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Coronavirus pandemic
OpinionLetters

Letters | Coronavirus crisis: the people of Hong Kong need to know when face masks are a must

  • Studies have shown that the use of surgical masks gives some protection against respiratory virus infections even in household and community settings
  • The authorities should educate people in areas where there have been community outbreaks on correct surgical mask usage

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Masks on tram passengers in Causeway Bay on March 3. Photo: Martin Chan
Letters
As the world grapples with the Covid-19 pandemic, it is instructive to examine the experience of Hong Kong, which has only reported some 130 Covid-19 cases (as of March 13) despite proximity to the Chinese mainland. Many people in Hong Kong have adopted social distancing, attention to hand hygiene and universal surgical mask usage since the Lunar New Year. These measures have undoubtedly played a role in arresting widespread community transmission of Covid-19.
Hand hygiene and social distancing are widely promulgated globally, but surgical mask usage is still controversial. Several authorities, including the World Health Organisation, have advised against their use by the public. Arguments against surgical mask usage are often at odds with the scientific evidence.

A common claim is that surgical masks do not protect against respiratory viruses. This is not true. Several peer-reviewed studies in medical journals have found that correct and consistent use of surgical masks in household or community settings conferred a significant degree of protection against influenza, severe acute respiratory syndrome and other respiratory virus infections, especially when combined with hand hygiene.

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Another misconception is that surgical masks should only be worn by symptomatic individuals. In fact, surgical masks are effective when worn by both respiratory virus-infected persons and their contacts. Furthermore, it is well recognised that even asymptomatic Covid-19 patients can still be infectious to others, rendering this recommendation inapplicable to the current pandemic.

Like other respiratory viruses, Sars-CoV-2, the virus causing Covid-19, is largely transmitted by droplets from infected persons. Therefore, the scientific evidence in favour of mask use against other respiratory viruses is generalisable to Covid-19.

There are also calls for surgical masks to be reserved for health care workers in the face of a global shortage. Health care workers handling suspected or confirmed Covid-19 cases wear N95 respirators and not surgical masks. As a health care worker myself, I argue that the best way to help health care workers is to prevent a massive Covid-19 outbreak in Hong Kong, which would rapidly overwhelm our fragile public health care system.
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