Mask wars are gaining momentum in Europe again, but they are different

Some states already require that people wear simple masks in public places, but better respirators to protect against the virus; Please understand, the 2020 recommendation that only a self-made cloth mask or even a scarf on the face is no longer appropriate.

However, many other countries, including the World Health Organization (WHO), continue to state that a cloth cover is sufficient.

Experts in favor of better protection argue that decision makers – governments – cannot, in principle, decide on which scientific arguments to base themselves.

Many politicians still question the benefits of masks, not everywhere they are mandatory, and in this case, these officials are not even inclined to discuss the type, price and availability of the masks.

Respirators are already mandatory in some places

There has been no shortage of mask storms since the start of the pandemic, when the WHO announced in March last year that healthy people are not required to wear them.

As early as April, the organization changed positions and began claiming that the masks were useful. European governments have embraced this recommendation and, sensing the lack of personal protective equipment, have even started to spread guidelines on how to make cloth masks themselves.

Since then, there has not been much debate, at least in Europe, unlike, for example, in the United States, about the use of masks in particular, although protests over the quarantine restrictions are still lacking.

However, now that the most contagious strains of coronavirus are spreading across Europe and are likely to lead to higher death rates, some countries (Germany, Austria, France and others) are tightening the rules. In some cases the mandatory use of FFP2 respirators has been introduced.

Such a procedure, mandatory respirators, was announced by the German state of Bavaria in January. The use of respirators in stores and on public transport was soon made mandatory throughout the country.

Austria joined its neighbor on January 25, with identical requirements. For their part, the French authorities have recommended not wearing self-made masks that do not meet certain criteria.

“Cloth or blue and white surgical masks prevent you from breathing out the virus to other people. But FFP2 respirators protect their users from inhaling the virus, ”explains Lawrence Young, a professor at Warwick School of Medicine in the UK.

However, many other European countries, including the WHO, are reluctant to change the rules that have been in place so far. WHO spokeswoman Maria Van Kerkhove says there is no evidence that the virus is transmitted in a different way than previously announced.

“The WHO has no plans to change its recommendation. The limited scientific data on masks in the community setting means that the use of higher-level masks is not recommended,” said Van Kerkhove.

Clinical or laboratory tests?

This statement is inaccurate, says Thomas Czypionka, director of the Health Economics and Policy Division at the Austrian Institute for Advanced Study.

Remember that many researchers believe that the only relevant evidence is the ‘gold standard’: randomized controlled clinical trials. Everything else is nothing.

“If this is the understanding of evidence-based medical science, and if it is said that there is no evidence for the effectiveness of masks, then it is known that it is concluded that masks are not recommended,” says Thipzypionka.

And he adds immediately: the point is that it was not possible to conduct clinical trials during the pandemic. Researchers from several countries have decided that, due to the potential risk of infection, it would be unethical to force one group of participants to wear masks and another not to wear them.

Instead, decision makers had to rely on observational studies based on laboratory data. Alone, as mentioned, this approach was not appropriate for some researchers evaluating only clinical trials.

Laboratory studies, however, show that wearing a mask significantly reduces the risk of inhaling the virus. Also, the higher the quality, the higher the quality of the mask or respirator.

“These scientists do not believe that the laboratory data is real scientific evidence,” said Julian Tang, a virologist at the University of Leicester in the United Kingdom.

However, according to this researcher, laboratory studies show that wearing a mask significantly reduces the risk of inhaling the virus. Also, the higher the quality of the mask or respirator, the greater the effectiveness.

Finally, recent findings from the US Centers for Disease Control and Prevention, based specifically on laboratory work, show that wearing two masks at the same time also significantly reduces the risk of infection.

“There are clinical trials, but their findings are unclear. Basically, the most important thing is that wearing a better mask when communicating with other people will really protect you, unless it is too uncomfortable,” emphasized J. Tang.

On the other hand, the Association of Schools of Public Health in the European region takes a different position. It states that the risk of infection is not taken into account in laboratory tests, making it impossible to formulate a definition of safe behavior.

And virologist Steven Van Gucht generally suggests remembering that most infections go unrecorded when people wear masks. According to him, close contacts and distance should be limited, not to mention cloth masks and respirators: “We have to talk about the real risks.”

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Another problem for governments is the lack of the necessary tools. When the pandemic broke out, masks were missing, which, according to Th.Sypyopka, complicated the publication of formal recommendations; many experts feared that the guidelines were not possible to implement.

Now there are no problems, but they could be repeated if millions of people one day had to buy a respirator.

Plus, FFP2 respirators still cost a lot. For example, at a pharmacy somewhere in the UK, a pack of five respirators costs £ 10 and a set of five surgical masks costs just £ 4.5.

It is not recommended to wash or use respirators or surgical masks more than once.

According to Claudia Pagliari, director of the World Health Center at the University of Edinburgh, in many parts of the world it is quite difficult to force people to wear simple masks, much less more expensive protection.

“If the WHO started saying that only those respirators work, the organization would basically recommend what only the rich can afford. I would send a message to others that you have to deal with what you have. It’s a very bad impression, isn’t it? ”Pagliari said.

Until now, at least the leadership of the Federal State of Bavaria in Germany continues to ensure that FFP2 respirators are needed. It is true that there are still problems; Let’s just say that beard lovers are furiously considering whether these respirators are effective if the dense beard cannot be pressed firmly against the face.