isolation of positive cases, the tracing of their contacts and above all the social distancing measures. Without forgetting the importance of washing your hands often, avoiding touching your face and coughing or sneezing into your elbow. Without these measures, even if you wear a mask, you risk being infected and to prolong the spread of the coronavirus for a long time to come.
Even those who have and wear them must respect the rules. Feeling safe and not respecting safety distances or hygiene guidelines just because you have a mask on would be a huge mistake.
MASKS: THE DECISIONS OF THE REGIONS
To date, some Italian regions, especially those in the North, have disseminated obligations, advice and recommendations on the use of masks. Everyone, as mentioned, went on his behalf. So let's try to understand the scenario:
- In Lombardia on April 5, the obligation to use masks when leaving the house came into force. Those who do not have them must cover their nose and mouth with scarves or foulards.
- In Toscana, President Enrico Rossi has issued an ordinance that will make the use of masks mandatory in public or private environments "within seven days" starting from 6 April and therefore by 13 April. The Municipalities will distribute the masks to all citizens free of charge. In total there will be 8,5 million disposable surgical masks available.
- In Veneto, Friuli Venezia Giulia and Valle d'Aosta, the use of masks is mandatory only inside commercial establishments (supermarkets, grocery stores, etc.)
- In Liguria and Emilia Romagna for the moment there is no imposition, but the Regions are moving to distribute masks to the entire population.
MASKS, BURIONI: "NECESSARY IN PHASE 2"
The current situation is therefore quite heterogeneous and subject to change. In fact, it must be taken into consideration that restrictions could be eased in the coming weeks. The obligation to stay at home will be effective until April 13 and, even if the arrival of ayet another extension, we need to prepare for the future. To the so-called phase 2, i.e. at the moment when we can go back out, but respecting certain stakes. "The data on the slowdown of the contagion are confirmed and the way in which the masks will have to be used in phase 2 of the containment is being evaluated", said the president of the ISS, Silvio Brusaferro on 3 April.
The virologist Roberto Burioni, professor at the Vita-Salute San Raffaele university, does not seem to have any doubts about what to do, who in an interview he gives to AdnKronos HealthSaid:
“Recommendations may change over time and vary as knowledge of this new virus increases. Now we know two things: it is a very contagious virus and surgical masks greatly hinder its spread. To tell us is a study published just yesterday on Nature Medicine. And this not only to protect ourselves but to protect others. So masks will be fundamental principals in the coming months. Because we don't know yet when we will be able to go out, but we hope as soon as possible. And we have to be ready."
Source: AdnKronos Health
MASKS: HOW TO WEAR THEM?
Anyone who decides to wear a mask must do it correctly, otherwise they risk nullifying any protective effort.
Based on WHO guidelines, on its website the Ministry of Health has provided some advice on how to wear masks:
“Here's how to do it: before putting on the mask, wash your hands with soap and water or an alcoholic solution. Cover your mouth and nose with the mask, making sure it fits snugly on your face. Avoid touching the mask while wearing it, if you touch it, wash your hands. When it becomes damp, replace it with a new one and do not reuse it; in fact they are disposable masks. Remove the mask by taking it from the elastic and do not touch the front of the mask; immediately throw it in a sealed bag and wash your hands.”
Source: Ministry of Health
Below is a video posted on YouTube by Agnese Collino, biologist and scientific supervisor of the Umberto Veronesi Foundation, which explains how to wear masks and gloves:
Below we propose a tutorial by Jerome Adams, US surgeon general, i.e. the executive chief of the United States Public Health Service Commissioned Corps and spokesman for public health issues within the federal government, who explains how to make yourself a mask in less than 1 minute. Obviously, in this case, we are talking about a device far from safety that can guarantee a surgical mask, Ffp2 or Ffp3, but which can make us feel a little safer when we are forced to leave the house.
SCARVES AND FOULARDS ARE THEY NEEDED?
The virologist Fabrizio Pregliasco explained to Corriere della Sera:
“Scarves and foulards are mainly used to limit the spread of droplets (droplets, ed.) from potentially asymptomatic people and therefore unknowingly contagious, but have a minimal filtering power for the wearer above all because they do not adhere well to the face as a mask can do".
Source: Corriere della Sera
In short, in the absence of a mask - as mentioned for DIY devices - scarves and foulards are better than nothing, also because they often represent a deterrent from touching your mouth and nose. Even in this case, however, everything becomes useless if the safety distance is not respected.
