How effective are face masks at stopping the spread of flu?

People on public transport are wearing face coverings again, while hospitals are asking staff and patients to mask up.

Not just a blast of nostalgia for 2020, it’s due to a strain of flu rampaging through the country causing so much pressure on the health service a hospital had to declare a critical incident yesterday.

So if you don’t want to catch it and be laid low for the festive season,

The short answer is: yes.

While this was a thorny topic of debate during the pandemic, with some protesters even cutting the mouth out from their masks to show they refused the ‘new normal’, the science is now more settled.

In a review of the evidence earlier this year, the British Medical Journal said: ‘In community settings, any mask use is protective during epidemics, especially if used early, when combined with hand hygiene, and if wearers are compliant.

‘Community use of N95 respirators is more protective than surgical masks, which are more protective than cloth masks, but even cloth masks provide some protection.’

They added that ‘extensive evidence’ gathered during the Covid-19 pandemic supports the use of masks during periods of high epidemic activity of any respiratory illness, such as flu.

Even people who do not feel unwell should mask up in such circumstances, because they could be asymptomatic and still transmitting the virus without realising it.

How do face masks work to reduce infection?

A University of Edinburgh study released in 2020 showed how face masks could reduce the distance breath travels by more than 90%.

They tested seven types of face covering, from medical grade to homemade cloth masks, and said all could potentially limit the spread of Covid-19.

This is because the breath can contain small droplets of water – some of which may contain traces of the virus – which are blocked to a greater or lesser degree by the mask.

While all of them limited the forward flow of breath, only surgical grade stopped it from leaking out around the back and sides.

Heavy breathing and coughing, in particular, were shown to generate intense backward jets.

This showed clearly how wearing a mask can protect others, but other studies have also shown how masks protect the wearer.

A report from the US Centers for Disease Control and Prevention (CDC) in 2021 showed how consistent use of a face mask or respirator in indoor public settings was also associated with lower odds of testing positive for Covid.

People who reported always wearing a respirator-tyle mask indoors were 83% less likely to test positive, while even those who only wore simple cloth masks were 56% less likely.

Flip-flipping guidelines on masks

During the Covid pandemic, there were conflicting claims about masks. In 2020, the World Health Organisation said only people with symptoms of respiratory illness were recommended to wear them.

Advice changed several times, sometimes discouraing their use and at times saying N95 respirators should be widely worn.

Masks become a symbol of government control, but the BMJ pointed out that early in a pandemic, before vaccines have been developed, they can beone of the only protective measures available.

It’s not just masks though

The NHS made an ‘urgent plea’ for people to get their flu vaccines on Monday, to reduce pressures on the health service.

And one of the main drivers of the spead of infection is people going about their daily lives while unwell, rather than reducing their contacts.

Daniel Elkeles, chief executive of NHS Providers, which represents NHS trusts, told Times Radio: ‘I think we need to get back into the habit that if you are coughing and sneezing, but you’re not unwell enough to not go to work, then you must wear a mask when you’re in public spaces, including on public transport, to stop the chances of you giving your virus to somebody else.’

He added that for everyone’s benefit, people coughing and spluttering in the office should probably just ‘go home’.

Amanda Walters, Director of the Safe Sick Pay campaign, told Metro: ‘Masking up on public transport can help, but we need to tackle the problem at source.

‘Better sick pay from day one will reduce the pressure for workers to drag themselves to work in a flu season that causes huge pressures on our NHS.

She said the most effective way to stop the spread of illness is allowing people who are unwell to feel supported in staying at home: ‘We all try to battle through illness when we can, but going into work with a bout of flu can prolong your recovery time and put many more people at risk.

‘Unfortunately the UK’s statutory sick pay system causes perverse incentives, as people don’t get paid for the first three days of illness and can feel pressured to work to avoid losing that income.’

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