Health organizations’ early recommendation to not wear masks was a mistake
In April, the World Health Organization said that “there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including Covid-19.”
They went on to say that members of the general public “only need to wear a mask if you are taking care of a person with Covid-19” or “if you are coughing or sneezing.”
This sentiment was echoed by organizations in the US such as the Centre for Disease Control as well as the director of the National Institute of Allergy and Infectious Diseases, Anthony Fauci, who shot to fame as the face and voice of reason when the first cases of the coronavirus hit American soil, who said: “Right now in the United States people should not be walking around with masks.”
(Before we delve further, it is worth noting that what follows is in no way a negation or denial of all the great work done by public health professionals and organizations, including those mentioned above, all across the world and, without whom, we would have absolutely no chance against the coronavirus. And, thus, we continue.)
WHO said what
Fast forward two months, and a plethora of research (including from the WHO itself) suggests that wearing masks is “highly protective” in health care and community settings, and that it “greatly” slows down the spread of the virus.
While N95 (or KN95 to some of you) masks are the most effective, even ad-hoc solutions such as bandanas or cotton cloths offer some level of protection without which a person would not have any.
Masks seem almost instinctive to the layperson -- there are viruses which affect you when you breathe them in, so it makes perfect sense to put something to cover up your nose and mouth. Which is why, in most parts of the world, especially in Asia, despite the WHO’s recommendations, people kept on wearing masks.
The reasoning is simple: Maybe the mask will do nothing to stop the virus from being inhaled. But it doesn’t hurt to put it on, especially when we know so little about the virus and what can be done to prevent it to begin with.
This bit of reasoning is so simple, in fact, that it almost boggles the mind why an organization, specifically whose job it is to ensure public health, would fail to suggest the use of masks, even as a mere precautionary step, especially when there was so little information available.
Let’s tweak WHO’s statement: “There is currently no evidence that wearing a mask by healthy persons … can prevent them from infection. However, there is no evidence to suggest that they don’t work either since we are discovering new information about this virus every day. Until research definitively shows otherwise, we would recommend that people wear masks whenever they leave their homes, in addition to practicing safe hygiene practices and maintaining social distance whenever and wherever possible.”
Masking the truth
But, instead of caution, there was negligence, and the world was lied to. We may argue about the justification for such a lie (which I’m coming to shortly), but there are no two ways about it: Some of the most trusted organizations on health saw it fit to steer the general public away from masks by stating, with confidence, that there was no need to wear them except in certain circumstances.
As far as I can tell, there are two justifications for this:
1) I will let Dr Fauci explain this one: “We were concerned, the public health community … that it was at a time when personal protective equipment, including the N95 masks and the surgical masks, were in very short supply. And we wanted to make sure that the people, namely, the health care workers, who were brave enough to put themselves in harm’s way … we did not want them to be without the equipment that they needed.”
2) Masks would give people a false sense of security, which would, in turn, discourage them from maintaining lockdown procedures and social distancing.
And here’s why neither of those holds up: Firstly, as true as it is that there was a shortage of PPE for health care workers, this lack of transparency cannot be justified within the confines of a democracy, where people have a right to know the truth regarding what their government is up to and why.
This means that we can be certain that this was not some stupid mistake. On the contrary, public health officials had decided that it would be better to blatantly lie to and misinform the public, to treat them as children who could not be trusted to act responsibly in the midst of a mask shortage (regardless of the fact that this may be true, especially in the US), instead of telling them the truth and letting them decide for themselves, or coming up with an alternative plan that would see governments prioritize the production of masks (and other PPE) and organize more controlled avenues of distribution, ones which prioritized health care workers.
This would be akin to the government imposing a nationwide lockdown to prevent the spread of the coronavirus, only for you to later find out that there had been no virus to begin with, and that they had imposed it as a desperate measure to reduce the detrimental effects of climate change. Sure, maybe the earth got to breathe for a few months, but now the economy’s in the tank, unemployment is at 25%, and you spent $2 trillion on sending inadequate presidential checks to your citizens and bailing out billion-dollar companies.
Secondly, a simple question: Which world is scarier and, thereby, would make one take extra precautions to take care of oneself -- a world where nobody is wearing a mask, or a world where everyone is?
At the beginning of this month, WHO Director-General Tedros Adhanom Ghebreyesus said: “I cannot say this clearly enough. Masks alone will not protect you from Covid-19.” Fauci echoed something similar: “It can protect you a certain degree, not a hundred percent, in protecting you from getting infected. The important thing is actual physical separation.”
These addendums to the recommendation feel like poor attempts at changing the topic and provide us, albeit indirectly, with further justification for the lie that had been told. Has anyone, since December, even come close to saying something along the lines of: Masks are useful against the coronavirus. In fact, they are so good at protecting you that you don’t even have to worry about social distancing or washing your hands. There is literally a 0% chance of you getting infected with a mask on.
This pseudo-response, presenting us with an answer to a question no one has even asked, is as hollow now as it was then. At no point, that I know of, has there been an admission of guilt, or recognition, of the fact that their initial recommendation was a mistake, or an acknowledgement of the immense harm this may have caused.
But I suppose that it would be too dangerous to admit fault at this point. Who can really blame them?
While, in the US, the mask has been politicized to the point of satire, it is fortunate that most countries saw it fit to err on the side of caution and either recommended them or made them mandatory. While I cannot speak for the rest of the country, in Dhaka, almost every person I encounter on the streets, from beggars to BMW-owning businesspeople, is wearing a mask, despite perhaps not knowing or understanding the science of it all, and they have been for some time.
It seems that they are privy to a bit of philosophy that the WHO and certain other public health organizations had forgotten, one that is particularly useful when it comes to health and safety: Why take the risk?
The recommendation to not wear masks had come from doctors and scientists, from well-regarded organizations, voices of reason and rationality, and as such, they automatically served as trusted sources for what to believe in the wake of a pandemic that had created immense space for doubt, confusion, conspiracy theories, and pseudo-science.
As a result, everyone amongst us who has fought on the side of truth for the past few months, listening to experts, attempting to dismiss myths, urging caution over ignorance, and recommending as well as practicing social distance, must now contend with a sickening feeling in the pit of their stomach.
This comes from, on one hand, a sense of gratitude for the many countries (especially our own) and individuals who had gone ahead with the use of masks despite recommendations to the contrary and, on the other, understanding that they had to go with their gut in a situation where they shouldn’t have had to, not, at least, to such an extent.
This also means that, for us, the sources we had used to highlight the severity of the virus to sceptics and naysayers have now also come into question.
And, with that, every recommendation they make, every conclusion they come to in the future, now must also come into question.
Who knows how many people, having entrusted the WHO, the CDC, and Dr Fauci, as they should have, went out unprotected into the world, and got themselves or their loved ones infected? Who knows how many amongst them could not get tested? Who knows how many, having tested positive, could not get treatment because they could not afford it?
Who knows how many people had to quit their jobs, or pay everything out of their savings, and went broke? Who knows, of the over 10 million cases and over half a million confirmed deaths we have seen since the coronavirus pandemic began, what portion of these cases came about as a result of having believed the most trusted sources on issues of public health?
I don’t. And, I suppose, neither does the WHO. But, even if they did, who would believe them now?
SN Rasul is an Editorial Assistant at the Dhaka Tribune and a Lecturer of English at North South University. He can be found everywhere @snrasul.