There is widespread pressure to call for cloth masks to be available publicly as a COVID-19 prevention strategy. The motivation for this is based partly on anecdotal evidence from other countries, from experimental studies suggesting airborne transmission of COVID-19, the concern that asymptomatic infection is a sizeable pathway, the possibility that it presents for community-based production of masks and from the sentiment that every measure possible should be mobilised to tackle COVID-19. At the same time, if dissemination of cloth masks lead to a false sense of security, impair other hygiene measures and reduce availability of surgical masks for health care workers, widespread use of cloth face masks in people not yet identified as sick, may have adverse effects.
But what is the evidence? The College of Public Health Medicine released a guidance document based on a rapid systematic review of the evidence. Essentially, we have no evidence to support cloth face-mask use widely in the community. But if face masks made from cloth are going to be introduced, the intervention cannot substitute or diminish maximum application of other hygiene measures – handwashing, cough etiquette, social distancing – all made applicable for all communities. Cloth masks must NOT be used as Personal Protective Equipment (PPE) for Health Care Workers. Medical Masks and N95 respirators must be reserved for particular categories, viz. health care workers, frontline workers, persons tested positive with COVID-19 and those caring for them.