Ask the Pharmacist

Q) I can’t keep track of whether we are supposed to wear a mask or not. I seem to read very different recommendations. What are the current guidelines?

A) Many of us are getting used to seeing the odd individual wearing a mask when out in public but you should soon expect to see many more over the coming weeks. This is due to a new recommendation from Canada’s chief public health officer, Dr. Theresa Tam, who recently reversed course and stated that all Canadians should wear masks when they are in areas where they are likely to be close to others.

Prior to April 6th, the guidance given to the general public was that the donning of a mask was only necessary if you were providing care to someone who has Covid-19 or if you were exhibiting symptoms of Covid-19 (fever, cough, shortness of breath ….) and were around other people. As a matter of fact, in the official literature from Public Health Ontario, it is clearly stated that unless you have symptoms, it is NOT recommended that you wear a mask in public.

Even before mounting evidence showed that this recommendation was faulty, it was an odd one to make anyways given that the argument against the wearing of masks was specious at best. There were two main arguments behind the suggestion to not wear a mask.

1. It might give the wearer a false sense of security leading to them paying less attention to proven prevention strategies (frequent hand washing, not touching your face and maintaining social-distancing) all of which are more important interventions. There is indeed some logic to this but many health experts felt that with the right messaging Canadians would catch on that these masks did not come with any sort of guarantee.

2. With the massive shortage of both surgical and N-95 masks that we are currently experiencing, existing supplies should be saved for our front-line healthcare workers who are far more exposed than most of us. That rationale still rings true as too many of our doctors and nurses have to make existing supplies last far longer than normal. At times, they are reusing both masks and other personal protective equipment (PPE), thereby, putting them at an increased risk of contracting the corona virus. However, even though at this point all commercially manufactured masks should be reserved for our medical professionals, that does not mean that members of the public cannot improvise and come up with homemade solutions that would be better than nothing.

Before we go into some of the possible options that most of us can use as a make-shift mask, let’s explore the rationale behind the new recommendation that everyone in public should wear some type of mask.

One piece of evidence is that in general, countries with an entrenched culture of wearing a mask (China, South Korea, Japan…) have successfully controlled the rate and the extent of the spread within their borders, once they became aware of the threat. Other countries which are less inclined to wear masks such as the U.S. and Italy have seemed to fare substantially worse. It is impossible to attribute these differences entirely to the use of masks but it does bear consideration.

In addition to these observations, there have been a number of scientific studies over the years that support the role of masks in limiting the spread of infection. One such study was conducted in 2008 and found that in households with a respiratory illness, the donning of a mask produced an 80% reduced risk in contracting the virus.

While the data supporting the use of homemade masks is rather lacking, there are some experiments that indicate they can be of at least some help. They also don’t necessarily require sewing skills although those with a talent for it can use one of the many available patterns on the internet to come up with better fitting and less cumbersome options than the rest of us (this is a link from a health centre in the States with sewing instructions on how to make one).

There are an incredible number of options being tried and tested currently including maxi pads, diapers, vacuum-cleaner bags (which are apparently very effective but their stiffness and thickness made them unsuitable to be worn as a mask), tea-towels and scarves among others. The best solutions seem to involve using a soft cotton material, ideally with a bit of “stretch” such as a pillow case or a t-shirt. Ideally it should be worn over the mouth and nose in a duo (i.e. two) layer.

While most do not believe this will prevent the wearer from getting Covid 19 if they are coughed on, there is some felling that it will help contain their own “droplets” from getting on others as they breath or talk. This is critical since it is widely believed that a large amount of our current spread is coming from individuals who have contracted the virus but feel no symptoms and therefore do not know to self-isolate. The long and short of this is, if you’re going to the grocery store or the pharmacy (remember, those are the only two places that you could or should be going these days), it is a wise and socially responsible idea to concoct some sort of face covering no matter how silly you may feel it makes you look.

Ideally, both you and your neighbours will have more than a few more years to redeem your fashion reputation. For more information about this or any other health related questions, contact your pharmacist.