Recent infections in NSW demonstrate how fragile is our control of community acquired Covid infections. As it will be many months before Australians are immunised and immune to Covid-19 we must focus on stronger containment strategies now. It’s time to mandate mask wearing and not just ask people to wear masks.
We have learnt a heck of a lot about the Covid-19 virus in the past 12 months and now understand why it is so difficult to stop its spread. Having developed extremely efficient ways to attach to and penetrate cells lining our mouth, nose, respiratory tract and even our eyes it is incredibly infectious.
Relatively small amounts of virus may see many, perhaps most, of those infected have few or no symptoms yet be able to efficiently pass the virus on to others. Over the year mutations have been recognised wherein the virus has become even more infectious. It is having a great time capturing 76 million people and killing 1.7 million of those it infects.
The virus can ‘live’ on certain hard surfaces for many days and can be transmitted from our hands to our mouth should we touch an infected surface. However, the overwhelming majority of infections occur when we inhale aerosolised tiny viral particles. We used to think that during speaking, singing and even coughing the virus would not travel more than six feet from its host.
Recent studies from South Korea, however, show exhaled virus travelling across quite large rooms and staying airborne for far longer than we had suspected. The implication of this research is significant, as it suggests the distance required for adequate ‘social distancing’ is much greater than we had thought.
From the early days of the pandemic, hand hygiene and keeping away from each other as much as possible were obviously important tactics but the case for wearing masks was controversial. At first it was suggested that masks could prevent an infected individual from infecting others but many months and much research later it has been clearly established that masks can very significantly reduce one’s chance of being infected.
Clearly masks do not provide complete protection but the Centers for Disease Control in the US, looking at all the research applied to the issue, have concluded that if 90% of the population wore masks when social distancing was difficult, transmission of the virus and the associated severe to fatal complications would be reduced by 70%.
In America President Trump’s politicisation of the Covid epidemic and his disparaging of mask wearing has actually resulted in the millions of adherents to the Trump ‘cult’ avoiding masks to show support for their leader. Trump and his team have consistently said it was up to the individual to decide if they wanted to wear a mask.
Fierce opposition to attempts by a number US governors to mandate the wearing of masks and social distancing have included riots and death threats. Unbelievably the US Supreme Court agreed that states could not mandate social distancing in places of worship. One judge, totally ignorant of the science underpinning the public health measure, said that restrictions on the numbers of worshippers were intolerable while liquor stores were left open!
Personal freedom, it seems, is all important. Many countries have seen similar resistance expressed with large rallies and protest marches
Many other countries, on the other hand, are and have been mandating the wearing of masks. In Australia we have been both lucky (Island at the end of the world) and sensible in utilising lockdowns to hose down infection surges. Mandated mask wearing was a feature of the most severe restrictions such as the recent Melbourne outbreak. In the heat of the battle we did very well but we are not being so smart when it comes to maintaining the peace.
Numerous studies have revealed that the true incidence of Covid infections in communities is some 6-24 times larger than is obvious. Examination of sewerage tells us the virus is still circulating in our communities. We have learnt the hard way how destructive to health, psyche and the economy are the efforts needed to stamp out a flare of the fire. Complacency is obvious and exposes us, as it has all around the world, to sudden explosions of new infections.
Politicians are wary of ‘mandates’. Enforcement is a problem and contentious. It’s one thing to impose during an obvious emerging crisis but more difficult to do so to maintain control. So we have premiers, health ministers and chief medical officers telling Australians that the presence of the virus should see us practising social distancing and wearing masks. In NSW the Premier actually used the word “begging” when asking people to wear masks in supermarkets, on public transport and any indoor occasion where social distancing was difficult.
My contention is that begging is not working.
It is obvious that as we cannot close ourselves off completely from the rest of the world where infections are far more prevalent than they are here, A lack of routine adherence to protective public health measures leaves us vulnerable to an imported case exploding into the community.
When reporters at Sunday’s press conference (December 20) asked the Chief Medical officer why mask wearing in public wasn’t mandatory she said she was impressed at the community’s adherence to this measure. Interestingly I had a flurry of calls after this (which catalysed this contribution) questioning which city she lives in, for the perception of most is that the percentage of people wearing masks in supermarkets and on public transport is tiny.
Certainly those of us in Sydney, looking at the circumstances associated with the Northern Beaches outbreak, should appreciate the reality that adherence to mask wearing and social distancing would have protected us from this cluster of infections that have so disrupted Christmas plans for thousands.
We all accept the mandate that we wear seat belts when driving, we all accept the mandate that we cannot smoke in public places. We should all appreciate that a mandate to wear a mask is justified as the minor inconvenience involved can help prevent possible major disruptions to our lives and economy before vaccines have controlled the epidemic.
If government won’t impose this mandate we should issue a personal mandate to ourselves to wear a mask when in a crowd and commit to urging others to do the same. Without a whole of community response there could be a lot of Covid suffering between now and vaccine time.