What are the new rules on face masks in the UK?

Dr Louise Wiseman MBBS, BSc (Hons), DRCOG, MRCGP
Photo credit: Halfpoint Images - Getty Images

From Netdoctor

Face coverings are set to become compulsory for people travelling on public transport in England from 15 June.

What are the new rules for face masks?

The UK government has announced that face coverings will be compulsory on buses, trains, ferries and planes from 15 June.

Lockdown rules are set to ease further from 15 June, with non-essential retailers to reopen and some secondary school pupils to return to classes, which could increase the use of public transport.

However, Transport Secretary Grant Schapps said that people wear 'the kind of face covering you can easily make at home'.

How will the new rules be enforced?

Face coverings will be a 'condition of travel' and people without them could be refused travel or even fined by British Transport Police.

What is the current government advice on face masks?

It is also advised that people wear face coverings:

  • On public transport and in some shops, where social distancing can't be observed
  • In other enclosed spaces where you come into contact with people that you don't normally meet.

Who shouldn't wear a face mask?

WHO recommends that face masks should only be worn if you have coronavirus symptoms or are caring for someone who is infected with the virus.

Otherwise, the organisation says, it might give you a false sense of security and make you less careful about other preventative measures, such as hand hygiene.

It is really important that if wearing a mask you do not let this change your behaviour and don't relax social distancing or stop washing your hands regularly.

How face masks can help to prevent the spread of COVID-19

It is vital to remember that you can be infectious when you have coronavirus asymptomatically or before your symptoms start (which can take up to 10 days).

Talking, especially coughing or sneezing, sheds large liquid droplets from our mouths. We have all seen the scientists’ graphics on the TV of particles spreading widely from one sneeze. The largest droplets don’t go so far as the smaller droplets. Some of the larger droplets dry out but form tiny droplets (aerosols) which might still be infectious.

With any virus, if those tiny droplets remain infectious and in the air for many hours afterwards, we say the virus is ‘airborne’. Some scientists have argued for and against whether COVID-19 is airborne and are still debating this but it is probably best to err on the side of caution. With COVID-19, we are learning on the job to an extent with new evidence emerging every day.

What is important about any face covering or mask is that it will stop spreading at source (to a certain extent dependent on design) of those droplets coming out of an infected person’s mouth before they spread further or become smaller particles. This is especially important in scenarios where we can't easily socially distance. So, if everyone in a space wore a mask or face covering the spread of corona would be reduced

Social distancing is universally important as at one metre between people there is about 30 to 60 times the spread of coronavirus compared to two metres.

Face masks or face coverings: what is the difference?

Imperative to all of this is protecting healthcare workers. Provisions of manufactured masks should be prioritised for those on the front line. A group of more than 100 UK doctors wrote an open letter to the government to suggest that homemade face coverings/masks be suggested to the public to prevent spread of coronavirus and that manufactured masks be preserved for the NHS.

What kinds of face mask should I get?

There are different types of face masks that you should know about first:

A respirator – a specially designed mask with a filter and a valve. They come under the names N95, FFP2 and FFP3. They are close fitting and protect the user from small and large droplets in the air and will stop some infection spread from the person wearing them. These respirators should be wholly preserved for supplies for healthcare workers looking after infected/suspected cases of corona.

Surgical face masks – cover your mouth, nose and chin. They stop larger droplets from outside and stop some infection spread from the person wearing them. These tend to have two sets of ties or elastic hooks. They often have a metal wire at the nose bridge to help fitting. These are also being recommended by the Government to be left for healthcare workers. Some people already have purchased these masks.

Homemade masks – can be cloth/paper made with ear loops, elastic or fabric ties or as simple face coverings. It is believed that these will can reduce spread from the person by 50 to 100 per cent dependent on design. The government is advising not to panic buy manufactured masks , saving them for the frontline – you may have masks already or choose to make your own.

How to put on a face mask

  • Clean your hands properly or use hand sanitiser if you have no access to water
  • Check the mask you use is going to cover adequately from bridge of the nose to the chin
  • For ear loop masks, hold the mask by both loops and gently loop over each ear
  • For tied masks, tie the upper strings in a bow first then lower strings
  • Once in situ don’t fiddle with the mask
Photo credit: Popartic - Getty Images

How to take off a face mask

  • Wash your hands or sanitise first, try not to touch the outer potentially infected surface and ideally remove by the ear loops, if two ties remove the bottom bow first then the top.
  • Dispose of the mask immediately if it is disposable or if not it will have instructions for decontamination.
  • If you have purchased or made a cloth face mask wash in detergent at 60 degrees.

(With any mask that is reusable, check it still fits correctly after washing and drying.)

What not to do when wearing a face mask

Bad mask behaviour puts you and others at risk, you should avoid the following:

  • Touching your mask can transfer infection from surfaces to your face
  • Lifting up your mask to smile or chat to your friend is detrimental
  • Letting your mask hang loose doesn’t stop you containing any viral spread and can allow viral particles to settle there then you put it back on and can become infected
  • If you have to touch your mask for some reason then sanitise or wash your hands carefully afterwards.
  • Do not let wearing any mask or face covering loosen your social distance rules!

How to help children

It is not recommended without a doctor’s advice for a child under two years old to wear a face mask – they might choke and they also might not be able to remove it themselves in an emergency. We can make it fun for children by trying a mask on a toy but nothing replaces trying to educate children about hand washing and social distancing which can of course be very tricky.

What if I am having breathing problems?

If you have breathing problems, wearing a face mask may not be right for you so check with your doctor.

How to make your own face mask

Can you make your own face mask? A single layer fabric material mask may get damp in a hospital and hold infection, so these are not recommended clinically, but in the community, a cloth mask, sensibly made, possibly of multiple layers could dramatically reduce the spread of infection and may give the user some degree of protection from infection. Remember the protection comes from those around you also wearing face coverings to stop the spread into the air and onto surfaces.

Ideally a homemade mask needs to be:

  • washable
  • breathable
  • have multiple layers

The Centre of Disease Control recommends following these instructions to make your own face mask:

  1. Cut out two 10-by-6-inch rectangles of tightly woven cotton fabric, such as quilting fabric or cotton sheets.
  2. Stack the two pieces of cloth together. Then, fold over the long sides a quarter inch and hem using a sewing machine or by hand. Then fold the double layer of fabric over half an inch along the short sides and stitch down.
  3. Run a 6-inch length of 1/8-inch wide elastic through the wider hem on each side of the mask and tie the ends tight. If you don't have elastic, hair ties or elastic head bands.
  4. Gently pull on the elastic so that the knots are tucked inside the hem. Gather the sides of the mask on the elastic and adjust so that the ask fits your face. Then securely stitch the elastic in place to keep it from slipping.

What fabric should I use for my face mask?

Scientists are studying preferred fabric for stopping spread but also potentially protecting the user. If cotton is used, higher thread counts are preferable but combinations of materials seem to work well. Before you start cutting up your best bed sheets remember what is also important is how well it fits around the contours of the face and that there are multiple layers. One study found that cotton with combined layers of silk or chiffon worked well and even cotton either side of some polyester cotton type quilting. There are simple patterns involving t-shirts, some needing a sewing machine. Always ask the t-shirt or fabric owner first.

For the more creative, it is suggested that kitchen towel is a good filter to mimic the central layer of a surgical mask. Scientists in Hong Kong looked under the microscope and found it similar, making a homemade two layered mask with a middle disposable filter and still washing the mask might just give an extra level of hygiene.

Even the simplest of face coverings should help reduce spread but a better fitting homemade mask will most likely also give you some protection from those around you not wearing masks.

The take-away

  • Social distancing, isolation and hand hygiene rules have not changed and must not be relaxed whether you are wearing a face mask or covering
  • Masks can become a focus for infection if mask behaviour is not good
  • Face coverings and masks primarily work in the population by reducing spread of corona, it will be user and covering dependent how much they protect the wearer

Last updated: 05-06-2020

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