While multiple cities in the US roll-out mandatory use of masks in public, the WHO's 2020 guidance recommends against wearing masks in community settings because of a lack of supporting scientific evidence and the potential for increased disease transmission through improper use

According to its "Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (‎‎‎‎‎2019-nCoV)‎‎‎‎‎ outbreak: interim guidance, 29 January 2020": 

"Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices."

In fact, the WHO's advice includes a caution that the improper use of masks may even "increase the risk of transmission associated with the incorrect use and disposal of masks."

Given that cities throughout the United States are now requiring the use of "face masks," the following very stringent recommendations would need to heeded for them to provide any theoretical benefit: 

1. Place mask carefully to cover mouth and nose and tie securely to minimise any gaps between the face and the mask

2. While in use, avoid touching the mask; - remove the mask by using appropriate technique (i.e. do not touch the front but remove the lace from behind)

3.  After removal or whenever you inadvertently touch a used mask, clean hands by using an alcohol-based hand rub or soap and water if visibly soiled.

4. Replace masks with a new clean, dry mask as soon as they become damp/humid

5. Do not re-use single-use masks

6. Discard single-use masks after each use and dispose of them immediately upon removal. 

7. Cloth (e.g. cotton or gauze) masks are not recommended under any circumstance.

Since these recommendations were adopted from the healthcare setting, there is little assurance that those within regular communities -- without medical training, supervision,  supplies, and facilities -- including young children, would be able to follow them stringently. 

In exceptionally  humid places like Florida, where do-it-yourself face masks made of cotten are not uncommon, the recently announced executive order in cities like Miami requiring everyone where masks in public spaces which does not qualify the type or proper use of these masks could be contributing to worsening the crisis, according to the WHO's presumably authortative and well-researched guidelines. 

The Evidence For the Effectiveness of Wearing Masks Does Not Exist

An article published on The Sun titled, "FACE IT: Face masks can 'increase risk' of catching coronavirus - how to protect yourself," interviewed an infection prevention specialist by the name of Elie Perencevich, a professor of medicine and epidemiology at the University of Iowa's College of Medicine, who stated:

"Masks won't protect the average person.

"Because they will wear them incorrectly and autocontaminate themselves."

Prof Perencevich added: "I've never seen a person practice hand hygiene before removing a mask in public and then after removing the mask."

He told Forbes that the average healthy person does not need to have a mask.

"There's no evidence that wearing masks on healthy people will protect them," he said.

"They wear them incorrectly, and they can increase the risk of infection because they're touching their face more often.

Indeed, meta-analyses of clinical research into use of face masks for the transmission of viruses that present with clinical similarity to COVID-19, such as influenza, have found little evidence in support of the effectiveness of such an intervention. 

A 2010 review, published in the journal Epidemiology & Infection, titled, "Face masks to prevent transmission of influenza virus: a systematic review," found little supporting evidence:

"In conclusion there remains a substantial gap in the scientific literature on the effectiveness of face masks to reduce transmission of influenza virus infection. While there is some experimental evidence that masks should be able to reduce infectiousness under controlled conditions [7], there is less evidence on whether this translates to effectiveness in natural settings. There is little evidence to support the effectiveness of face masks to reduce the risk of infection." 

The decision to wear a mask is highly personal and should not be universally mandated; measures that are meant to protect the community are ineffective if they hurt individuals in that community. Please email and tweet your state and local officials now and urge them to do their part to make sure that mask-wearing is voluntary, not mandatory.

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