WHO updates guidance on masks for health workers and the public - here's what you need to know

Jun 5, 2020

'Find, isolate, test and care' - WHO Director-General Tedros Adhanom Ghebreyesus Image: Reuters

Linda Lacina

Digital Editor, World Economic Forum

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COVID-19

World Health Organization held a media briefing on 5 June to update the public on the COVID-19 coronavirus pandemic.
WHO updates its mask guidance for health workers and the general population.

The World Health Organization (WHO) shared new guidance regarding mask wearing at today's coronavirus briefing for health workers and the general public based on a review of evolving evidence.

WHO officials stressed that the new advice is an update to previous guidance, and that masks should only ever be used as part of an overall comprehensive strategy. "The cornerstone of the response in every country must be to find, isolate, test and care for every case and to trace and quarantine every contact", said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

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What is the World Economic Forum doing about the coronavirus outbreak?

Responding to the COVID-19 pandemic requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.

Since its launch on 11 March, the Forum’s COVID Action Platform has brought together 1,667 stakeholders from 1,106 businesses and organizations to mitigate the risk and impact of the unprecedented global health emergency that is COVID-19.

The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.

As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.

Here's what has changed and what hasn't:

What's hasn't changed:

Those who are sick should wear a mask if they must go out. (Ideally, however, those who are sick should stay at home and those confirmed to have COVID-19 should be isolated and cared for in a health facility and their contacts quarantined).
Home caregivers should wear a mask to protect themselves and prevent further transmission.
Health workers should wear medical masks and use other protective equipment when dealing with suspected or confirmed COVID-19 patients.

What's new:

In areas with widespread transmission, the WHO advises medical masks for all people working in clinical areas of a health facility, not only workers dealing with patients with COVID-19. In other words, said the Director General, when doctors are doing a ward round on the cardiology or palliative care units where there are no confirmed COVID-19 patients, they should still wear a medical mask.
In areas with community transmission, the WHO now advises that members of the general public aged 60 and older and those with underlying conditions should wear a medical mask in situations where physical distancing is not possible.
The general public should wear non-medical masks where there is widespread transmission and when physical distancing is difficult, such as on public transport, in shops or in other confined or crowded environments.
Additionally, the WHO has released new guidance on cloth masks, recommending that they consist of at least three layers of different materials: an inner layer being an absorbent material like cotton, a middle layer of non-woven materials such as polypropylene (for the filter) and an outer layer, which is a non absorbent material such as a polyester or a polyester blend.

To develop the guidance, the agency consulted with a range of international experts from different countries and disciplines such as infectious diseases and epidemiology. Their review of a variety of evidence demonstrated some new findings, including that face protections, including respirators or medical masks, can result in a large reduction of transmission of coronaviruses, including COVID-19.

Recommendations, such as those regarding fabric masks, are the result of new research that the WHO commissioned that was not available a month ago. This new evidence, said Dr Maria Van Kerkhove, WHO Technical Lead, has shown that the recommended fabric combination "can actually provide a mechanistic barrier that if someone were infected with COVID-19, you can prevent those droplets from going through and infecting someone."

Officials acknowledged that in some countries with dense populations it is difficult, if not impossible, to maintain social distancing, making masks "very important," stressed Soumya Swaminathan, WHO Chief Scientist, and meaning that offices, transport agencies and schools will need to examine their recommendations closely as countries lift lockdown restrictions. "Every organization, industry and sector needs to think about what are the measures that need to be put in place," said Swaminathan.

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Throughout the COVID-19 crisis, mask guidance has varied by country, expert and organization. Some countries have recommended non-medical masks only for sick people, while other experts have advocated for non-medical mask use by healthy members of the general public when outside of their homes. Some countries, such as the Czech Republic and Slovakia, even made mask wearing mandatory.

The WHO had previously recommended against the wearing of medical masks by the general public given the global PPE shortage. It had been reluctant to advocate for wider usage of non-medical masks by healthy people given the lack of data available at the time.

Today, WHO officials reminded the public that masks still must be worn correctly, cared for and kept clean to ensure that they are effective. "People can infect themselves if they use contaminated hands to adjust a mask or repeatedly take it on or off," explained the Director-General.

"I cannot say this clearly enough," said the Director-General. "Masks alone will not protect you from COVID-19."

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