White House Likely to Urge Face Cover to Combat Aerosol Risk

The White House is likely to recommend that people living in areas hardest hit by the coronavirus cover their faces in public, as new research shows that the pathogen may hang in the air after people sneeze, cough or even talk.

The administration won’t urge Americans to buy commercial medical-grade masks, which are in short supply at hospitals. The recommendation would apply to areas with high levels of community transmission of the virus, the person said.

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Public-health authorities and researchers have been racing to understand how the coronavirus spreads. A growing body of research suggests that small, virus-laden droplets of spit or mucus from a cough, sneeze or even talking could linger in the air, creating a source of infection that circumvents hand-washing and surface cleaning.

The government would ask people to cover their faces for essential activities such as going to the grocery store, while continuing to recommend that Americans stay home from work and school as much as possible and avoid gathering in groups.

The person asked not to be identified because a final decision on the guidance hasn’t been made. It’s not expected on Thursday, but soon, the person said.

The recommendation may have been influenced by a quickly assembled report from the U.S. National Academies of Sciences, Engineering and Medicine.

Spread Risk

The April 1 report, which was requested by the White House’s Office of Science and Technology Policy, concludes that the virus can be spread through the air, even during regular conversation, at far higher levels than first thought.

Scientists originally believed that the risk of infections came mainly from droplets produced when an infected person coughed or sneezed. Recent research suggests that the virus may also be aerosolized when a patient exhales.

Broad use of facial coverings is less about protecting the wearer, and more about protecting others. With some people experiencing mild or no symptoms, a facial cover may help limit exhaled or expelled virus droplets from infecting others.

A recent study from the University of Nebraska found the virus’s genetic signature scattered throughout the rooms and in the air surrounding Covid-19 patients, extending even out into the hallways of the hospital where they were receiving care. Work is still underway to determine if the particles were capable of infecting people.

Another report that examined levels of SARS-CoV-2 at two hospitals in Wuhan, China, where the outbreak began, found that they were highest in the toilet facilities for patients and in the rooms where health staff put on and removed their protective gear. A key source of exposure could be when the virus is tossed back into the air when a mask or other form of personal protective gear is removed.

Gear Shortages

Demand by the public for masks -- even if the White House urges “face coverings” and not medical masks -- could create new shortages health care providers, who face the highest risk of contracting the virus when they care for infected patients. Health workers have faced severe shortages of protective gear, in some cases putting their health at risk.

Officials in Seattle and King County, where the first case of Covid-19 and the first community transmitted case were detect in the U.S., said masks may be appropriate in some cases for the public. Medical masks, however, should be reserved for health care providers, they said.

“Medical masks are needed for health-care workers who are in close contact with someone who has COVID-19,” Jeff Duchin, Health Officer for Public Health Seattle and King County. “We need our health-care workers to be able to continue providing their services during this pandemic. For the general public, homemade fabric masks, especially if well-made and fit, may provide some benefit.”

On Wednesday, Los Angeles Mayor Eric Garcetti urged people not to buy up medical-grade masks.

“Please do not get medical grade or surgical masks,” Garcetti said as a press conference. “We must not contribute to the shortage of this personal protective equipment.”

He announced #LAProtects, a campaign that seeks to have garment and apparel makers in Los Angeles ramp up production to make up to 2 million cotton non-medical grade masks per week, while design and architecture schools will use 3-D printing technology to make personal protective gear.

During the press conference, somebody asked how the face and culture of the city will change with everybody wearing masks. Garcetti picked up a black cloth mask and affixed it to his face.

“This will be the look,” he said.

— With assistance by John Tozzi

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