Mask mystery: Why are U.S. officials dismissive of protective covering?

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In recent weeks, facing public uncertainty about coronavirus and a severe domestic shortage of medical-grade face masks, top Trump administration officials offered adamant warnings against widespread use of masks, going so far as to argue that members of the general public were more likely to catch the virus if they used them.

“You can increase your risk of getting it by wearing a mask if you are not a health care provider,” Surgeon General Jerome Adams said during an appearance on “Fox & Friends” earlier this month.

“If it’s not fitted right you’re going to fumble with it,” warned Health and Human Services Secretary Alex Azar late last month, when asked about N95 respirator masks.


“Right now, in the United States, people should not be walking around with masks,” said Dr. Anthony Fauci, an immunologist and a public face of the White House Coronavirus Task Force, on CBS’ “60 Minutes” earlier this month. He, like the others, suggested that masks could put users at risk by causing them to touch their face more often.

But as the crisis has played out around the world and intensified in parts of the U.S., reasons have emerged to doubt the wisdom of this guidance, which ranks among the most forceful warnings against mask use by national health authorities anywhere and does not differentiate between medical-grade masks and simple cloth coverings. A number of societies where mask use is more widespread, and where mask shortages have been less severe, seem to have had more success containing the virus. Now, some health experts, who say there is no evidence for the claim that masks increase users’ risk of catching the virus, are calling for more widespread use of face coverings in the U.S.

“Guidance needs to change and needs to be clear that these nonmedical, nonsurgical masks are beneficial to the general public and should be worn when outside of the home,” said Robert Hecht, a professor of epidemiology at the Yale School of Public Health.

The increasing calls for more use of masks raise the question of whether authorities’ recommendations were based on genuine concerns about spreading Covid-19 or instead motivated by a desire to prevent a run on limited supplies of masks: “Seriously people — STOP BUYING MASKS!” tweeted Adams in late February. “They are NOT effective in preventing general public from catching #Coronavirus but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

Katie Miller, a spokeswoman for Vice President Mike Pence, who chairs the White House Coronavirus Task Force, referred questions to HHS. Neither the surgeon general’s office nor the HHS press office responded to emails or phone calls requesting comment.

In response to emails requesting comment from Fauci, Elizabeth Deatrick, a spokeswoman for the National Institutes of Health, referred questions to the Centers for Disease Control and Prevention.

“At this moment, there are no updates or anticipated changes to the guidance,” said Arleen Purcell, a spokeswoman for the CDC, who reiterated existing CDC guidelines that patients with symptoms should wear masks but that people who are well should not wear the masks to prevent contracting the virus. Unlike the verbal warnings from top health officials, the CDC’s written guidance does not suggest that wearing a mask could increase the risk of catching the virus.

Purcell did not address questions about the assertion that masks could increase users’ risk of catching the virus or whether the CDC was studying coronavirus responses in other parts of the world where face mask use had been more widespread.

Asked on Monday afternoon about suggestions that mask-wearing could prevent transmissions, President Donald Trump offered a noncommittal response. “We haven’t discussed it, but we could. We are getting the number of masks you need,” he said. “We will take a look at it.” Trump also suggested that wearing masks might be a way to help people get back to work. “We are not going to be wearing masks forever, but it could be for a short period of time after we get back in gear.”

The current federal guidance against wearing masks is at odds with that issued in many other parts of the world, such as the Czech Republic, Beijing and Shanghai, where mask use has been mandated for anyone going out in public. A number of East Asian societies, where mask use is widespread — such as South Korea, Hong Kong and Singapore — have reported lower levels of infection than the U.S. has, despite being closer to the source of the outbreak in Wuhan, China. In Taiwan, where reported levels of infection are also relatively low, authorities have called for people to use face masks whenever they are in enclosed spaces, such as public transportation.

Some Western authorities and public health experts have also begun calling for more widespread use of face masks. On Monday, the government of Austria mandated the use of face masks for anyone entering a supermarket.

Days earlier, the German Medical Association, that country’s umbrella organization for doctors, issued new guidance on Thursday urging citizens to find a simple fabric mask or make one themselves, and to wear it in public — while forgoing medical-grade masks.

A group of mostly UK researchers, publishing in the Lancet, a top peer-reviewed medical journal, on March 20, recommended that “vulnerable populations, such as older adults and those with underlying medical conditions, should wear face masks if available. Universal use of face masks could be considered if supplies permit.”


As of Monday, federal authorities were not budging. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center in Tennessee, said CDC experts were “very loath” to issue recommendations that were not based on robust data.


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