International Physicians and Health Care workers call on WHO and CDC to reserve PPE for frontline medical teams and recommend nonmedical fabric face masks be worn by public.
We the physicians and health care workers around the world, working on the front lines fighting against COVID-19 and treating victims of this disease call on the CDC and WHO to add further safety information to their public recommendations during this escalating public health crisis. We trust the CDC and WHO to lead our medical teams and help us keep the public safe from harm. During this crisis, the public education and information we receive from WHO and CDC is crucial to keeping us all safe and to minimize further loss of life. We hope to work with these esteemed organizations to implement their recommendations to contain COVID-19.
COVID-19 is a novel virus. Thus far we have learned it is a respiratory virus that is highly infectious being spread by asymptomatic carriers and those lacking noticeable symptoms through large droplet transmission. As such, face masks have an important role to play in slowing the spread of this disease by people who may not even know they are infected. Several countries including, Hong Kong, Taiwan, China and South Korea have recommended all healthcare workers and the public wear facemasks to prevent community transmission. The fall in the number of reported cases of people contracting the disease in these areas demonstrates this method, together with social distancing and hand washing, was successful in slowing the spread of COVID-19.
Throughout US history emergency medical responses included the use of facemasks and nonmedical face masks during pandemics. The WHO recommended face masks during severe influenza outbreaks. CDC also recently recommended health care workers use nonmedical fabric facemasks such as bandanas and scarves when surgical masks are unavailable to care for patients with Coronavirus.
As physicians and health care workers ourselves, we are acutely sensitive to the shortage of masks, but we think we should make recommendations to the public while also being truthful about the shortage and its consequences. However, today, given the growing pandemic and body of new and emerging evidence, data regarding the high proportion of asymptomatic and presymptomatic transmission, it is imperative that the population adapt their behavior to help flatten the curve of COVID-19 transmission. Reducing transmission in the population will also reduce the number of patients we eventually have to admit, treat or even intubate, and thus help alleviate the mask and other protective equipment shortages in the future.
We urge the CDC and WHO to recommend the general public wear nonmedical fabric face masks in public. We appreciate the continued reservation of supplies of personal protective equipment for healthcare workers. We understand until such time a sufficient supply of medical facemasks is available for the general public, nonmedical fabric face masks including homemade masks from scarves and bandanas will prevent symptomatic and asymptomatic transmission by containing large droplets that spread COVID-19. We stand with the WHO and CDC to advocate for the public to send N95 respirators, surgical masks and other supplies to hospitals to help front line healthcare workers facing supply shortages.
The following should supplement prior recommendations:
1.The novel coronavirus is known to spread via droplets. Since infections are now shown to take place between individuals who are not showing signs of infection, individuals going out in public should wear a nonmedical fabric face masks until the supply of medical face masks are sufficiently abundant for health care workers and the general public. Scarves, bandanas and other homemade face coverings can be used to act as a barrier to stop and prevent the spread of coronavirus.
2.Personal protective equipment should continue to be reserved for health care workers and any unused N95 respirators and medical face masks should be sent to hospitals for use on the front lines to treat patients with COVID-19. Priority for N95 masks should be given to professionals performing aerosol generating procedures such as intubation.
3.These recommendations should act to supplement and not replace guidelines and other recommendations made to date.
4. We urge the CDC and WHO to publish guidelines for making, using and sanitizing homemade masks, perhaps including sanitizing and reusing procedure masks as they become available for the general public, though the bulk of those should be reserved for health-care workers until we are over the shortage.
We are facing an unprecedented health crisis. Working together, adhering to the recommendations and remaining in our homes will contain this disease. Preserving personal protective equipment for healthcare workers, we hope to increase our ability to treat infected patients and care for the public – thus reduce the spread of the disease and the number of deaths from COVID-19. With your help and decisive action, we can and will prevail.