Australia is an outlier in not yet recommending or providing high-quality face coverings that provide filtration- respirators (N95/P2/KF94/FFP2) to the community. The Covid-19 virus is transmitted through breathing in small particles known as ‘aerosols’ that contain the virus. These small particles are produced by breathing, talking, and coughing, and they float and linger in the air like cigarette smoke. Unlike respirators where air is only breathed in through the mask material filtering the air, surgical masks do not seal around the face, so unfiltered air is breathed in via the gaps around the mask. Respirators, when sealed to face, are designed to filter out these small particles containing virus.
In September 2021, OzSAGE issued recommendations on community mask use. The Omicron variant is more transmissible than previous variants, and cloth or surgical masks may not be protective enough. Many countries have already changed their guidelines to recommend better protection. In the US, 400 million N95 respirators are being provided free to Americans.
Covid-19 is an airborne disease. It is therefore crucial that members of the community have the necessary respirators and information to know how to keep themselves safe from Covid-19. This is especially true in Australia because two doses of vaccine does not protect well against Omicron and the rates of third dose vaccination are low. Even three doses are not fully protective. Respirators are therefore a key part of a Ventilation and Vaccine-PLUS strategy. There is strong scientific evidence that respirators reduce transmission. Statements to the contrary are not based on evidence and mislead the public in making informed decisions about how to best protect themselves.
A Vaccines-Plus strategy is based upon layers of protection. Respirators are one of these layers that the general community can use to protect themselves. Soon almost every one of us will know a friend or family member who has become sick with Covid-19. But this outcome can be prevented if people are given respirators as one of the layers of control in Vaccines Plus. The WHO has stressed that Omicron is not mild and people should be actively protecting themselves from transmission.
Recommending the use of respirators in the community is not new. These high-quality masks have been previously recommended in community settings, for example during bushfire season, during the safe removal of asbestos by the general public, and to protect from legionella in soil and potting mix. Government bodies have produced simple and straight forward guidance for the community on the use of these high-quality masks in those settings. This needs to be urgently expanded to apply to protecting our communities from Covid-19.
We need to slow the spread of Omicron and other Covid-19 variants for many reasons including:
- To allow time to ensure children are fully vaccinated especially as schools are re-opening with primary school children only just receiving their first dose of the vaccine
- To allow time for adults to receive their boosters, including people with blood cancers and other immunocompromising diseases who are now recommended to have a fourth dose.
- To reduce the risk of adverse health outcomes including long COVID and death
- To protect vulnerable members of society and those serving the public in face-to-face roles
- To reduce pressure on the health and ambulance system, including the short staffing of care for people with disabilities
- To keep the economy functioning
- Respirators should be provided free to the community, with priority to provision for those with disabilities or in residential care.
- Government-led education campaigns are critical to help communities understand what to look for in a respirator and how to use them. Guidelines should be developed to assist the community to safely reuse their respirators.
- For those who cannot access a respirator, there is evidence that the fit of surgical masks can be dramatically improved by creating a type of seal: bracing, double masking, knot and tucking and toggles.
- Respirators are needed in schools. Where it is developmentally appropriate, all children in school should wear respirators. As fit is important, the use of appropriately sized respirators such as child-size KF94 respirators should be used instead of cloth or surgical masks. Respirators improve comfort and are more effective to protect the wearer and others around them. Education for parents on how to protect their children as they return to school is urgently needed.
The messaging around masks is very disjointed – many commentators are adding to this confusion by offering their own views which fly in the face of the evidence. Everyone needs to get the message that ‘Masks work’ and are a part of the solution to ending this pandemic.Prof Lisa Jackson Pulver Professor Public Health, Deputy Vice Chancellor Indigenous Strategy and Services, University of Sydney.
Cloth and surgical masks are leaky so they don’t offer as good protection as an N95/P2 respirator which are specifically designed to protect us from airborne hazards. We already use N95/P2 respirators in the community to protect us from the small particles in bushfire smoke for example, and they’re just as useful for Covid-19″Ms Kate Cole OAM Occupational Hygienist
With such high levels of community transmission people with disability, many who have other co-morbidities and receive support from multiple workers, are at significant risk yet respirators are only recommended for workers when they are supporting someone who is COVID-19 positive or a close contact themselves. While the Omicron is widely circulating respirators should be mandated at all times when workers are supporting people with disability. OzSAGE provides important guidance how to ensure they are most effective in the absence of professional fit testing.Professor Anne Kavanagh Chair of Disability and Health Disability and Health Unit | Melbourne School of Population and Global Health, Co-Director, NHMRC Centre of Research Excellence in Disability and Health
Australians including our children urgently need and deserve high quality masks especially as our children are heading back to school. We all need to do our part to help our community thrive during this pandemic.A/Prof Nada Hamad Sydney Haematologist
Respirators need to be used in workplaces during community transmission as part of layers of multiple controls, including safe indoor air ventilation improvements, to preserve the workforce and keep business functioning safely and effectively with less disruptionDr Karina Powers Occupational and Environmental Physician
COVID-19 is an airborne disease. It’s like cigarette smoke. People breathe out very small virus particles that can float and linger in the air for a long time. With the omicron variant, you only need to breathe in a few of these particles to get infected. That means we need better masks to stay safe.Dr Zoë Hyde, Epidemiologist, University of Western Australia