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October 16, 2021

The ‘great mask debate’ continues over Covid 19

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Mia Armitage*

Public debates over whether all Australians should be wearing face masks during the COVID-19 pandemic now include at least two GPs on the Northern Rivers.

Mullumbimby-based Dr Ian Kingston told Echonetdaily earlier this week mask use is one of the most effective physical interventions for preventing the spread of respiratory viruses.

The GP supported his opinion with evidence published via two medical research articles, one in Medscape Family Medicine and the other in a Cochrane Review.

Dr Kingston said infected droplets weren’t just spread when people sneeze or cough, but also through talking.

Meanwhile, the World Health Organisation (WHO) was reportedly in the process of reviewing new data related to mask-use in Hong Kong but was yet to announce any changes to its advice on the public wearing of face-masks.

So far, WHO has said hygiene and physical distancing is more important than mass use of face masks and with a shortage of quality face masks in Australia, lead authorities here have been following the WHO advice.

Possible correlation vs causation

Sydney University adjunct professor and Lennox Head based GP Dr Dan Ewald, also clinical advisor to the North Coast Primary Health Network, described the issue as ‘the great mask debate’.

Dr Ewald told Bay FM’s Community Newsroom overseas face mask evidence wasn’t conclusive and could show correlations.

‘It’s understandable that there are differences of opinion when there isn’t a clear evidence-based answer to the question,’ Dr Ewald said.

‘There’s plenty of logic to suggest that masks could be useful but there are also some lines of logic that masks could be a problem,’ he said.

Dr Ewald said a lot of transmission was happening from asymptomatic people and experts didn’t yet know how.

‘It might not be from coughing or sneezing or talking,’ he said, ‘it might be because they’ve been rubbing their nose and then touching a table and then you come and touch the table’.

The professor and GP suggested some of the evidence to date could show correlation rather causation.

‘We’ve also gotta remember that a lot of the circumstantial evidence that we’re looking at are coming from situations where people are living in much more crowded conditions than most of Australia lives in and that could be an important factor,’ he said.

‘People that choose to wear a mask may also be much more conscientious about washing their hands and they may be much more conscientious about keeping distance from people.’

Homemade masks could be a ‘hazard’, says professor

Dr Ewald said if high-quality masks were available to everyone in Australia and people were having to regularly enter crowded spaces such as packed public transport, he would be more supportive of universal face mask-wearing.

But he said most people living in regional areas such as the Northern Rivers were unlikely to be entering crowded, high-risk areas unless they were health-workers or other essential workers on the frontline of the pandemic.

The doctor also said wearing home-made masks, bandanas and scarves was unlikely to be effective against the spread of COVID-19.

‘If it stops you touching your face, that’s a good thing ‘coz that’s one of the traditional messages we’ve been promoting all along,’ Dr Ewald said.

‘But if putting a mask on your face actually makes you touch your face more – coz people keep fiddling with them – if you don’t use the mask really carefully and you end up having your fingers contacting the inside surface areas of the mask, then you’re doing the opposite of keeping germs away from the insides of your mouth and nose, you’re bringing them specifically into the space of your mouth and nose,’ he said.

‘So how you use a mask could turn it into a hazard rather than a help.

‘I think to do that well, you’d have to combine it really well with messages about how to use a mask safely so that it doesn’t become a liability.’

Dr Ewald said research into all aspects of the pandemic was ongoing and he was confident the WHO would be examining the matter of face-masks closely.

In the meantime, given Australia’s well-known shortage of high-quality face masks and personal protective equipment in general, Dr Ewald reiterated the importance of prioritising healthcare workers.

  • Mia Armitage is Bay FM’s Community Newsroom producer



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  1. It is simple !,
    you don’t have to wear a mask , it is only for those who don’t want to risk their life, or are reluctant to infect others. All the rest of you can do what you like, or unfortunatly what you are forced to do due to lack of PPE and insufficient testing capability.
    Cheers G”)


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