To mask or not? Medics divided on calls to end use of face masks

With increased rates of Covid-19 vaccinations, a section of health officials has recommended shedding off wearing of facemasks.

The Amref Health Africa Group Chief Executive Officer, Dr Githinji Gitahi, yesterday said with all signs indicating transitioning from pandemic to endemic phase of Covid-19, it was time to reduce mask mandates and accelerate vaccine access in Africa.

But he also acknowledged that properly worn masks have contributed significantly in reducing the speed of transmission and protecting people and health systems.

He explained that the masks have not eliminated the virus effect, “which only changes by host immunity or change in the virus itself through mutation – like seen with the Omicron variant’s dramatic infection rate but much lower severity”.

Currently, the risk of transmission is low in many countries, said Dr Gitahi, and thus pushing for a review of the policy of wearing masks.

“We need to rethink current policy to adapt it to the current situation by removing mandatory masks everywhere,” he said.

However, the Ministry of Health has urged Kenyans to keep wearing face masks and warned that the country was not yet out of danger posed by Covid-19.

Health Chief Administrative Secretary Rashid Aman said the Ministry would continue to maintain supply and use the non-pharmaceutical requirements as the first line of defense in minimising transmission of the virus. 

“We’re not done with the virus yet, the fact that we have overcome the Omicron wave does not mean we’re in the clear,” Dr Aman said.

He said the country is yet to vaccinate 70 per cent of the population which puts everyone at a risk with an uncertainty of waves recurring.

Data from the ministry indicates that in the last one week, the country has recorded less than 100 new Covid-19 cases with less than one per cent positivity rate. 

“We still have a long way to go, and we need to be cautious people… we don’t want to throw caution to the wind then be struck with another serious wave,” Aman said.

As various countries across the globe ease Covid-19 restrictions, especially when it comes to the use of masks, the Ministry of Health has warned that the country is not yet out of the woods.

In July last year, World Health Organisation (WHO) officials were concerned about the easing of precautions meant to stop the spread of the coronavirus. The officials urged even fully vaccinated people to continue wearing masks and to keep taking other measures to prevent infection.

The Centers for Disease Control and Prevention (CDC), on the other hand, told fully vaccinated Americans in May that they no longer needed to wear masks indoors or to maintain a distance of six feet from other people.

The agency also eased advice about testing and quarantine after suspected exposure to the virus.

“Whereas masks as a tool are extremely useful, they must be utilised when they have highest effectiveness and lowest cost,” Gitahi said adding that masks have a cost of implementation as people must buy them and a cost to the environment as disposal has been a concern.

The Amref boss indicated that his sentiments does not mean that masks as a tool for fighting the pandemic is discarded adding it must be retained and used based on the situation.

The situations include, “levels of community transmission, location, vaccination rates, hospital capacity, emergence of new variants that are circulating and a policy framework to guide decisions for when to escalate mandates and when to de-escalate them.”

Dr Gitahi observed this is likely not the end of the coronavirus, but even if it is no longer a pandemic, people will continue to contract the virus, be hospitalised, and in some cases die from Covid-19 like they do from Influenza, malaria, measles, and other diseases.

How much the future coronavirus surges impact communities will depend on many factors such as vaccination rates, immunity, hospital capacity, and equitable availability of Covid-19 tools like vaccines and treatments – an area rapidly changing for the better.

And for this, vaccine and therapeutic equity is key between rich and poor countries, rich and poor communities, and urban and rural settlements within countries.

“This inequity is becoming the new injustice. Until the entire world is vaccinated, the coronavirus will continue to be a problem, even for highly vaccinated countries,” said Gitahi who recommends  policies that are people-centred to reduce negative impacts of control measures.