Is there a long-term future for masks in Australia?

Anastasia Tsirtsakis

29/07/2020 3:42:41 PM

It has been said that social distancing will be part of our lives for the duration of the pandemic. Could that also be true of face coverings?

Crowd of people in masks
While buoyed by the idea that restrictions may be starting to take effect, experts have warned that masks should not lull people into a false sense of security.

Dr Vicki Kotsirilos, founding Chair of the RACGP Specific Interests Integrative Medicine network, certainly thinks masks are here to stay.
Victoria recorded 295 new coronavirus cases on Wednesday 29 July, a welcome downward trend that commenced on Tuesday following the state’s biggest single-day increase of 532 infections on Monday.
While it is reassuring that measures in place may be starting to prove effective, Dr Kotsirilos believes people should not be lulled into a false sense of security.
‘Even though this is a positive sign that we’re on the down – it’s a sign that people in the community are putting in a lot of effort – the current restrictions and wearing masks should continue even when the numbers are extremely low to avoid a third spike,’ she said.
‘Studies have actually shown that if both people [near each other] are wearing masks, the risk of COVID transmission is drastically reduced. So it’s a really important strategy with not only physical distancing and hand hygiene, to also have masks.’
Since residents of Metropolitan Melbourne and the Mitchell Shire returned to stage three restriction three weeks ago, there has been growing concern about the economic impacts, and how long the measures can be sustained.
Could masks hold the answer to a return to ‘normal’?
Dr Kotsirilos says that is unlikely.
‘Masks alone can’t be the answer,’ she said.
‘Unfortunately it does require everything else as well: physical distancing, hand-washing.’
Australia’s Deputy Chief Medical Officer Professor Michael Kidd echoed this in an opinion piece on Tuesday, emphasising that while masks play a ‘significant role’ in preventing spread, they are an ‘additional measure’.
‘Physical distancing is still the most effective way we have to stop COVID-19 from spreading – even among people wearing masks,’ he wrote.
‘And the wearing of a mask doesn’t mean you can stop practising good hand hygiene.’
As clusters emerge in NSW – 19 new cases were recorded on Wednesday – both Professor Kidd and NSW Premier Gladys Berejiklian have encouraged those in areas with coronavirus outbreaks to wear a mask, particularly where adhering to the 1.5 m social distancing rule is not possible.
Premier Berejiklian said that social distancing ‘will be part of our lives for the duration of the pandemic’.
Dr Kotsirilos believes this is also true of masks – a cultural change that will require people to adapt.
‘I see this infection being with us for quite some time, and so masks will be considered long term,’ she said.
‘So I think the easiest way to cope with the changes is to adapt, not to resist.
‘And for us to all adapt to these changes, we need to find other ways to cope and reduce our stress levels through exercise, through social media to stay connected with other people, and wearing masks routinely now.’

But, in the interim, Dr Kotsirilos does have concerns about the effectiveness of masks when not fitted properly.
‘If we look at the community, not everybody’s wearing masks properly,’ she said.
‘Some of them have underneath their noses out, you have joggers and cyclists not wearing masks because they’re exempt. I actually find that particular advice inappropriate because they are breathing quite deeply. If they’re harboring the virus, they’re actually still spreading the virus.’

Australia’s Deputy Chief Medical Officer Professor Michael Kidd said that that while masks play a ‘significant role’ in preventing the spread of coronavirus, they are an ‘additional measure’. (Image: AAP)
Professor Kidd reinforced the message that while wearing a mask, it should be covering a person’s mouth and nose, and outlined clear instructions. 
‘The person wearing it also needs to avoid the temptation to touch the mask while it is being worn,’ he said.
‘Before someone puts on a mask, and after taking a mask off, they should wash or sanitise their hands.
‘Single-use masks can generally be worn for up to four hours before they have to be replaced – and such masks should be disposed of properly in a bin.
‘Cloth masks made of three layers of cotton can be reused, but must be thoroughly washed and dried – at least daily.’
As the community adjusts, Dr Kotsirilos says GPs play a central role when it comes to educating the community and individual patients.  
‘It’s a good opportunity in a face-to-face consultation to check if they are using the mask perfectly, and to ask how if they are feeling comfortable and talking to them about different options,’ she said.
‘If people find tight-fitting masks uncomfortable, there are alternative, loose-style masks that are available. All you need is a barrier, a physical barrier between yourself and other people.’

As of Wednesday 29 July, participants of the National Disability Insurance Scheme (NDIS) in Victoria and NSW will be able to claim the cost of personal protective equipment (PPE), including masks, worn while with support workers. Providers allowing workers to continue delivering essential disability supports to NDIS participants can also claim their PPE.
Participants living in their own home who test positive for COVID-19 and are required to self-isolate will be able to claim related cleaning costs.
‘It’s important none of us get complacent,’ Federal NDIS Minister Stuart Robert said.
‘These measures ensure everyone’s able to do their bit, and follow the public health guidelines while
minimising the risk of spread and protecting each other from the virus.’
Recognising the impact such rapid change can have on people, Dr Kotsirilos also it is important for GPs to continue to check in on patients’ physical and mental wellbeing.
‘At the start of the conversation, it’s actually a really good time to ask an open-ended question: “How are you coping with the pandemic?”’ she said.
‘And there may be a lot of patients who say, “Yes, I’m doing really well”. But for others it’s the opportunity to open the conversation about any difficulties they’re experiencing at home, like family violence, like alcohol consumption – which has actually gone up.
‘Talking about when it’s safe to go out, like for exercise, and to maintain exercise. Because if it’s going to be with us for a long time, it’s important to maintain a healthy lifestyle.’
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Dr William Lancashire   30/07/2020 9:32:13 AM

No. Masks should not be mandatory. The advice from the federal government is wise and considered. And the GPs who are not infectious disease specialists or epidemiologists and are leaping onto social media with out any consideration of the consequences of their actions onto an already anxious and frightened public should be very aware of their own hubris!

Dr Ian Mark Light   30/07/2020 10:07:48 AM

I would add fresh air flow as a vital means of drastic reduction in spread .
The spread in meat works aged care homes family gatherings and the towers exemplifies the threat of crowded indoor spaces .
Outdoors if the air is fresh is far less dangerous .
It’s masks or head visors for those who hate masks physical distancing hand and surface cleaning and fresh air flow .

A.Prof Vicki Kotsirilos, AM   30/07/2020 6:41:40 PM

In response to Dr Lancashire statement - "No. Masks should not be mandatory."
In Victoria according to federal and state Government advice, it is mandatory to wear masks due to 2nd wave of COVID. Please note in the article it states
"Since residents of Metropolitan Melbourne and the Mitchell Shire returned to stage three restriction three weeks ago, there has been growing concern about the economic impacts, and how long the measures can be sustained."
I am sorry it was not made clear, but the mandatory use of masks was referring to these areas although with today's COVID figures in Victoria exceeding 700, the mandatory use of masks has now extended to rural areas.
As GPs we are experts to advise our patients, based on Government advice - and to check they are using masks appropriately to ensure they are safe and well. Incidentally I was a senior lecturer & adjunct with the Dept of Epidemiology with Monash University.