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Covid-19 Primary Care Resources

Advice on wearing PPE for the public

Revised UK and WHO guidance: education on proper use is critical


This information is sourced from The Cabinet OfficeThe World Health Organisation (WHO)the LancetPHE, the MDU and the UKRI:

In light of the increasing transmission of new variants of Covid-19, surgical masks have been recommended by some groups as a better alternative to standard face coverings. However PHE guidance on face coverings remain the same.

Preliminary evidence suggests that mask use significantly lowers the risk of Covid transmission by large droplets

The Cabinet Office advises the public that you must wear a face covering by law in these indoor settings

Face coverings are also:

  • Advised in other enclosed public spaces where social distancing may be difficult and in care homes
  • Needed in NHS settings, including hospitals and primary or community care settings, such as GP surgeries

The Cabinet Office also advises the public that:

  • Face coverings are largely intended to protect others
  • Emerging evidence suggests that the risk of transmission may be reduced by using thicker fabrics or multiple layers
  • Face coverings should not be used by children under the age of 3 or those who may find it difficult to manage them correctly

The Cabinet Office also gives advice on how to wear a face covering and maintaining and disposing of a face covering. These links give useful advice for the public (eg, not taking a mask on and off in quick succession, not touching the outside, not putting it down on a table in a cafe or disposing of it in the recycling)

A key issue however is the vast majority of the public do not wear PPE correctly and there is a need for primary care to advise the public about correct use. An observational study published in the Lancet on 3rd May 2020 of 10,211 pedestrians in Hong Kong found that:

  • Despite very high prevalence of face mask use in Hong Kong, poor use of masks is common
  • 13% of mask users wore them incorrectly eg upside-down/ inside out/ too low (i.e. exposed nose / mouth)
  • 84% were disposable surgical masks and 76% reported re-using masks

The WHO’s view on masks:

  • Wearing a medical mask can limit the spread of Covid-19
  • However, the use of a mask alone is not sufficient
  • Other measures such as physical distancing and hand hygiene should be adopted
  • If there is widespread community transmission governments should encourage the general public to wear a washable and reusable mask ideally made of 3 layers of fabric
  • WHO provides a video on the composition of a fabric mask and how to safely wear one

The WHO’s view on gloves:

  • WHO does not recommend the regular use of gloves by people in the community
  • The wearing of gloves may increase risks, since it can lead to self-infection or transmission to others through touching contaminated surfaces which is not followed by removal of gloves and hand hygiene

The WHO has published resources for the public including videos on when and how to use masks

On 10th February 2021 a CDC paper stated that both of the following mask modifications both substantially improved reduced wearer exposure to Covid-19:

  • fitting a cloth mask over a medical procedure mask
  • knotting the ear loops of a medical procedure mask and then tucking in and flattening the extra material close to the face

See also:

Face covering exemptions

Mask wearing in primary care