Explainer: Should we wear masks inside our homes as advised by the govt?

Staying indoors ensconced in the safety of your home should keep the roaming SARS-CoV-2 at bay, one was told. Until now. On Monday (April 26), Dr VK Paul, member (health), NITI Aayog, involved closely in the country’s COVID-19 management, said at a press briefing that the “time has come” for everyone to wear masks at home too even if they did not have a family member who has contracted COVID-19 in the house. What was the reason for this recommendation?

What prompted this suggestion by the government? 

Latest research has shown that the SARS-CoV-2 is transmitted and spreads largely by respiratory droplets, which travel in the air when someone coughs, sneezes, talks, shouts or sings. These droplets can drop on another person in the vicinity and they can breathe in the virus. Moreover, since a large part of the population may be asymptomatic, they may end up passing on the infection to people inside their home. That probably accounts for why in this second wave, entire families living in one home are all jointly falling prey to this disease.

Also read: France says handmade cloth masks less effective against new COVID variant

Why has it become significant to mask up in your home in the second wave?

The second wave has been more serious than the first with the infection spreading like wildfire in the country. Daily, India is recording more than 3.5 lakh cases and 2,800 deaths. It faces the twin challenge of a crumbling health infrastructure and mutating viruses, and with worrying internal assessment that cases will peak in mid-May.

The number of COVID-19 patients has been relentlessly increasing and worse, the patients are complaining this time about shortness of breath and are in urgent need of medical oxygen.

According to Dr Paul, if no one wore masks, there was a 90 per cent risk of an infected person transmitting the disease to someone else, whereas, if everyone wore masks at all time, the risks went down to 1.5 per cent, he said. Masks, which are largely being used to protect others from getting COVID-19 rather than just the wearer, will not just break the chain of transmission, but also protect those at highest risk. This is the kind of thinking the the government wants to encourage.

An Indian Express report said the government had two targeted outcomes: First, they wanted to protect the elderly and those with co-morbidities from that one asymptomatic family member and secondly, to lower local house outbreaks that have been the hallmark of the second wave.

Also read: What’s behind the rise in number of COVID-19 cases?

What is the government basing this suggestion on?

The government is basing this suggestion on data from studies done by the North Carolina Department of Health and Human Service, which stated that there is “a negligible risk of transmission” when two people who are masked maintain a distance of six feet between them.

To elaborate on the data, the risk is 1.5 per cent (low) when two people who are interacting wear masks, and the risk is 5 per cent (medium) when the infected person is masked up and the uninfected person is unmasked. However, the chances of getting the virus shot up to  30 per cent (high), if the infected person is not wearing a mask but the person who is not infected is wearing one. However, the risk is the highest at 90 per cent, when neither the infected nor the uninfected person is wearing a mask.

The North Carolina Department of Health and Human Service said that there is a negligible risk of transmission when two people wear masks and maintain a distance of six feet.

Has any other health agency or government given such orders?

In November 2020, the North Carolina passed an order that is similar to what Dr Paul recommended which stated that everyone must wear a face mask indoors if anyone else in that space is not a member of the same household, even if it is a small number of close friends and family.

The CDC too recommended that masks should still be worn in addition to staying at least six feet apart, especially when you are indoors around people who don’t live in the same household with you. Older people are considered to be vulnerable to any outsider coming into the home and they must mask up when they interact with them.

Also read: Why people are getting COVID-19 even after getting vaccinated

Any other study which echoes this same suggestions?

A study done of Chinese families in Beijing suggested that wearing masks at home might help ward off the spread of COVID-19 infections among family members living in the same household, but only before symptoms develop.

This study which was published in the British Medical Journal said that this practice of wearing masks at home was 79 per cent effective at curbing transmission before symptoms emerged in the first person infected but it wasn’t protective once symptoms had developed. The researchers had questioned 460 people from 124 families in Beijing China.

The findings backed universal face mask use not just in public spaces but also at home. According to them household transmission is a major driver of epidemic growth and added  that their findings could be used to inform precautionary guidelines for families to reduce intrafamilial transmission in areas, where there is high community transmission or other risk factors for COVID-19.

Another study looked at the outbreak on the USS Theodore Roosevelt, which was a setting where people lived in close quarters. When face covering were used on-board the risk of contracting COVID-19 was reduced by 70 per cent.

the bottom-line: do you mask up at home or not?

You can’t really be sure about every relative or repair person who shows up at your door. Instead, of second-guessing or assuming that they are following the rules, mask up when someone who doesn’t live with you enters the home. But, with the second wave in India  hitting entire families in one shot, it seems prudent to wear masks at home as well, however tedious or uncomfortable it is going to make you feel.