Makerere don speaks on coronavirus masks

Dr Peter Waiswa, Associate Professor, Dept of Health Policy, Planning and Management

At the beginning of the outbreak in Uganda, I bought masks, one for each of my nuclear family.

Even now I travel with one in my pocket, and every day when I change trousers, I also change the mask to new pockets.

I also have a mask in my car, which car, for now, I don’t drive due to the lockdown. But, as of now, because I am social distancing as much as I can, I have not yet even tried on my mask.

Two weeks ago, I had a discussion with one of my senior professor colleagues – a very senior infectious diseases guru.

Victoria University

He had all kinds of masks, but did say they are useless in infection prevention for the general public, but they are useful to patients to prevent spreading infection, and to health workers, to protect them from acquiring infections. Being a senior, I respected his opinion.

It is generally agreed that the novel coronavirus is acquired through touching our “wet” surfaces (read mucosa in science) in our faces– that is eyes, nose and mouth; or through breathing-in air infected with droplets from infected persons. Until recently, scientists claimed that the virus only rests on surfaces but not in the air. However, new evidence shows that the virus can be suspended in the air, and is even spread through talking, coughing, yawning and of course sneezing (CNN 02/04/2020). A study in the US suggests that coughs can reach 6m and sneezes up to 8m. The BBC (02/04/2020) reports that “Researchers at the Massachusetts Institute of Technology (MIT) in Cambridge, US, used high-speed cameras and other sensors to assess precisely what happens after a cough or sneeze.

They found that an exhalation generates a small fast-moving cloud of gas that can contain droplets of liquid of varying sizes – and that the smallest of these can be carried in the cloud over long distances”.

One major review of available published work (called a Cochrane Review) found strong evidence during the 2003 SARS epidemic in support of wearing masks.

A community transmission study in Beijing, China found that “consistently wearing a mask in public was associated with a 70% reduction in the risk of catching SARS.”

So, with the above, and back to the question – should the public in Uganda wear a mask or not to prevent the novel coronavirus infection? My take is that it depends.

In the current circumstances if you are in a crowded area like a market or in a hospital or indoors in poorly ventilated rooms with many people do wear a mask reduce the risks.

The quality of mask matters. Most homemade masks are known not to stop the virus, and even a quality one if defective, wet or contaminated is not helpful.

If used, it is recommended that facemasks must be worn correctly, changed frequently, removed properly, disposed of safely and used in combination with good universal hygiene behaviour in order for them to be effective. I am aware that soon local manufacture and selling of masks will happening soon by one of our textile factories. It is my recommendation that they must first be put to the test by relevant authorities before they are made accessible to the public. The same should apply to imported ones.

Keep safe, wash hands frequently with soap and water, do not touch your face with unclean hands, social distance even from loved ones, and stay home, stay safe.

Dr Peter Waiswa, Associate Professor, Dept of Health Policy, Planning and Management



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