Mask-wearing Q&A: Should we be wearing them? Where? Should they be mandatory?

With high levels of illness related to respiratory viruses leading to record overcrowding in Irish hospitals and placing severe pressure on GP services, is it time for everyone to start wearing face masks and coverings again?

Just this week the chief medical officer, Prof Breda Smyth, asked everyone to start wearing masks on public transport and in crowded and confined places again to help reduce the spread of viruses, including Covid-19.

“Covid is still with us and we are not wearing our masks,” she said in a video message. “Remember wearing a mask isn’t just for you, it’s for everyone. Masking up means that you are less likely to transmit infectious droplets to others.”

Should mask wearing be made mandatory again in places that are most risky for vulnerable individuals to pick up circulating viruses including Covid-19, influenza or the respiratory syncytial virus (RSV)?

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Prof Sam McConkey, infectious disease consultant at Beaumont Hospital, says he would not recommend mandatory universal mask wearing.

“I recommend wearing masks in crowded indoor spaces and in healthcare settings,” he says.

Dr Ray Walley, a GP in north Dublin and associate clinical professor of general practice at University College Dublin, says that mask wearing should be mandatory on public transport during the current surge in winter viruses. 

“People need to use public transport. They can make choices about going into other places. Mask wearing in mandatory on public transport in other countries such as Germany.  Making mask wearing mandatory for the next three to four weeks would help us get past the peak of winter viruses and reduce the amount of cancelled elective surgery due to use of beds for viral infections,” he says.

Should people just wash old face coverings for re-use or are higher grade medical/surgical masks preferable?

As during the Covid pandemic, the most important thing is do is to wear a clean mask (eg don’t wear a single use mask that has been lying around for days or weeks) and wear it correctly. Prof Smyth reminds people to wear close-fitting masks that cover the nose.

“Don’t touch it or pull it down over your chin,” she advises.

Is there a risk the so-called tridemic (Covid-19, influenza and RSV) will cause more severe illness as people catch both viruses at the same time?

Prof McConkey says there are about eight to 10 respiratory viruses circulating and the risks are greatest for those with respiratory conditions such as asthma, COPD and emphysema.

“Covid isn’t causing the deadly respiratory failure that it did one or two years ago. It’s a milder version and the new duel vaccine booster will protect people from severe disease from any new variants that might emerge,” he says.

Regarding the other circulating viruses, he adds: “These viruses aren’t going away. They will be here every winter and all the masks in the world won’t solve infections spreading between patients in hospitals. The biggest obstacle to that is the lack of single rooms in public hospitals and this requires big public investment.

“We also need more beds in public hospitals every winter to cope with the increased numbers of older people in our population. Transferring patients to private hospitals with lower staffing levels won’t solve it.”

What other measures can people take to reduce their risk of becoming ill? Should we curb our socialising over the new year period?

Prof McConkey advises that we “stay away from people if you are sick. Don’t go to work. Don’t go out at all if you are sick. Keep up to date with your flu and Covid vaccines”.

However, he says that celebrating is important for our culture and community.

“We need to be sociable for our long-term health and happiness.”