Medical experts say 'mouth and nose lockdown' could prevent another 'full-body lockdown'

Medical experts are pushing for the Government to bulk buy masks to give out in case there's another outbreak of COVID-19, saying a 'mouth and nose lockdown' could prevent the need for another level 4 lockdown.

They're also urging "include mandatory mask provisions" at different pandemic alert levels, making them compulsory at workplaces and other public indoor settings at level 2 and above. 

The recommendations were outlined in an article published in the New Zealand Medical Journal (NZMJ) on Friday.

"What we're learning is that it's mainly a respiratory pathogen - you pass it on to people by breathing, talking, laughing, singing - all those things fire out the droplets and can infect a whole room full of people,"  co-author Michael Baker, an University of Otago epidemiologist, told Newshub.

After eliminating the disease from our shores a number of cases have cropped up at the border, as Kiwis return home to avoid the pandemic - which is still raging overseas. 

While tests have failed to uncover any cases in the community, there have been a number of close calls - with reports of people leaving managed isolation and quarantine without being tested. In one case, a couple released on compassionate grounds were later found to be infected with the virus, which has killed nearly half-a-million people in the past six months. 

"New Zealand succeeded in eliminating COVID-19, but this success has been challenged by poor management of cases at the border in mid-June 2020," the article reads.

"Elimination status for the country may remain fragile given likely increases in arrivals from countries where COVID-19 is circulating, especially if border restrictions are eased further."

While many countries have had to reintroduce lockdown measures in response to new outbreaks, New Zealand implemented one of the strictest lockdowns in the world to eliminate the virus completely, taking advantage of our unique geographic position, in the hope we'd never have to do it again. 

If everyone had access to free masks, the authors say, we could avoid it even if community transmission resumed.

"The countries in the world I think are doing the best job in managing this threat, they've all taken on board the idea of the multi-barrier approach - you don't just have one line of defence against this virus, you have as many as you can." 

Michael Baker.
Michael Baker. Photo credit: RNZ

Many Asian countries, despite their proximity and close travel ties to China, have been far more successful at controlling their outbreaks than Western nations, such as the US, Brazil and the UK. 

"Due to previous experience with significant epidemics and pandemics," they have a culture of wearing masks in public, the NZMJ article explains. "But until very recently there has been reluctance in Western countries to use masks in public places."

Part of this is down to confusion between the different kinds of masks and what they're used for, the experts say. Medical masks cost more, and are designed to stop wearers from contracting pathogens - but mass masking refers to the wearing of cheaper masks, sometimes just pieces of cloth, which stop people from spreading the disease in the first place.  

"Effective mass masking in populations can be implemented using homemade equipment with straightforward instructions for correct use...  Cloth masks are effective and have the added advantage of preserving single-use mask stocks for medical use."

Dr Baker says it needs to become as commonplace as covering up in summer to avoid getting burned.

"Some of us grew up and didn't put on sunscreen, but now we do. It's not something you particularly want to do, but we just recognise it's a necessary precaution - facemasks are in the same category now." 

Hong Kong has a population slightly higher than in New Zealand. Its government supplied free masks for everyone, and even though it's attached to the Chinese mainland - where the virus was first detected - as a result, has only had 1194 confirmed cases of COVID-19 seven deaths.

At level 1, which we're at now, the experts say masks should be mandatory for everyone on "inbound international flights and airport terminals, quarantine and isolation facilities", including staff.

At level 2, they should be mandatory on domestic transport - including trains and buses - as well as indoor workplaces, shops, schools and universities, care homes and where the public comes into contact with health professionals. 

At level 3, they recommend masks be mandatory even outdoors wherever 10 or more people congregate. 

"Universal mask adoption - a 'mouth and nose lockdown' - could help to avoid the need for another 'full-body lockdown'."