Your responsibility: The best advice on … masks

What can we do as individuals to combat the winter COVID-19 wave? In the first part of our special series, the health team asks experts for the best advice on masks.

State Health Minister Mary-Anne Thomas “strongly recommends” Victorians wear masks indoors and in crowded places, but there will be no mandate, except on public transport and in medical settings or indoors if you’re a close contact.

So how do people decide what to do? And what’s the best advice for individuals, given the COVID-19 fatigue?

According to health experts, the best advice is that every Victorian, including children over the age of eight, should wear industrial respirators such as N95 or P1 masks.

They should be worn in indoor settings that attract large crowds but have poor ventilation, from shopping centres to supermarkets, restaurants and on public transport.

They say cloth and surgical masks, while better than no mask at all, are still poor filters of small airborne COVID-19 particles, raising the risk of an infection with the BA.5 subvariant of Omicron, which is fuelling the latest wave.

Cloth masks leave a person 13 times more likely to contract an influenza-like infection than surgical masks, one study of 1600 Vietnamese healthcare workers shows.

“No gaps,” Melbourne University epidemiologist Nancy Baxter said when asked about which masks people should use. “But any mask is better than none.”

The more tightly fitting P2 or N95 masks are available at hardware stores, supermarkets and chemists. But if only medical masks are available, wearing a cloth mask over the surgical mask or “double masking” can provide added protection. Knotting the ear loops before tying them around the ears can also reduce gaps, one study shows.

Professor of biostatistics and epidemiology at the University of South Australia Adrian Esterman said he wore a mask in crowded outdoor settings where he could not safely socially distance, such as football matches. He also wore one recently in a cinema and wears one in a restaurant until he sits down.

Masks matter

• Everyone over the age of eight should wear an N95, P1 or P2 mask in crowded indoor settings.
• Good-quality, fitted masks reduce your risk of COVID infection by two thirds.
• Cloth and surgical masks are better than no mask, but are poor filters of airborne COVID particles.
• If only medical masks are available, wear a cloth mask over the surgical mask for added protection.

“Basically, any time you are walking through a crowd of strangers you should be wearing a mask,” he said.

Esterman said there was general scientific consensus that wearing a mask was beneficial to curbing the spread of the BA.5 variant, but it was difficult to obtain exact figures because “it’s almost impossible to do a randomised control trial of face mask wearing.

“But the trials that have been done show that … if you’re wearing a good-quality mask, like an N95, you’re basically two-thirds less likely to get infected.”

A non-infected person wearing a fitted mask has up to 75 per cent reduced chance of catching COVID-19, separate research shows.

Masks can help protect against the BA.5 subvariant of Omicron, which is fuelling the latest wave.Credit:Justin McManus

Esterman said N95 or P2 masks were superior to cloth or surgical masks for two key reasons: they have a higher degree of filtration and they do not let airborne particles escape because they fit the face better.

Baxter said the Omicron subvariant outbreak would be more contained in Victoria if more people were wearing masks.

She cited a study of 20 million people across six continents that found mask wearing reduces the effective reproductive number – or the average number of people an initial case infects in a population – by 19 per cent.

“What I’m asking everyone to do is to look at what you’re doing and think about what you could do that’s a little safer in terms of COVID-19 spreading,” she said.

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