The U.S. and the World Health Organization do not agree on two major virus blockers — masks and social distance — resulting in inconsistent public advice on how to prevent COVID-19 infections.
The Centers for Disease Control and Prevention has a set policy on its website: “Stay at least 6 feet (about 2 arms’ length) from other people.”
“Our recommendations are 1 meter or more distance between individuals,” Dr. Ryan said at a press conference last week at WHO’s Geneva headquarters. “We recently had a systemic review that’s been conducted to look at influence, influence-like illness, coronavirus and COVID-19 which has found a strong protective effect of a distance of 1 meter or more so that’s important.”
The CDC also splits with WHO on masks worn to block viruses expelled in sneezes, coughs and speech.
In March, the CDC recommended coverings only for sick people and those caring for them. But in early April, it reversed course after studies showed that infected people without symptoms could spread the germ.
“Everyone should wear a cloth face cover when they have to go out in public, for example to the grocery store or to pick up other necessities … The cloth face cover is meant to protect other people in case you are infected,” the CDC says.
“Keep the covering on your face the entire time you’re in public,” the CDC adds in a recommendation that seems to require wearing a mask while taking a walk or sitting in a park.
On this issue, there is wide disagreement among health professions, including WHO and the CDC.
WHO’s Dr. Ryan still rejects public mask-wearing.
“There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit,” he said March 30. “In fact, there’s some evidence to suggest the opposite in the misuse of wearing a mask property and fitting it properly.”
He reiterated last week that mask-wearing is for the infected and people treating them.
“If someone is ill, as you know, we recommend the use of medical masks in that context or/and for people who are caring for somebody who is ill,” Dr. Ryan said.
And WHO’s website says, “If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.”
A number of esteemed American medical experts took this exact view at one point.
In early March, as the pandemic spread in America, Dr. Anthony Fauci, who heads the National Institute of Allergy and Infectious Diseases, said on CBS’s “60 Minutes”:
“The masks are important for someone who is infected to prevent them from infecting someone else. Now when you see people and look at the films in China and South Korea, where everyone is wearing a mask, right now in the United States people should not be walking around with masks. Right now there is no reason to be walking around with a mask. When you’re in the middle of an outbreak wearing a mask might make people feel a little bit better and it might even block a droplet but it’s not providing the perfect protection that people think that it is. And often there are unintended consequences. People keep fiddling with the mask, and they keep touching their face. When you think ‘mask,’ you should think of health care providers needing them and people who are ill.”
Today, Dr. Fauci wears a mask in public.
“I want to protect myself and protect others, and also because I want to make it be a symbol for people to see that that’s the kind of thing you should be doing,” he told CNN last week. “When I walk around the street in the neighborhood I live in Washington, D.C., which still has a considerable number of infections, it’s very clear that many people are doing that.”
U.S. Surgeon General Jerome Adams was also not a mask proponent in March.
“It’s important to understand that we are looking at the data every single day and we make the best recommendations to the American people we can based on what we know,” Dr. Adams said. “What the World Health Organization and the CDC have reaffirmed in the last few days is that they do not recommend the general public wear masks.”
“If you have a mask and it makes you feel better, then by all means wear it, but know that the more you touch your face the more you put yourself at risk and know that right now the data isn’t quite there to say that there is a net benefit to the individual of wearing a mask,” he said.
Earlier on Twitter, he said: “They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”
A referee in this disagreement is The New England Journal of Medicine. An article in early April by five physicians cast masks as generally useless when worn outside.
“We know that wearing a mask outside health care facilities offers little, if any, protection from infection,” the article said. “Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.”
The CDC and WHO also seem apart on quarantines and isolation. In late March, Dr. Ryan backed the idea of removing family members from their homes if they test positive. South Korea, for example, imposed this protocol.
“What we have seen from a number of countries now is that this virus can be controlled,” Dr. Ryan said. “What we have seen is that through the aggressive measures of case finding, testing those cases, isolating those cases, caring for them depending on the severity they have, making sure they have adequate care, they don’t progress to severe disease if that’s possible, to find all of their contacts, to follow them for 14 days. If you quarantine your contacts, so remove them from the family home or remove them from the community so that they don’t have the possibility to transmit to other people.”
The U.S. does not impose family separations. The CDC recommends: “In the home, anyone sick or infected should separate themselves from others by staying in a specific ‘sick room’ or area and using a separate bathroom (if available).”
On lock-downs, Dr. Fauci endorsed a one-size-fits-all for the entire country.
Asked on CNN in April if America needs a national lock-down, Dr. Fauci said, “I think so. I don’t understand why that’s not happening.”
“The tension between ‘federal mandated’ versus ‘states’ rights’ to do what they want is something that I don’t want to get into,” Dr. Fauci said. “But if you look at what’s going on in this country, I just don’t understand why we’re not doing that. We really should be.”
Dr. Ryan expresses opposition.
“We have to find a balanced strategy that manages the risks of the disease against the risks to life and livelihood and that’s something we’ve said since the beginning,” he said. “We’ve been very, very clear. A comprehensive strategy is not a comprehensive lock-down. A comprehensive strategy is a strategy of surveillance, finding cases, testing, isolating, using quarantine.”
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