As Victoria faces the prospect of a third week of double-digit new daily coronavirus infections, the question of whether face masks are an effective way to slow outbreaks has re-emerged.
In the early stages of the pandemic, Australian authorities had advised that their use was not necessary for most people, but it has emerged that new guidelines being developed could require Victorians to wear face coverings.
Experts say if recommendations change, it is because of time and new evidence.
"A lot has changed in six months. We’ve learnt a whole lot more about the virus and we’ve learnt a whole lot more about what to do to prevent infection," Hassan Vally, an associate professor in epidemiology at La Trobe University, told SBS News.
A healthcare worker conducts a COVID-19 test at a Coronavirus pop-up testing facility in Broadmeadows, Melbourne where cases have spiked. Source: AAP
"As our knowledge improves, the advice is changing and it’s going to continue to change - we’re learning as we’re going."
Distance is still the most effective barrier to stop droplets being transmitted between people, but masks "represent another barrier to infection", Professor Vally said.
"The advice on whether to wear a mask is also context-based, so it depends on how much virus you have circulating in the community."
"The WHO recommendations say if you have a lot of virus in the community then they’re pretty prescriptive or pretty clear that the advice is to wear a mask."
While the recent resurgence in Victoria is concerning, Professor Vally said it is a "middle-ground" in comparison to the community transmission seen in other countries.
Sao Paulo, Brazil, where COVID-19 case numbers are soaring. Source: EFE
"Everything is not straightforward, so I would say people should be making decisions based on their own circumstances," he said.
Countries have not only varied advice surrounding the use of face coverings, but even within some nations, such as the United States, guidelines vary greatly.
The necessity of masks is an "incredibly complex" subject, Professor Vally said, but what made the debate initially hard were two majors drivers.
"One was the uncertainty of how masks work in a community setting, the other driver was we didn’t think we had enough masks for the frontline health workers that needed masks," he said.
Mary-Louise McLaws, a professor of epidemiology, hospital infection and infectious diseases control at the University of New South Wales, agreed.
At the beginning of the coronavirus outbreak, epidemiologists were concerned that health professionals may not have had enough masks on the frontline. Source: AAP
Professor McLaws said that people need to accept there will be new information that will change public health policy.
“The one thing we need to learn during the pandemic is to be resilient. If we tell you something at the beginning of it, it’s a brand new disease and we’re learning - accept the fact that we’re learning,” she told SBS News.
Professor McLaws said that face masks could be adopted by the community to control the Victorian outbreak.
“We may start to see others start to wear it and it becomes a social norm," she said.
"I’m not suggesting that everyone outside of Victoria or Melbourne wears a mask, except for public transport where you can’t keep your distance and definitely in an aeroplane."
There is also a growing understanding of how effective cloth masks are, Professor McLaws said.
"The WHO has now put out a guide about the cloth masks needing to have three layers - the outer layer is water-resistant, the inner layer is a soft property that doesn’t irritate the skin, and the middle layer is a polyester that can act like a filter."
"We need to send a message that we don’t expect you to wear them in the street, but when you’re inside public transport or inside an office where you can’t keep your physical distancing, then yes."
Acting chief medical officer Paul Kelly said there had been no recent changes to the advice.
Deputy Chief Medical Officer Professor Paul Kelly said "In areas with increased risk of transmission, masks could be part of the solution in that setting.." Source: AAP
"I would reconfirm what I have said, and the Australian health protection committee guidance has said for some time, in general terms, masks are not needed in most circumstances for most people, most of the time," he said during his briefing on Wednesday.
"There are some times when masks can be part of a solution and one of those would be where there’s a large increase in community transmission and social distancing cannot be guaranteed.
"Victorian authorities I know are looking very closely at whether they need specific advice for people living in those hotspot areas. That would be consistent with the national approach. [In] hotspot areas, with increased risk of transmission, masks could be part of the solution in that setting."
People in Australia must stay at least 1.5 metres away from others. Check your state’s restrictions on gathering limits.
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