Updated Apr. 6, 2020 9:56 AM
Less than one month into the new era of social distancing, quarantines and self-isolation amid the coronavirus pandemic, Americans have found themselves in a quandary: To wear a mask or not?
Until recently, much of the guidance from the medical community suggested healthy Americans need not wear face masks while going about everyday life. But that has since changed.
On Friday, the Center for Disease Control and Prevention issued new guidelines on wearing masks in public.
"CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others," the CDC announced Friday. "Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure."
The CDC still stands by their recommendation, however, that people not use surgical masks or N-95 respirators, which are critical supplies to be reserved for healthcare workers and other medical first responders. They also note that it is still critical to continue social distancing.
A Taiwanese woman wears face mask to protect against the spread of the coronavirus in Taipei, Taiwan, Tuesday, March 31, 2020. (AP Photo/Chiang Ying-ying)
The new guidelines represent a major change of course from the country's top officials.
When reached by AccuWeather on Tuesday, CDC press officer Arleen Porcell said the "CDC does not have guidance scheduled to come out on this topic." Porcell reiterated the CDC's position that masks should be worn by those who are sick or are caring for someone who is sick.
However, on Monday, CDC Director Robert Redfield told National Public Radio (NPR) that the agency is taking another look at the data around mask use by the general public. In an interview that was released on Tuesday, Redfield admitted, that the issue of face mask guidelines "is being aggressively reviewed as we speak."
At the end of February, weeks before the COVID-19 pandemic truly began wreaking havoc in the United States, U.S. Surgeon General Jerome Adams took to Twitter to urge citizens to stop buying masks, a sentiment echoed by Vice President Mike Pence.
Seriously people- STOP BUYING MASKS!
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!
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51.2K people are talking about this
“This morning we talked a great deal about additional medical supplies,” Pence said during a press conference on Feb. 29, the day of the first coronavirus death in the U.S. “Let me be very clear -- and I’m sure the physicians who are up here will reflect this as well: The average American does not need to go out and buy a mask."
But on Wednesday morning, Adams appeared on Good Morning America and told host Robin Roberts that the stance of the CDC has been adjusted in the weeks since.
"Now, we've learned about this disease," Adams said. "We've asked the CDC to take another look at whether or not having more people wear masks will prevent transmission of the disease to other people. But," Adams added, "here's the most important thing: Even if you do wear a mask it can't be at the expense of social distancing."
Adams' original position in February also considered the troubling shortage of masks available to healthcare workers, a stark reality that hasn’t lessened. On Wednesday morning, he stressed again that the general public doesn't need an N95 medical mask and by wearing one, individuals may be taking it out of the hands of a health care worker who needs it.
Initially, many officials and specialists shared the view that masks are unnecessary for the healthy, uninfected public because they were ineffective at preventing transmission. However, some of those same specialists are also now learning from the experiences of other countries, such as South Korea, on how to best flatten the curve.
State Rep. Denise Marcelle, D-Dist. 61, wears a mask as legislators convene in a limited number while exercising social distancing, due to the new coronavirus pandemic, at the State Capitol in Baton Rouge, La., Tuesday, March 31, 2020. (AP Photo/Gerald Herbert)
Jinwon Kim and Jaehyung Kim, two Korean sociologists, wrote a piece for The Independent about the societal reactions surrounding COVID-19 and the differing cultural approaches surrounding individualistic efforts to prepare for the outbreak.
“As sociologists, what we find interesting during this dark time is how we have developed different coping mechanisms and responses: individual efforts versus systemic or collective efforts,” the sociologists wrote on March 19. “In New York City, New Yorkers have run to grocery stores and stocked up on frozen and canned foods, disinfecting wipes and hand sanitizers. Oh, don’t forget toilet paper! Meanwhile, in Seoul, people are, overall, more calm and appear to be living their lives as usual – even in Daeugu, the epicenter of the outbreak in Korea. Instead of panic-buying, people wait patiently in long lines to buy facial masks, which are now distributed by the government at some places.”
On Monday, President Donald Trump said he “will take a look” at recommending that Americans wear masks in response to a road map for combating coronavirus authored by Dr. Scott Gottlieb, the former head of the Food and Drug Administration.
In a followup email, Porcell told AccuWeather the CDC has no further comment regarding Trump's comments or if there would be any consideration to encourage the general public to begin wearing masks.
Published by the conservative-leaning American Enterprise Institute, Gottlieb wrote that emerging evidence supported the idea of Americans wearing masks in order to prevent infected people from transmitting the disease unknowingly.
President Donald Trump holds his hand to his face as he talks about masks during a briefing about the coronavirus in the Rose Garden of the White House, Monday, March 30, 2020, in Washington. (AP Photo/Alex Brandon)
The comments run counter to Adams' and Pence’s from just four weeks prior, but the recent examples set by countries such as South Korea have shifted public opinion.
“Face masks are used widely by members of the public in some countries that have successfully managed their outbreaks, including South Korea and Hong Kong,” Gottlieb wrote. “The World Health Organization (WHO) recommended members of the public use face masks in the event of a severe influenza pandemic.”
"If you are sick: You should wear a facemask, if available, when you are around other people (including before you enter a healthcare provider’s office)," Porcell said in an email. "If you are caring for others: If the person who is sick is not able to wear a facemask (for example, because it causes trouble breathing), then as their caregiver, you should wear a facemask when in the same room with them. Visitors, other than caregivers, are not recommended."
AccuWeather recently spoke with Dr. Linsey Marr, an aerosol scientist at Virginia Tech, about how viruses spread in the air. She provided an apt analogy to easily visualize how they move in the air, advising to think about how second-hand smoke is dispersed and affected by the various forces around it.
"Face masks will be most effective at slowing the spread of SARS-CoV-2 if they are widely used," Gottlieb argued in his report, "because they may help prevent people who are asymptomatically infected from transmitting the disease unknowingly."
South Korean Prime Minister Chung Se-kyun takes off his face mask to hold a press conference on South Korea's recent preventive measures against the new coronavirus at the Seoul Correspondent Club in Seoul, South Korea, Friday, March 27, 2020. (AP Photo/Ahn Young-joon)
The dissonance between whether to wear a mask or not has led to a societal stigma attached with individuals' decisions, particularly for uninfected immunocompromised individuals or immigrants from Asian countries. In an interview with Time, Cheryl Man, a 20-year-old Chinese student in New York City, described her experiences with being the only employee at her company that wears a mask.
“Why do they think it’s about me? It’s a civic duty,” she said. “If I have a mask on, and if -- touch wood -- I’m infected, I could cut the chain off where I am. That could save a lot of people.”
A common argument against the public wearing masks is that the masks aren't overly effective at protecting against the virus. However, respiratory medicine expert David Hui, who studied the SARS outbreak, said the masks would be most effective at preventing infected asymptomatic individuals from spreading the virus.
Members of the Protection Civile Noemie Biamba, left, and Cyril Lamriben, right, wear masks to protect against the conoravirus escort a 51-year-old woman, suspected of having the coronavirus infection from her flat to an ambulance in Paris, Saturday, March 28, 2020. (AP Photo/Michel Euler)
"If you are standing in front of someone who is sick, the mask will give some protection," Hui said, according to Time. "The mask provides a barrier from respiratory droplets, which is predominantly how the virus spreads."
In South Korea, over 9,700 confirmed cases of COVID-19 have resulted in just 162 deaths from the virus. Professor Kim Woo-joo from Korea University Guro Hospital told Stephen Park, founder and CEO of Asian Boss, a South Korea-based media company, that he disagrees with the WHO recommendation to not wear masks. Kim said the differences between Asian countries and the U.S. is a problem.
“If you look at WHO's recommendations, they don't encourage normal people to wear masks. However, in Asian countries, because of the cultural differences, they do recommend people to wear masks,” Kim said in the interview.
“That's what they say, which I think is problematic. Masks have been proven to prevent infection," Kim continued. "Just look at China, Hong Kong, Japan, and Korea. In Asian countries, people wear masks. In the meantime, if you look at many European countries and the U.S., the virus is spreading rapidly. One of the reasons Korea has a relatively low rate of infection is because everyone is wearing a mask and washing their hands regularly.”
Kim went on to say that South Koreans learned the importance of sanitation efforts from past epidemics like the swine flu in 2009 and the MERS outbreak in 2015. He also said officials learned the importance of quickly developing test kits to make them easily accessible.
Jinwon Kim and Jaehyung Kim, the sociologists writing for The Independent, said wearing a mask wasn't just a precaution for select, uninfected members of the public. But rather, it was a crucial element of the country's successful social distancing efforts.
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