Editor’s note: On April 3, Gov. Tom Wolf asked that all Pennsylvanians wear face masks when leaving home. Later on Friday afternoon, President Donald Trump shared new CDC guidance recommending cloth masks in public for everyone.

The state and CDC says surgical masks and N95 respirator masks should still be reserved for healthcare workers or patients in healthcare settings. Homemade masks, paper masks or even bandanas and scarves can be used by the general public in addition to social distancing. Cloth masks should be washed after each use.

Guidance around wearing face masks during the COVID-19 pandemic is getting murkier by the day.

From the start, the Centers for Disease Control and Prevention [CDC] and the World Health Organization have recommended that face masks only be worn by those who are sick or caring for someone who is sick. “Seriously people- STOP BUYING MASKS!” U.S. Surgeon General Jerome Adams tweeted on Feb. 29.

Yet while Western authorities warned against face masks for the general population, many Asian nations did the opposite. The Chinese Center for Disease Control recommends face masks be worn when out in public; South Korea has been vigorously stocking its pharmacies with masks; and, since early February, Taiwan has rationed its mask sales to two per person each week. 

According to recent reports, the American government’s official position could soon change. The CDC is considering altering its guidance to encourage the general public to wear face masks, the Washington Post reported on Monday. And Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Tuesday that the White House coronavirus task force is seriously considering adopting similar guidance, according to Politico, as long as doing so wouldn’t take resources away from medical professionals.

In an effort to get to the bottom of the issue, PublicSource sought to curate additional feedback from four local experts on the question: Should all Pennsylvanians start wearing face masks? The main takeaways: save medical-grade masks for healthcare workers. If you do choose to wear a mask, make sure to wear it properly and diligently continue other mitigation efforts, like hand-washing and strict social distancing. 

Dr. Amesh Adalja, a Pittsburgh-based infectious disease expert

“There’s no strong evidence that [masks are] effective for the general public at this time,” said Adalja, also a senior scholar at the Johns Hopkins University Center for Health Security.

He brought up three main concerns with having the public wear masks:

  • An increase in demand could take masks away from medical workers who need them most.
  • Wearing a mask could give people a false sense of security, leading them to not wash their hands as often or become more lax on social distancing.
  • People may use the masks improperly — such as by touching their face to adjust the mask or removing it by the unclean cloth part rather than the ear strings — making them more likely to spread or contract the virus.

“It’s not an obvious type of solution, and if there are benefits, there are also risks as well,” Adalja said. “Obviously, if you’re overtly sick, if you’ve got symptoms and you need to go out … you should wear a mask. But if you’ve got no symptoms, there’s no need to wear a mask.”

Dr. Rachel Levine, secretary of the Pennsylvania Department of Health

Levine said at Tuesday’s press conference that the department is discussing whether the general public should wear cloth face masks but does not yet have a specific recommendation. “We have not made a decision but we’re observing what the CDC is doing really carefully,” she said.

Levine explained that the person wearing a cloth mask protects others — not the other way around. “For cloth masks, my mask protects you, and your mask protects me,” she said. “If someone is potentially having very mild symptoms of COVID-19, if they wear a mask, it can prevent large droplets from being dispersed into the air,” helping to protect others from the virus.

Dr. Debra Bogen, director of the Allegheny County Health Department

In an ideal world during this pandemic, everyone would wear a mask, Bogen said in a press conference on Tuesday, but “if we did recommend masks for all, there wouldn’t be enough for our healthcare workers who need them.”

She said the public can wear homemade masks, noting that in some countries like the Czech Republic, doing so is now mandatory. 

“If you decide to wear a mask in public, it’s not about protecting you, but about protecting others in case you have it,” she said. Bogen said that according to some models, 40% to 50% of people with COVID-19 may not show symptoms but may still be able to transmit the disease to others. 

“For now, if people choose to wear a mask in public, please make sure you’re not touching your face or the mask, remember to take them on and off using the straps behind the ears, and remember to wash your hands,” she said.

Dr. Gavin Harris, an infectious disease and critical care physician fellow at UPMC

Harris echoed others’ sentiments to reserve medical-grade masks for those on the front lines. “I cannot emphasize enough that frontline medical workers and healthcare workers really should have priority at this time,” he said.

He said it is not yet known how effective surgical and cloth face masks are in preventing COVID-19. According to one 2013 study from the Society of Disaster Medicine and Public Health, surgical masks and homemade masks are both somewhat effective in preventing droplet transmission from the wearer, though homemade masks are significantly less so. “The conclusion of that study is that they should only be used as a last resort to protect droplet transmission,” he said.

Like Adalja, Harris warned that masks may provide a false sense of security. “Any benefit that we’re looking at is most likely modest,” he said, and must be combined with other mitigation efforts.

“In crises like these … good, sound clinical science is crucial for the public good,” he said. “I think that we need to be cautious that public opinion does not overrun proven science.”

Juliette Rihl is a reporter for PublicSource. She can be reached at juliette@publicsource.org.

PublicSource has a special page dedicated to our reporting on COVID-19 for the Pittsburgh region. See it here and sign up for our newsletter to stay informed. We hope you are following the news and, if your situation allows, social distancing guidelines.  Have a tip or an idea? Please email mila@publicsource.org.

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Juliette Rihl reports on criminal justice, public safety and mental health for PublicSource. Her 2020 series on how court debt impacts low-income Allegheny County residents prompted the county to join...