Coronavirus: Face masks were first unnecessary, they’re now compulsory. What changed?

Science has informed much of the world’s response to coronavirus. The advice of the scientific community, and particularly the World Health Organization (WHO), has influenced the rules laid down by governments to try to slow the spread of the virus.

But despite the pandemic entering its sixth month at least, many people still remain confused about the most fundamental advice – including whether they should wear a face mask or not.

During the early days of the virus, the scientific community generally told the public that only people infected with the virus needed to wear a mask. Today, most health authorities state nearly everyone, infected or not, should be wearing masks as a crucial tool to stop the spread of the virus.

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The WHO, which has been at the forefront of the international fight against the virus, first advised the public in January that face masks are generally not recommended.

However, the WHO then updated its guidelines earlier this month, recommending to governments that they ask everyone to wear fabric face masks in public places to prevent the spread of the infection.

The change in recommendation has led to many of the public confused about whether face masks are necessary, and provoked question marks about how to disseminate advice from the scientific community.

Science changes over time

While it might appear strange that scientists would change their mind on such a key recommendation, it is common for scientific advice to change as experts build a greater body of research.

When COVID-19 first emerged in China’s Wuhan, scientists knew little about the brand new virus.

As a result, they were forced to work with what limited data they had.

This problem was made worse by COVID-19’s ability to spread through asymptomatic cases – people who show no symptoms – making it difficult to identify. In the initial stages, scientists were unaware of the virus’s asymptomatic qualities.

As the knowledge of asymptomatic spread became more prevalent, health authorities began recommending face masks be continually worn by everyone, infected or not, to limit the spread of the virus.

The default start with the coronavirus was zero knowledge. As scientific understanding of the virus has grown, so too have recommendations, which is one reason why regulations have changed.

Saving PPE for professionals

The virus prompted significant supply chain fears for medical supplies early on in the pandemic. In February the WHO was warning that the world was at risk of running out of masks and other personal protective equipment (PPE) to fight the virus.

“The world is facing a chronic shortage of personal protective equipment,” WHO Secretary General Tedros Adhanom Ghebreyesus told the WHO’s executive board in Geneva at the time.

Health authorities have consistently sought to educate populations as to the importance of “flattening the curve.” This policy calls for the public to work together to reduce the number of daily infections, through lockdown and face mask rules, and prevent healthcare institutions from being overrun.

The most critical fighters of the pandemic are front line health care staff, indeed shortly after warning face masks were running out, the WHO added that masks must be prioritized for medics to allow continued help for the infected.

Earlier messaging that face masks were “not advised” may have been one step of protecting the vital supply of PPE for the professionals – essential for doctors, nurses and other healthcare workers to be able to treat patients without being put in danger.

Regardless of earlier public messaging, the prevailing scientific opinion is now that wearing face masks will remain a necessary step for the foreseeable future.

A study released last week found that the use of face masks combined with lockdown procedures could nearly entirely prevent a second or even third wave of coronavirus.

“Under certain conditions, when lockdown periods are implemented in combination with 100 percent face mask use, there is vastly less disease spread,” the researchers said in the study. This then leads to “flattened” second and third waves which would result in bringing the epidemic under control, according to the scientists.

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