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Toby Morris
Toby Morris

SocietyApril 6, 2020

Siouxsie Wiles & Toby Morris: Should we all be wearing face masks to prevent Covid-19 spread?

Toby Morris
Toby Morris

The face mask question is more complicated than it might at first seem, explains Siouxsie Wiles.


The Spinoff’s coverage of the Covid-19 crisis is only possible because of the support of members. If you can, please consider joining Spinoff Members here. Read Toby Morris’s new Side Eye comic, created with Siouxsie Wiles, here. And more of Siouxsie’s writing here.


Maybe you’ve seen the graph that says those countries where everyone wears a mask are the ones that have managed to keep Covid-19 under control? The first thing to say about that claim is that those countries also did lots of other things, too – they acted fast, with intense testing, contact tracing and quarantine.

The reality is, when it comes to wearing a face mask there are pros and cons that differ depending on where in the world you are. I’ll get to these shortly. But this is a complicated one. Even the experts can’t agree on whether everyone should be wearing one. That’s raised accusations of racism as well as given life to several conspiracy theories. Face masks have become such a heated topic over the last few weeks that I’ve personally been harassed and threatened over it.

Until now, the WHO has recommended that if you are healthy, you need only to wear a mask if you are taking care of a person with suspected Covid-19. They also recommend wearing a mask if you are coughing or sneezing. The WHO has now convened a group to review new evidence to see whether or not they should update those recommendations. Which is the right thing to do.

The different kinds of face masks

There are lots of different types of face masks. The three you have probably heard mentioned are N95 respirators, surgical masks, and cloth or home-made masks.

N95s are designed to protect the wearer from breathing in or swallowing droplets and very small particles – like bacteria and viruses. To work, N95s need to form a tight seal around your face. That means first having a “fit test” to ensure the mask forms a proper seal. If you’ve a beard, forget it. Because N95s are designed to form a tight seal they can become very uncomfortable as heat and humidity build up. As with all masks, people need training to put them on and off without contaminating themselves or the mask. Importantly, N95s are needed by healthcare workers who are caring for people with Covid-19 and have the biggest risk of getting infected. They form one part of their PPE – personal protective equipment.

Surgical masks are disposable, loose-fitting face masks that cover your nose, mouth and chin. They’re mainly used to protect the wearer from sprays and splashes, or to stop the wearer from spreading their respiratory secretions to others – like a patient during surgery. Cloth masks are homemade versions of surgical masks made out of whatever you have to hand.

Will surgical and cloth masks help stop the spread of Covid-19?

Because of what they are made of and how they fit, surgical and cloth masks are unlikely to stop you catching Covid-19. But the question everyone is asking is: do they play a role in stopping the spread of the virus? The prevention of spread has become especially important as understanding of how the virus transmits has changed.

At first it was thought the virus was spread through droplets from people with symptoms. Now it’s understood that people can shed the virus even before they have symptoms. And some people may shed the virus without ever developing symptoms. Precisely how many people do this isn’t known. There is now also a worry that people can spread the virus through talking and singing.

This is why physical distancing is so important and why the distance we need to stay away from other people has changed. First it was one metre. Now it’s two. A new study might see that revised again. Dr Lydia Bourouiba is an associate professor at the Massachusetts Institute of Technology in the US. She runs the very appropriately named Fluid Dynamics of Disease Transmission Laboratory and used a high-speed camera to film a healthy person coughing and sneezing. Some of the droplets from a vigorous sneeze travelled as far as seven or eight metres. So, if you are someone who fancies having a glass of wine with neighbours from two metres away, don’t. Do it online instead.

But back to the original question: can masks play a role in stopping the spread of Covid-19? It’s too early for studies yet about this particular coronavirus but a study on influenza has just been published in the journal Emerging Infectious Diseases. The authors looked at the data from the 10 randomised controlled trials and showed overall, wearing surgical masks didn’t do anything to reduce the spread of influenza.

On the other hand, an analysis of SARS trials, which is caused by a related coronavirus, did show some effect. Overall, one infection was prevented for every six people who wore a surgical mask. That said, hand-washing was much more effective. But it doesn’t mean we can’t do both, right?

In the last few days, another study has just been published that looked at whether surgical face masks could prevent transmission of human coronaviruses (though not Covid-19) and influenza viruses from people with symptoms. They collected the breath of 123 people who they knew had influenza (43 people) or the rhinoviruses (54 people) and coronaviruses (17 people) that cause the common cold. Some of these people were randomly allocated to wear a face mask when the researchers collected their breath. The rest didn’t wear a mask. The researchers then looked for viruses in everyone’s exhaled breath. The first thing to note is that the number of people in the study is small. With that in mind, they were only able to detect coronavirus from roughly four out of 10 people when they weren’t wearing a surgical face mask. If the Covid-19 coronavirus behaves in a similar way, then this study suggests not everyone will be shedding virus every time they breathe out. But the even better news is that they weren’t able to detect any virus when people were wearing a surgical mask.

Why I’ve been reluctant to recommend masks for everyone – at least here in New Zealand

Quite a few reasons. A bit like what happened with hand sanitiser, I was really concerned that if everyone rushed out to buy face masks then those who really needed them would go without. I was also really worried that people would feel a false sense of security and then not do all the things that will help protect them and others from Covid-19. And every time I’ve gone to the supermarket I’ve seen evidence of this.

One of the reasons you’ll see advice about mask wearing changing is partly because new evidence is coming to light, like the studies I’ve mentioned. But it’s also because there are many places where the virus is spreading exponentially, and many people are still going about their business. In this scenario, the more people who wear masks, the more likely those who are infected but don’t know it will be wearing one. And that will help capture at least some virus-laden droplets which should help reduce transmission. In other words, the pros vastly outweigh the cons.

So, if you are living in a place with widespread community transmission of Covid-19, please wear a mask. And if you are living in New Zealand, where we are all in our bubbles and aren’t seeing exponential spread of the virus? Then check out one of the excellent tutorials on making your own face mask and wear it when you go out to the supermarket or to access other essential services. That way you’ll be protecting our essential workers.

But promise me this. That’ll you’ll wash your hands before you put your mask on, and then again once you’ve got it on. That you won’t touch it while you are wearing it. And, if you do, you’ll immediately wash your hands. That you will wash it after every use and allow it to dry properly before using it again. And that you’ll keep up with regular hand-washing and physical distancing.

Keep going!
High angle view of female entrepreneur concentrating on work while daughter playing at home office

SocietyApril 6, 2020

How to work from home without wrecking your back

High angle view of female entrepreneur concentrating on work while daughter playing at home office

Alex Casey talks to a physiotherapist about how we can all save our necks and backs from a world of pain while working from home during the lockdown. 

As we enter another week of lockdown, you might be starting to feel a new twinge at the nape of your neck, or a growing ache in your lower back. Working from home creates a whole new range of challenges and distractions, especially in the middle of a global crisis, and one of the last things on the priority list for many is taking care of your poor old posture. 

Because it’s too late to drive to the mall to buy a posh standing desk, or march into the physio and plop yourself down on the table to have a whinge, I called Caitlin Day, physiotherapist and owner of Unity Studios, for some tips on how we can avoid wrecking our backs in our home offices.

1. No working from the couch or bed

It may seem like delicious lockdown treat to work from the comforts of your bed, but do not be lured in by the siren calls of your duvet and pillows. “The couch or your bed is actually the worst place that you could spend a significant amount of time sitting in because they are ergonomically designed to make you slouch,” says Day. “It’s really tempting, because they are comfortable for the short term, but don’t do it.” 

2. Stick to what you know

Your set-up at home should be a similar configuration to whatever you have at work, whether it is a standing desk or a ye olde sitting desk. “My suggestion would be that if you don’t have an office desk but you have a dining table and chairs, use that,” says Day. “If you are using a laptop, get a separate keyboard and a mouse and prop the laptop up on a couple of books to make it eye level. That aligns your head to be looking straight forward as opposed to slouching down.” 

This is not a standing desk

3. Take a stand (for your posture)

If you prefer to stand while you work, you can recreate a standing desk using a pile of books on a kitchen bench or even atop a humble ironing board. “Anything that is waist or hip height and can handle a computer set up should work,” says Day. 

4. Work with what you’ve got

If you missed your window of opportunity to rush out and panic buy a bunch of ergonomic whatchamacallits, fear not! The humble bath towel is here to help. “Roll it up like a sausage, shove your bottom right back in the chair and shove the towel right down along the belt line between the chair and the back,” suggests Day. “That’s essentially a lumbar roll which will support your lower back and help you to sit a little bit taller in your chair.” 

5. Move your body, every every body

Day reckons that sitting is the new smoking and “motion is lotion”, which seems a bit Buffalo Bill-esque, but I guess he did love to dance. “Even if you have a good set-up, it is still not recommended to sit for longer than 30 minutes. Our spines love to move – that’s why there’s such a high rate of back and neck pain in office workers.” She suggests setting a timer on your phone to go off every 30 minutes, and taking that time to stand-up, stretch, do a little dance etc. 

6. Find your angles

If you are plopped in a chair right now, take a moment to think about the angles of your hips and knees. “Ideally you want a 90 degree bend in your hips and a 90 degree bend in your knees,” says Day. “If you can, prop your feet up with books underneath them or sit on something like a cushion on the chair if you need to make it a bit higher.” 

Correct dog, incorrect knee angle

7. Stretch, stretch, stretch

The key hot spots you are going to want to stretch are the hip flexors, the neck and the lower back, says Day. “Usually with back pain, exercises need to be individualised because people often need to work on different things, but there are YouTube videos to work on all of those areas in the meantime, and they are pretty easy to get the hang of.” 

8. Don’t burn your bra… for now

As bra-wearers across the country fling their boob cages off, ready to enjoy four weeks of free-boobing bliss, Day issues a warning: “Look, I’m all about freeing the boobs, but if you’ve got particularly big ones you might want to keep wearing your bra, because they can bring your centre of gravity forward and make you slouch again.” 

9. Take up yoga and/or pilates

If you have found yourself less active, or have less access to the ways you like to exercise, Day recommends getting into pilates or yoga through an online class, a service which she offers from her studio. “There is a lot of research to suggest that pilates and yoga is exactly what people with back pain need, because its a combination of core strengthening and stretching. If you are feeling sore, I’d say you should get into pilates or yoga sooner rather than later.”

10. Don’t try to fix it yourself

Whatever you do, don’t enlist the help of some well-meaning person in your bubble to crack you back. “I would strongly advise against that, because if something does go terribly wrong, the last thing the health system needs right now is more people filling up the hospital beds,” Day warns. Physiotherapists are still available for consults via video – don’t take the risk just because your flatmate likes to walk along people’s spines for a laugh.

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