Higher-quality masks could be one of our most important lines of defence against omicron – particularly as officials have said further lockdowns are unlikely. So why hasn’t the government updated advice around which masks offer the best protection or ensured we have access to them?
At this point in the pandemic, there’s consensus that Covid-19 is an airborne virus. That means, for the most part, it spreads from an infected person’s breath – in some cases travelling metres – through aerosols and liquid microdroplets. Because of this, masks are one of the most significant tools to protect ourselves and each other from catching the virus.
As much of the world is overwhelmed with cases of the newer omicron variant, and increasing numbers of cases are detected at our border, the threat of an outbreak here looms ever nearer. The spread of omicron has been so rapid because of its extreme transmissibility.
“We’re dealing with the most transmissible variant we’ve seen yet,” says Joel Rindelaub, a research fellow at the University of Auckland. Omicron, he says “is almost like the pinnacle of transmissibility as far as aerosol transmission is concerned”.
So with that in mind, “it’s very important to have the best protection available”, he says. While any face covering is better than nothing, experience overseas has made it very clear: some masks are much better than others.
Despite this, the New Zealand government hasn’t updated advice around which types of masks offer the most effective protection, nor has it ensured we have access to them.
That’s something epidemiologist Michael Baker says needs to change – and quickly.
“At the moment, I think our settings are very crude and I think most people are quite confused about when to wear masks and so on,” he says.
There needs to be practical advice for the public around which masks are most effective and a “dedicated effort going into working out what is the best evidence-informed approach we can have”, Baker says.
Chloe Ann-King, founder of hospitality union Raise the Bar, agrees that there needs to be clearer and updated guidance, especially for people in high-risk workplaces like hospitality. “There could be a lot more specific guidance around masks,” she says. Especially, she adds, “when we know what’s happened to workers in our industry overseas as a result of omicron”.
We’ve mandated face coverings in Aotearoa in certain business settings and on different forms of transport. But our official guidance offers very little advice when it comes to the varying effectiveness of different kinds of masks. The laws and advice dictate the use of “face coverings”, rather than “face masks”. On the official Covid-19 website, the government only distinguishes between “single-use face coverings” and “fabric reusable face coverings”. There’s no mention of the more effective N95, P2 or FFP2 types of masks.
Respirator masks must meet minimum standards, and these certifications vary depending which country you’re in. FFP2 is the UK version, Korea’s is KF94, in China it’s KN95, the US standard is N95, and in Australia and New Zealand it’s P2. Both Rindelaub and Baker agree that N95 and P2 masks offer the best protection, and they’re available at some hardware stores and pharmacies.
There are two main reasons why respirator masks are so effective. The first is that they’re made from a special material consisting of a web of tiny fibres charged with electrostatic energy that attracts and intercepts foreign particles. These types of mask are also designed to achieve a very close facial fit. When fitted properly, they should form a secure seal around the nose and mouth – a characteristic that differentiates them from the vast majority of fabric and surgical masks.
Despite their reputation for being single-use, respirator masks can in fact be reused after hanging them up in the sun for a period. The inventor of the N95 mask, Peter Tsai, has recommended buying seven of the masks and rotating them daily, so that virus particles have time to become inactivated over the week.
Baker says the “fabric mask is a bit of a leftover from when there was a real supply shortage and people were worried about there being enough masks for healthcare workers”. Now, he says, “we’ve got over that supply problem”.
Baker believes the government needs to ensure there’s a good supply of high-quality masks at a suitable standard, as well as set clear guidelines and rules that support using masks in the right places at the right times. That might mean using cloth masks in lower-risk outdoor settings and respirator styles when grocery shopping or in the workplace.
But these higher-quality masks also tend to come with a higher price tag, so “equity is of huge concern”, says Baker. He reckons there needs to be serious consideration around accessibility by the government. That’s echoed by Ann-King who says the cost could be a “huge barrier” for “workers in low-waged industries”.
We’re fortunate enough to learn from overseas experience with omicron. Governments in various countries have begun advising the public to opt for varieties of masks like N95, FFP and P2. Germany has mandated filtered masks on public transport. In the US, the White House has announced it will be distributing “high quality” masks to people across the country. In some US states, free respirator masks are being dispensed from libraries and community centres after the CDC (Centers for Disease Control and Prevention) advice was updated last week to tell people to wear medical grade masks like N95 rather than fabric.
Asked about the current government advice on masks, a Ministry of Health spokesperson said the ministry “continually reviews the latest science, international and national evidence and advice on Covid-19 transmission and PPE in light of the omicron variant.
“Omicron was first detected in late November and we are still learning about the variant, including its impact on our current PPE guidance. It is important to note that in New Zealand’s context of low Covid-19 prevalence, we don’t always immediately adopt strategies or technologies used in other countries. ” The spokesperson added that P2 and N95 masks are used by “frontline staff who are exposed to potential or confirmed Coid-19 cases at the border and in healthcare settings”. As well, border and MIQ facility staff “must wear P2/N95 particulate respirators when in areas where they could or will be in contact with a returnee”.
“It’s great that there’s a very high uptake of mask use in this country,” says Rindelaub. But, he says, “what we’re seeing from overseas is that these cloth masks just probably won’t be enough in the face of omicron.
“We need to upgrade our mask use, as this variant has upgraded its transmissibility.”