| Background:
| Background:
Home BuDS’ Guidance on Face Coverings and Masks – 31 July 2020

BuDS’ Guidance on Face Coverings and Masks – 31 July 2020

BuDS is recommending that everyone wears a face covering or mask inside all public buildings and in all higher risk places alongside doing social distancing and hand-washing. Read on for more…

BuDS researchers have looked at scientific reports published by the NHS, medical and academic bodies, and a clinical epidemiologist has reviewed all our work. We are confident that what we say is as accurate and balanced as it can be. If you go to our website, you can also see all the places we got our information from.

A lot of what social media is reporting about face coverings isn’t accurate and some of it is deliberately misleading or fake news. BuDS has carefully looked at the inaccurate and fake claims made about face coverings and masks and we are responding to them in a separate post.

WHAT’S A FACE COVERING?

A face *covering* is, according to the Government, “something which safely covers the nose and mouth”1. This means any sort of close-fitting cloth or fabric covering over your mouth and nose. Even just a scarf tied across your mouth and nose counts as a face covering. Face coverings are not intended for medical use and do not count as official Personal Protective Equipment (PPE), and as such can be made from any suitable cloth or fabric material.2 You can easily tell a face covering from a face mask because a face mask will have a tab or label saying it meets the relevant EN standard or the European CE standard.

WHAT’S A FACE MASK?

A face *mask* is a specialist face covering designed and manufactured to specific EN or CE standards. They are split into two types – surgical or medical face masks and PPE masks.

Surgical or medical face masks are designed to protect other people from infection spread by the wearer – they are not mainly designed to protect the person wearing the mask. Surgical face masks have several layers of fabric and work by preventing droplets containing viruses and bacteria breathed out by the wearer going into the air. Surgical masks are legally ‘medical devices’ and must be CE registered to be sold3, and they offer a very high level of protection for the people meeting the mask-wearer.

A PPE face mask on the other hand is designed specifically to protect the person who is wearing it4.  PPE masks do not allow air to pass through them except through a small filter, which removes dust, tiny particles and water droplets which may contain Covid-19 from all the air breathed by the mask-wearer. PPE masks must meet strict British and International Standards5, although the Government has relaxed the need for them to have a current CE marking6.

PPE masks can come in lots of different forms. Most are only used in hospitals such as power-operated respirators which cover the whole head or masks with large filters which cover the whole face. However, what are known as ‘PPE half masks’ with N95 or N99 levels of protection can be readily bought by the general public. These are masks which tightly cover the mouth and nose, with either ear or head straps, so that the air breathed-in by the wearer is filtered before it enters their body. Some are disposable and designed to be thrown away after use and some are washable or have filters which can be changed.

DO FACE COVERINGS OR FACE MASKS MAKE YOU SAFER?

The balance of scientific opinion is that, yes, face coverings *do* make you safer if used correctly. British scientists recently looked at nearly 200 scientific studies of face coverings carried out across the world. This study concluded that face coverings and surgical masks give you a small amount of protection from breathing in droplets which could contain Covid-19, but wearing PPE masks designed to prevent droplet infection offered a high level of protection.  But any face covering or mask gave you some protection. .7,8 See below for more details.

DO FACE COVERINGS AND MASKS MAKE OTHER PEOPLE SAFER?

Current scientific evidence is that wearing any face covering or mask makes other people around you much safer. This is because, if you have Covid-19, the face covering or mask traps most or all of the droplets of water containing the virus that you breathe out If you weren’t wearing a covering or mask, you would otherwise breathe droplets out into the air where other people breathe them in and catch the virus9 Remember, most people with  Covid-19 do not know they have the virus, because they don’t feel ill.10 But they can still infect other people, who might die or be seriously ill as a result.

CAN FACE COVERINGS AND FACE MASKS MAKE ME ILL OR HURT ME?

No. There is no reliable scientific evidence at all that wearing a face covering or face mask will make you ill or hurt you. Many people such as doctors, health staff, builders and craftspeople wear surgical or PPE masks all day every day without any health risk at all. There are many fake news stories about this – see our separate post for more.

If you don’t use a face covering or mask correctly, there is a small chance that you could put yourself at higher risk of catching Covid-19. However, it is much safer for you and others to use a face covering or mask even with this small added risk, which you can reduce or remove if you follow simple rules, such as washing your hands after handling the covering or mask, washing or sterilising it regularly, and not sharing it with anyone else. BuDS has covered these simple rules in more detail in another post.

WHAT SORT OF FACE COVERING OR FACE MASK SHOULD I WEAR?

BuDS is giving you different advice to the Government. The UK Government recommends that surgical and PPE type masks should not be used by the general public11, because it is worried that there may be shortages of these masks if the general public starts wearing them. However, the World Health Organisation and many other governments around the world do recommend that some people do use PPE or surgical masks.12 BuDS wants to give older, disabled and shielding people the best advice possible, and so we have decided to follow the World Health Organisation and the opinion taken by most Governments.

The type of face covering or mask you should wear is different according to your circumstances.

OLDER, HIGHER-RISK & SHIELDING: If you are at higher risk of dying or having a serious illness if you catch Covid-19, we recommend that you wear a PPE half-mask with N95 or N99 levels of protection when in higher-risk places or meeting higher-risk people. This is because the PPE half-mask is more effective at protecting you from the virus. In lower-risk places or when meeting lower-risk people, to protect yourself and others, you can wear the PPE half-mask or a face covering. Both will protect you in lower risk situations.

MEETING PEOPLE WHO ARE CLINICALLY SUSCEPTIBLE: If you meet people who are at a high risk of dying or being seriously ill if they catch Covid-19, but you are not yourself at high risk of dying or serious illness, we recommend that you wear a surgical mask to protect the people you are meeting with. We recommend the surgical mask because it is more effective than a face covering at stopping you from infecting others. Remember, most people with the virus do not know they have it, but they can still infect and possibly kill someone else.

PEOPLE AT HIGH RISK OF INFECTING OTHERS: If you are not at higher risk of dying or having a serious illness if you catch Covid-19, you don’t need to wear a PPE mask for your own protection. However, if you live a life that might make you at higher risk of having the virus yourself, we recommend that you wear a surgical mask in *all public places* to protect others who you might otherwise infect. We recommend the surgical mask because it is more effective than a face covering at stopping you from infecting others. Remember, most people with the virus do not know they have it, but can still infect and possibly kill someone else.

EVERYONE ELSE: If you are not at higher risk of dying or having a serious illness if you catch Covid-19, and you *don’t* live a life that might make you at higher risk of having the virus yourself, we recommend that you still wear a face covering in *all public places* where you could come into contact with other people closer than 2 metres, to protect yourself and particularly others who you might otherwise infect.

People who are at higher risk of dying or having a serious illness if they catch Covid-19 are people who’ve been told that they should be shielding, everyone aged 70 or above (even if they are perfectly healthy) and anyone with a serious health condition including cancer and dementia.

People who are high-infection-risk to meet are people who work at or go to high-infection-risk areas, like health and care workers, shop workers, teachers, security guards and transport workers. People whose work means they meet a lot of people are also high-infection-risk, like police officers, doctors and nurses, vicars, priests and religious leaders.

Places which are higher-infection-risk to go to are places where groups of people gather at certain times, such as town centres, shopping centres, bigger schools, supermarkets, railway and bus stations, big offices and factories, crowded parks and streets, and of course beaches, stadiums, cinemas, museums and events. Inside places are much more risky than outside places.

People who are a high risk of infecting others are people who work at or go to high-infection-risk areas or whose work means they meet a lot of people, as well as members of the public who visit high-risk places.

WHEN DO YOU *HAVE* TO WEAR A FACE COVERING?

PUBLIC TRANSPORT: From 15 June, the Government have made it compulsory to wear a face covering when using public transport like trains, buses, ferries and trams, or face a fine of up to £100. The law states that service can be denied to those not wearing a covering. This means that transport staff or police can turn you away or ask you to get off, or fine you, if you try to use a train, bus, ferry or tram if you are not wearing a face covering. This is the same as if you don’t have a ticket.13

SHOPS & SUPERMARKETS: In the same way, it will be compulsory from 24 July to wear a face covering when visiting shops and supermarkets. Anyone not complying with this, as on public transport, can be denied service by shop staff and asked to leave, or denied entry. Police can also fine you, although the police have said they will not do this except in extreme cases.14

SHOPPING CENTRES: It will also be compulsory from 24 July to wear a face covering when visiting a shopping centre, even if you do not intend to visit any of the shops. Anyone not complying with this, as on public transport or in shops, can be asked to leave, or denied entry. Police can also fine you, although the police have said they will not do this except in extreme cases.15

BANKS & POST OFFICES: It is also compulsory from 24 July to wear a face covering in post offices, banks and building societies. Anyone not complying with this, as on public transport or in shops, can be asked to leave, denied service, or denied entry. Police can also fine you, although the police have said they will not do this except in extreme cases.16

TRANSPORT HUBS: Additionally, it will be compulsory from 24 July to wear a face covering in what the Government define as ‘transport hubs’, which includes indoor train stations and terminals, airports, maritime ports, and indoor bus and coach stations or terminals. Anyone not complying with this, as on public transport or in shops, can be asked to leave, denied service, or denied entry. Police can also fine you, although the police have said they will not do this except in extreme cases.17

AIRLINES: The Government have not yet said if they are going to change the standard conditions for air travel so that all UK air passengers have to wear face coverings. Many individual airlines  make it a condition of travelling that you wear a face mask, though.

HOSPITALS AND NURSING HOMES: The Government has said that, from 15 June, people visiting a hospital or nursing home *ward* should always wear a mask or face covering.18 But you don’t *have* to wear a face covering or mask if you visit a hospital as an outpatient or for an appointment. However, hospitals and wards are high-risk places to catch Covid-19 so we recommend that you wear either a PPE mask or face covering depending on how dangerous Covid-19 is for you. 19

GP SURGERIES: You don’t *have* to wear a face covering or mask if you visit a GP surgery or treatment centre, although some surgeries will ask you to. However, GP surgeries are high-risk places to catch Covid-19 so we recommend that you wear either a PPE mask or face covering depending on how dangerous Covid-19 is for you.20

TAKE-AWAYS AND CAFES: Face coverings will be compulsory from 24 July in take-away restaurants or cafes that do not provide table service, other than in designated seating areas. Anyone not complying with this, as on public transport or in shops, can be asked to leave, denied service, or denied entry. Police can also fine you, although the police have said they will not do this except in extreme cases.21

LEISURE SITES, ENTERTAINMENT VENUE AND PLACES OF WORSHIP: The Government has confirmed that from the 8th August, it will be mandatory to wear a face covering or mask inside entertainment sites such as cinemas and theatres, museums, galleries and places of worship.22 This is highly recommended by the Government until it becomes law on the 8th August, though will not be enforced until that date.23

PUBS, RESTAURANTS AND OTHER BUILDINGS: Oddly, the Government have confirmed that you will not have to wear a face covering or mask in restaurants and cafes, pubs, hairdressers, gyms and leisure centres, dentists or opticians (despite the NHS stating that face coverings should be worn in health settings). This is despite the fact that the risk in these sites is just the same as it is in shops, hospitals or public transport. BuDS recommends that you should definitely wear a PPE mask or face covering all the time if you do have to go inside a building for any reason, except your home. This protects you and other people who you might otherwise infect. Remember, the Government has political reasons for making their rules, not just medical reasons. Many people feel that the Government is taking a calculated risk with people going to entertainment and leisure places to encourage economic growth. Whether that is right or not, if you have a higher risk of dying or being seriously ill if you catch Covid-19, you might not want to take chances with your life for the sake of the economy.

INSIDE BUILDINGS: It is much less safe inside buildings, because the still air inside buildings means that Covid-19 droplets stay around for longer and can spread over longer distances.24 You should definitely wear a PPE mask or face covering all the time if you do have to go inside a building for any reason, except your home or the home of someone in a bubble you are part of.25

WHO DOESN’T HAVE TO WEAR A FACE COVERING OR MASK, EVEN WHEN THEY ARE LEGALLY REQUIRED?

Ministers have said, and it’s been widely reported, that ‘disabled people’ won’t need to wear a face covering even on public transport, in shops and other places where they are legally required. However, this isn’t actually the case. The Government’s own guidance says that only people who aren’t *able* to wear a face covering are exempt, along with deaf people who use lip reading. So only disabled people whose disability *prevents* them from wearing a face covering, such as some autistic or learning-disabled people, or people with severe breathing issues, won’t need to wear a face covering, but disabled people in general will have to wear them.26 BuDS strongly recommends that disabled people do not take advantage of exemptions unless they absolutely have to. Wearing a mask or face covering keeps you and others safer, so it is much better to make every effort to wear one before using an exemption.

Note that exemptions only apply when the law covers the place or journey, such as on public transport or in shops. Owners of businesses, places and services can make their own rules about face coverings and masks and refuse you entry, or ask you to leave, if you don’t follow their rules. It is illegal to discriminate against disabled people by refusing to make ‘reasonable adjustments’ for them, so shops and businesses should not refuse genuine cases where a disability makes it impossible for someone to wear a mask or face covering. However, the business or place might argue that public safety means that it is not a ‘reasonable’ adjustment to allow disabled people in without a mask. In this case, legal action would be needed to decide who was right.

If you have to wear a face covering, removing it so that you can take medication, to eat or drink for health reasons (eg if diabetic), or for identification purposes if requested by an official, are all covered by exemptions.

If you use lip reading for communication, or you are with someone who uses lip-reading, then you are also exempt from wearing a face mask or covering. Remember, however, that you might be safer wearing a mask and being unable to communicate by lip reading.

Further details of exemptions can be found on the Government website.27

Remember, if you live in Bucks, you can get a police-recognised letter from BuDS stating that you cannot wear a face covering or mask because of your disability.

FACE COVERINGS & SCHOOLS

The Government’s advice about face coverings in schools is different from its general advice and many people feel it makes no sense. The Government feels that teachers and children will be safe from Covid-19 in schools without wearing face coverings, even though schools are crowded public buildings. The Government say that the school environment, with social distancing, good hygiene and frequent hand washing, means that face coverings are not needed in schools, even though face coverings are needed in other similar environments. So, children, and teachers, will be told NOT to wear face coverings in schools.28

This may cause odd situations, like older school children having to wear face coverings on the school bus by law but having to take them off as soon as they reach school, even though they are with the same people and therefore at equal, if not higher, risk.

Remember, the Government have said that children and young people who are or were shielding should return to school in September. However, BuDS recommends that you contact your school and GP about this and make sure it is actually safe for your shielding child to return to school.

FACE COVERINGS AND CHILDREN

The Government have said that children under 11 (primary school and below) will not have to wear face coverings on public transport or in supermarkets, even though the rest of the population are required to.29  However, other than for babies and toddlers, it is medically safe for children to wear face coverings and masks and BuDS recommends that they do so in public places to prevent them infecting other people. Remember, it is very rare for children to show symptoms of Covid-19, but they can catch it and they can give it to other people in some cases.30 There is a lot of fake news about this on social media.

FACE COVERINGS & OLDER PEOPLE

Older people, however old or frail they may be, are not exempt from having to wear a facemask where it is legally required unless they have other conditions that make them exempt. People over 70 are at extremely high risk of dying or being seriously ill if they catch Covid-19 (much more than even shielding people) and so they should wear a PPE mask in higher-risk places to protect themselves, as shown above.

WHAT DOES THIS MEAN FOR ME?

BuDS is recommending that *everyone* wears a face covering or mask inside all public buildings and in all higher risk places. The type of mask or face covering you should wear depends on your circumstances as described above in this post.

Remember, wearing a mask or face covering does not mean you can stop social distancing and washing your hands. You should wear a mask or face covering alongside doing social distancing and hand-washing.

FINALLY

You can freely share this post using Facebook. However, please do not share only parts of the post or alter it so that it looks like your own work. If you do, BuDS may take legal action against you.

 

References

[1] https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

[2] https://www.gov.uk/guidance/regulatory-status-of-equipment-being-used-to-help-prevent-coronavirus-covid-19?utm_source=Gov&utm_medium=Email&utm_campaign=MHRA_COVID-19_updates&utm_content=HCP7#face-masks-and-face-coverings

[3] Ibid.

[4] Ibid.

[5] https://www.bsigroup.com/en-GB/topics/novel-coronavirus-covid-19/medical-devices-ppe/

[6] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886169/Guidance-for-businesses-ppe-regulations-version-3.pdf

[7] https://royalsociety.org/-/media/policy/projects/set-c/set-c-facemasks.pdf?la=en-GB&hash=A22A87CB28F7D6AD9BD93BBCBFC2BB24

[8] https://www.newscientist.com/article/2248820-what-are-face-covering-rules-in-england-and-why-did-the-policy-change/

[9] https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

[10] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19infectionsinthecommunityinengland/july2020

[11] https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

[12] https://www.who.int/publications/i/item/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

[13] https://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers

[14] https://www.gov.uk/government/speeches/face-coverings-to-be-mandatory-in-shops-and-supermarkets-from-24-july

[15] https://www.gov.uk/government/news/face-coverings-mandatory-in-shops-supermarkets-shopping-centres-and-enclosed-transport-hubs-from-friday

[16] Ibid.

[17] Ibid.

[18] https://www.gov.uk/government/news/face-masks-and-coverings-to-be-worn-by-all-nhs-hospital-staff-and-visitors

[19] Ibid.

[20] Ibid.

[21] Ibid.

[22] https://www.gov.uk/government/speeches/prime-ministers-statement-on-coronavirus-covid-19-31-july-2020

[23] Ibid.

[24] https://www.bbc.com/worklife/article/20200324-covid-19-the-ways-viruses-can-spread-in-offices – link to sources within article

[25] https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

[26] https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

[27] Ibid.

[28] https://www.gov.uk/government/publications/coronavirus-covid-19-implementing-protective-measures-in-education-and-childcare-settings/coronavirus-covid-19-implementing-protective-measures-in-education-and-childcare-settings

[29] https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

[30] https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/ (the site is a publishing base for scientific studies relating to medicine)

 

Sources

https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

https://www.hse.gov.uk/coronavirus/ppe-face-masks/face-coverings-and-face-masks.htm

https://www.gov.uk/guidance/regulatory-status-of-equipment-being-used-to-help-prevent-coronavirus-covid-19?utm_source=Gov&utm_medium=Email&utm_campaign=MHRA_COVID-19_updates&utm_content=HCP7#face-masks-and-face-coverings

https://www.gov.uk/government/speeches/face-coverings-to-be-mandatory-in-shops-and-supermarkets-from-24-july

https://www.theguardian.com/world/2020/apr/11/can-a-face-mask-protect-me-from-coronavirus-covid-19-myths-busted

https://www.newscientist.com/article/2248820-what-are-face-covering-rules-in-england-and-why-did-the-policy-change/

https://royalsociety.org/-/media/policy/projects/set-c/set-c-facemasks.pdf?la=en-GB&hash=A22A87CB28F7D6AD9BD93BBCBFC2BB24

https://www.who.int/publications/i/item/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

https://www.gov.uk/government/news/face-masks-and-coverings-to-be-worn-by-all-nhs-hospital-staff-and-visitors

https://www.gov.uk/Government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

https://www.healthing.ca/diseases-and-conditions/coronavirus/mask-myths-no-carbon-dioxide-build-up-wont-make-you-sick

https://www.bbc.co.uk/news/53108405

https://www.gov.uk/government/publications/coronavirus-covid-19-implementing-protective-measures-in-education-and-childcare-settings/coronavirus-covid-19-implementing-protective-measures-in-education-and-childcare-settings

https://www.gov.uk/government/publications/how-to-wear-and-make-a-cloth-face-covering/how-to-wear-and-make-a-cloth-face-covering

https://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers

https://thehill.com/policy/healthcare/496483-evidence-mounts-that-outside-is-safer-when-it-comes-to-covid-19

https://www.bbc.com/worklife/article/20200324-covid-19-the-ways-viruses-can-spread-in-offices

https://www.businessinsider.com/children-do-transmit-covid-19-says-researcher-amid-confusion-2020-4?r=US&IR=T

https://dontforgetthebubbles.com/evidence-summary-paediatric-covid-19-literature/

https://hms.harvard.edu/news/covid-19-children

https://www.bsigroup.com/en-GB/topics/novel-coronavirus-covid-19/medical-devices-ppe/

https://www.theguardian.com/world/2020/jul/23/face-masks-mandatory-shops-takeaways-stations-england-friday?CMP=Share_AndroidApp_Teams

https://www.bbc.co.uk/news/uk-53513026

https://www.gov.uk/government/news/face-coverings-mandatory-in-shops-supermarkets-shopping-centres-and-enclosed-transport-hubs-from-friday

https://www.gov.uk/government/speeches/prime-ministers-statement-on-coronavirus-covid-19-31-july-2020