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Respiratory patients should not be exempt from wearing face masks, say experts

inhaler asthma

People with respiratory conditions should not be exempt from wearing face masks in public, international respiratory experts have said.

In a paper for the European Respiratory Journal, experts from the Respiratory Effectiveness Group argued that exemptions imposed by ‘several Governments’ for patients with asthma and COPD are ‘not evidence-based’.

It said: ‘It must be strongly stated that such exemption is not evidence-based, and it may carry increased risk of personal infection to the estimated 544.9m people worldwide suffering a chronic respiratory disease.’

The REG, consisting chiefly of academics from the UK and Spain, also said there was no evidence that wearing face coverings can trigger an asthma attack or exacerbate COPD from an ‘increase in inspiratory pressures’.

The experts wrote: ‘Although facemasks undoubtedly enhance breathing resistances, the degree of discomfort experienced by some patients is influenced by its affective component.

‘Dyspnea is a sensation, and supratentorial affects such as anxiety and claustrophobia might cause the added sensation of “being unable to breathe” with a mask.’

But it added: ‘Indeed, the WHO states that face masks of breathable material, worn properly, will not lead to health problems.’

As well as the risk posed to individuals, avoiding wearing face coverings may increase the risk of group infections, the researchers said.

‘Beyond hand hygiene and physical distancing, face masks are fundamental for personal and group protection to prevent the spread of infection both in patients and in their caretakers,’ their paper said.

Lead author Dr Joan B Soriano, of the World Health Organisation’s Covid-19 Clinical Network Knowledge Exchange Team, said: ‘Patients with asthma, COPD or other respiratory diseases should wear the mask without exceptions.

‘If they have respiratory failure or with a feeling of shortness of breath when putting it on, they should most likely limit their activity, especially outdoors.’

In the UK, it has been mandatory to wear a face covering in areas such as shops and public transport since June.

But Government advice says people who ‘cannot put on, wear or remove a face covering because of a physical or mental illness or impairment, or disability’ are exempt.

It does not specify particular diagnoses and patients are not required to present a GP note to prove their exemption.

However, GPs have reported fielding a large number of questions from patients regarding exemptions.

At the beginning of the pandemic, the chief medical officer urged patients with asthma and COPD take more stringent measures than others in protecting themselves against the virus due to increased vulnerability.


Patrufini Duffy 2 October, 2020 8:32 pm

Publication bias.

David Church 5 October, 2020 12:09 pm

Surely they are one of the groups most likely to benefit from wearing of face-masks.
Some common sense at last.