Face coverings are now mandatory on public transport in England.
With more people expected to return to work today – as non-essential shops reopen in the latest easing of the coronavirus lockdown – commuters will face fines if they don’t comply.
It follows plenty of debate as to whether face coverings are actually effective. At the start of April, as the UK headed towards the peak of the virus, England’s deputy chief medical officer said “we do not recommend face masks for general wearing for the public”.
However, announcing the new rules earlier this month, the government said wearing face coverings “offers some – albeit limited – protection against the spread of the virus”.
The UK’s first two confirmed coronavirus cases were announced on 31 January, almost two months before the lockdown was imposed on 23 March.
So, why did it take four and a half months for the wearing of face coverings on public transport to be imposed? What changed?
Yahoo News UK looks at how the government’s messaging about face coverings softened over time, what was discussed and by whom, and what the public has been told over the past few weeks.
4 February (four days after the first two cases are confirmed)
Minutes for the fourth COVID-19 meeting of the government’s Scientific Advisory Group for Emergencies (Sage) show top scientists – including Prof Chris Whitty and Sir Patrick Vallance – hear guidance “that there is limited to no evidence of the benefits of the general public wearing face masks as a preventative measure”.
At this point, masks are only advised for health and social care workers visiting people suspected of being infectious.
3 April (11 days after the lockdown is imposed)
With the virus continuing to spread rapidly, Prof Jonathan Van-Tam, the deputy chief medical officer for England, is asked about face masks at Downing Street’s daily coronavirus press conference. He insists “there is no evidence that general wearing of face masks… affects the spread of the disease”.
He says that while widespread mask wearing is “wired” into the cultures of south-east Asian countries, the UK does “not recommend face masks for general wearing by the public”.
7 April (55,242 cases and 7,471 deaths)
At the 23rd COVID-19 meeting of Sage, scientists again cite evidence that says “increased use of masks would have minimal effect in terms of preventing the uninfected general population from becoming infected”.
9 April (65,077 cases and 9,608 deaths)
The 24th meeting of Sage cites advice from the World Health Organization (WHO) that “there is currently no conclusive evidence that face masks are beneficial for community use”.
The first indication of a softened stance.
Sir Patrick, the government’s chief scientific adviser, who chairs the Sage meetings, tells the daily press conference that “the evidence on masks is much more persuasive for masks stopping you giving it to somebody than it is for you preventing you catching it”.
He says a policy review is ongoing.
The 25th meeting of Sage decides that despite “weak evidence”, masks “probably” have a “small effect” in preventing the spread of the virus.
Scientists say they may be beneficial in enclosed environments with poor ventilation.
21 April (1,172 deaths are reported, the highest daily death toll during the pandemic)
Minutes for the 27th meeting of Sage show the first positive discussions surrounding face coverings on public transport.
They say: “There is evidence to recommend the use of cloth masks in certain higher-risk settings as a precautionary measure where masks could at least be partially effective.
“The common denominator is that these settings are enclosed spaces where social distancing is not possible consistently, creating a risk of close social contact with multiple parties the person does not usually meet.
“Public transport and some shops (if crowded) are examples of such settings.”
In an interview with LBC, health secretary Matt Hancock is reminded that face masks are mandatory on public transport in Germany.
Hancock, however, says: “The government position hasn't changed. We of course look at the scientific evidence all the time.”
Hancock, questioned on the matter at that day’s press conference, speaks out against the “weak science”.
A first major public breakthrough as Boris Johnson suggests the government will soon advise wearing face coverings in public as part of measures for easing the lockdown.
The prime minister says: “What I think Sage is saying, and what I certainly agree with, is that as part of coming out of the lockdown, I do think that face coverings will be useful both for epidemiological reasons but also for giving people confidence they can go back to work.”
Sir Patrick tells the House of Commons health and social care committee that evidence of the effectiveness of wearing face coverings in public is "not straightforward" but that it could have a "marginal but positive" impact in reducing the spread of the virus.
11 May (two days before the first easing of the lockdown)
The government releases its coronavirus recovery strategy, marking the first easing of the lockdown.
Face coverings are officially recommended for the first time, and described as “most relevant” when people spend short amounts of time indoors in crowded areas, such as buses, trains or some shops.
“The evidence suggests that wearing a face covering does not protect you, but it may protect others if you are infected but have not developed symptoms,” the strategy document says.
Transport secretary Grant Shapps confirms face coverings will become mandatory on public transport on 15 June, with more people expected to return to work as the government further lifts its lockdown.
So, does that mean the science has changed?
Scientists remain split on the exact benefits of wearing a mask. Here is what some of them had to say following Shapps’s announcement...
Dr Antonio Lazzarino, from University College London’s department of epidemiology and public health, said: “While no ad-hoc studies with a correct design have been carried out, it is now commonly accepted that face coverings provide very little protection, if any.”
However, Trish Greenhalgh, professor of primary care health services at the University of Oxford, was more positive: “Face coverings aren’t 100% effective, but they’re not 0% effective either.
“I’ve seen evidence that a double layer of cloth is between 60% and 90% effective in stopping the spread of viral-laden droplets coming from the wearer, and also that the same mask is also 30% to 50% effective at stopping virus particles getting to the wearer.
“You can argue about the exact percentages, but overall, if everyone wears a face covering when they’re at close quarters, transmission is going to go down dramatically.”
Prof Sian Griffiths, who was co-chair of the Hong Kong government’s Sars inquiry, said: “The evidence for the use of face masks or face coverings has been accumulating and it is now widely accepted that, along with other social distancing measures and hygiene measures, they can contribute to decreasing the risk of transmission in the community.”
Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading, warned: “If this change in policy is to be successful at reducing infections, it will have to be accompanied by a major new campaign to educate 66 million people on how to properly make, put on, handle and clean their face coverings.
“Most people in the UK have no experience of wearing face coverings, and it will be much harder to get used to than washing hands more often or keeping two metres from others.”
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