White House expected to roll out mask guidance to combat COVID-19 spread

The Trump administration is formalizing new guidance to recommend that many Americans wear face coverings in an effort to slow the spread of the new coronavirus as the president defends his response to the crisis.

“Because of some recent information that the virus can actually be spread even when people just speak as opposed to coughing and sneezing — the better part of valour is that when you’re out, when you can’t maintain that six-foot distance, to wear some sort of facial covering,” Anthony Fauci, the top U.S. infectious disease official, said Friday on Fox & Friends.

But, Fauci said, physical distancing is still the best practice where possible to mitigate spread of the coronavirus.

Fauci also made clear that the aim is not to “take away from the availability of masks that are needed for the health care providers who are in real and present danger of getting infected from the people that they’re taking care of.”

The recommendations were expected to apply to those who live in areas hard hit by community transmission of the virus that causes COVID-19.

A person familiar with the White House coronavirus task force’s discussion said officials would suggest that non-medical masks, T-shirts or bandannas be used to cover the nose and mouth when people go outside – for instance, at the grocery store or pharmacy. Medical-grade masks, particularly short-in-supply N95 masks, would be reserved for those dealing directly with the sick.

Advice contrary to past recommendations

Some infectious disease experts say not much reliable research has been done on the efficacy of non-medical-grade masks, but some past studies have suggested they block only a small amount of the aerosol particles that can transmit influenza viruses and are not an effective way of reducing transmission.

Only medical masks such as those labelled N95 are designed and fitted to filter out particles that carry the COVID-19 virus. Other masks, such as surgical masks, are looser fitting and made of material that may reduce concentrations of some aerosol particles.

The World Health Organization, the government of Canada and federal public health officials such as chief public health officer Dr. Theresa Tam recommend that only those who have symptoms or are taking care of a person with suspected COVID-19 infection wear masks.

“Putting a mask on an asymptomatic person is not beneficial, obviously, if you’re not infected,” Tam said earlier this week.

The WHO, in its guidance for health care workers, has said that “cloth (e.g. cotton or gauze) masks are not recommended under any circumstance.”

WATCH l Mask advice has varied by country, over pandemic timeline:

Doctors answer your questions about the coronavirus, including whether or not the advice on masks has changed. 3:03

The person familiar with the White House coronavirus task force’s discussion about masks spoke on the condition of anonymity to discuss the proposed guidance before its public release.

U.S. President Donald Trump, who was tested again for coronavirus Thursday using a new rapid test, indicated he would support such a recommendation. The White House said Trump’s latest test returned a negative result in 15 minutes and Trump was “healthy and without symptoms.”

Dr. Deborah Birx, the task force’s co-ordinator, told reporters that the White House was concerned the mask guidance would lead to a “false sense of security” for Americans.

She said new data shows the administration’s social-distancing guidelines were not being followed to the extent necessary to keep virus-related deaths to a minimum.

WHO still recommends limited mask use

The World Health Organization on Monday reiterated its advice that the general population doesn’t need to wear masks unless a person is sick. Since the epidemic began in China, the WHO has said masks are for the sick and people caring for them.

WHO’s epidemic chief, Dr. Mike Ryan, said there are risks of spreading the virus by improperly fitting the mask or from someone improperly putting it on or taking it off.

The discussions on face masks came as the White House defended its handling of the pandemic, particularly its efforts to speed the distribution of ventilators and protective equipment needed by medical professionals.

The emerging guidance on masks appeared to be more limited than a Centers for Disease Control and Prevention draft that suggested the recommendation apply to nearly all Americans, according to a federal official who has seen the draft but was not authorized to discuss it on the record.

Officials were expected to limit the geographic scope to just those areas where the virus was spreading rapidly, the official said. An announcement was expected as soon as Friday.

Under the previous guidance, only the sick or those at high risk of complications from the respiratory illness were advised to wear masks. The new proposal was driven by research showing that some infections are being spread by people who seem to be healthy.

Questions over droplets in the air

On Wednesday, Eric Garcetti, the mayor of Los Angeles, urged his city’s four million residents to wear masks when they’re in public. On Thursday, New York City Mayor Bill de Blasio followed suit in his city, the epicentre of the virus’s spread in the U.S.

In response to recent studies, the CDC on Wednesday changed how it was defining the risk of infection for Americans. It essentially says anyone may be a considered a carrier, whether that person has symptoms or not.

The virus spreads mostly through droplets from coughs or sneezes, though experts stress that the germ is still not fully understood.

Mariachi player Aurelio Reyes wears a homemade face mask, before playing at El Mariachi Plaza in the Boyle Heights area of Los Angeles on April 1. Eric Garcetti, the city’s mayor, has recommended the wearning of masks when going outside amid the spreading coronavirus. (Damian Dovarganes/The Associated Press)

Scientists can’t rule out that infected people sometimes exhale COVID-19 virus particles, rather than just when coughing or sneezing, but there isn’t enough evidence to show if that can cause infection, according to a committee convened by the National Academies of Sciences, Engineering and Medicine to advise the White House.

The question has to do with whether the new coronavirus spreads mostly by droplets that don’t linger for long in the air or also by tinier aerosolized particles. Certain medical procedures, such as inserting breathing tubes, can create those tiny particles, which is why health care workers wear close-fitting N95 masks during such care.

Trump, Schumer spar over crisis

Meanwhile, Democrats criticized Trump after he sent a letter to their party’s Senate leader, Chuck Schumer, after the New Yorker took aim at the administration’s coronavirus response.

“The federal government is merely a back-up for state governments,” Trump wrote. “Unfortunately, your state needed far more of a back-up than most others.”

Trump said states should have done more to stockpile medical supplies.

Schumer, in turn, called the letter petty in a social media post.

“Americans are dying and losing jobs. Businesses are teetering. Stop the pettiness. Be a leader. Do your job,” he wrote.

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