What’s the real story with masks in SA?

Monday, 20 April 2020: Health NGO Right to Care, which is supporting the Department of Health with its coronavirus response, is calling on all South Africans to wear masks when leaving home. “South African citizens must wear cloth masks, not only because we have to comply, but also because it could protect other people if you are infected but not aware of it. A mask is one of the layers of protection against the spread of the virus,” says Dr Eula Mothibi, executive director at Right to Care who also manages Right to Care International.

Dr Eula Mothibi, executive director of Right to Care, who also manages Right to Care Internationa

“There is sufficient evidence that indicates we must all wear masks in public. The latest data indicates that there are fewer infections in countries in Asia, where wearing a mask is common place.”

The minister of health, Dr Zweli Mkhize, instructed all South Africans to wear cloth masks last week. The public were initially discouraged from wearing masks to ensure that supplies are available for health workers.

Dr Mothibi says the jury is out on how effective they are in protecting the wearer against the virus. “There is not a lot of evidence, but studies show it could stop you infecting others if you are unknowingly infected. In addition, the mask acts as a barrier to touching your face which can lower the risk of contracting the virus from contaminated surfaces. Rather be safe than sorry and wear a mask. The guideline is that cloth masks should have three layers, but if you only have a cloth mask with one layer, it is still better than nothing.”

She encourages the public to wear only cloth masks and leave surgical and N95 masks for healthcare workers who need them daily when they work with infected patients. It is critical that South Africa’s healthcare workers have masks as should they become infected, they are unable to work and healthcare facilities could close.


Don’t infect yourself – how to put a mask on and take it off

Dr Mothibi emphasizes that it is very important to put your mask on and take it off in the right way to ensure that you do not become infected in the process. She recommends that people follow these steps when putting on a mask:

  1. Wash your hands with soap and water.
  2. Take the mask by the strings or elastics and fit these behind your ears or head without touching the mask itself. The mask must cover your mouth and your nose completely and not be so tight that you cannot speak comfortably.

When taking the mask off, follow these steps:

  1. Wash your hands with soap and water.
  2. Take the mask off by the strings and be careful not to touch the mask. Do not wear it more than once.
  3. Drop the mask into hot soapy water and wash it. Hang the mask in the sun to dry and preferably iron to ensure the virus does not survive.

Ideally have more than one mask so that you can wash it daily.

Do not lower your mask when speaking, coughing or sneezing and do not touch it when it is on. The inner side of the mask should not be touched by your hands. Polyester or nylon are fabrics are ideal for masks. There should be very small spaces between the fibres and the fabric should not allow liquids to move through them easily.


One of the layers of protection

There has been some concern that wearing a mask will make people complacent about the other measures required to prevent infection and Dr  Mothibi says it is important to follow all the strategies to ensure layers of protection as you would protect yourself against the cold by wearing different layers of clothing. “Wearing a mask is a layer of protection along with washing your hands often, social distancing, staying and home and self-isolation if you are infected. We must train ourselves and remind each other if we see that someone is not sticking to all the layers of protection,” she says.


Small children and the elderly

Dr Mothibi warns that people must be careful when using masks on children under the age of two and people, such as the elderly or infirm, who are unable to remove the mask themselves. “It is not recommended for them and they should be staying at home,” she says.


Guidelines for cloth masks have been developed through engagements with the World Health Organisation (WHO), the University of Stellenbosch, the Cape Peninsula University of Technology, staff at the National Department of Health and at the Department of Trade, Industry and Competition. These guidelines will be developed into a set of recommendations for the South African clothing and textile industry when making masks for use by the general public.


Right to Care is supporting the Department of Health with its coronavirus response providing training and technical assistance including coordination, dedicated disaster management, enhanced surveillance, case identification and contact tracing, enhancing capacity for screening, testing, case management and communication.