Children and Adults Should Wear Masks in Public to Reduce COVID-19, Anesthesia Professionals Urge

CHICAGO – Physician anesthesiologists and other anesthesia professionals strongly urge everyone older than 2 to wear a mask in public, noting that it is the most effective means of reducing the spread of COVID-19.¹ The recommendation by the American Society of Anesthesiologists (ASA) and Anesthesia Patient Safety Foundation (APSF) reflects the unique perspective on the health risks of the virus by anesthesia professionals – who are on the front lines caring for patients with the infection – and is supported by the Centers for Disease Control and Prevention (CDC).²

Because airborne transmission is the primary route of transmission, universal wearing of masks in public is necessary to ensure public safety by preventing the spread of COVID-19, according to the ASA-APSF statement. Mask wearing may reduce the transmission risk of COVID-19 by as much as 50%, and if 95% of people wear masks, 33,000 lives could be saved by Oct. 1, according to a model developed by the Institute for Health Metrics and Evaluation.³

“Wearing a mask protects others as well as yourself and offers the opportunity for every person to make a difference,” said ASA President Mary Dale Peterson, MD, MSHCA, FACHE, FASA. “There is absolutely no evidence that masks can cause infection or breathing problems such as lack of oxygen or too much carbon dioxide. My fellow physician anesthesiologists, other health care workers and I wear masks for many hours every day to protect patients and ourselves and can verify they are very safe.”

Public health experts point to the success of controlling COVID-19 in Hong Kong, which is a densely populated area where almost everyone wears a mask in public. Despite a population of more than 7.4 million people and never locking down fully, Hong Kong has had only seven COVID-19 deaths.⁴

Wearing masks is effective because it blocks the spread of droplets through the air when people speak, sing, cough or sneeze, which is how the virus is most likely to spread. In addition to protecting others, masks may protect those who wear them by filtering out infected droplets before they are inhaled.

Many people with COVID-19 either have no symptoms or haven’t yet developed them but can spread the virus to others, which is why it’s important to wear a mask even if you don’t feel sick.

While masks are vitally important to stop the spread, they are not a replacement for maintaining a physical distance, the statement notes. Because the virus is more likely to spread among people who are in close contact with each other, maintaining a physical distance of about six feet is important.

Medical-grade masks should be prioritized for health care workers, people who are especially vulnerable, those who have tested positive for COVID-19 and their caregivers. ASA and APSF suggest others wear a simple cloth or paper mask and recommend:

• Cleaning your hands with soap and water or an alcohol-based hand-sanitizer before putting on the mask and after removing it
• Covering your nose and mouth, fitting the mask as closely as possible to the face
• Keeping the mask on when talking, coughing or sneezing – if it becomes soiled it should be changed
• Avoiding touching the front of the mask when removing it
• Throwing away paper masks and washing reusable cloth masks after each use

“Anesthesia professionals who treat seriously ill COVID-19 patients have seen the devastation of this disease up close,” said Mark A. Warner, MD, president of APSF. “Preventing the infection whenever possible is vital and mounting evidence suggests that all of us are safer if everyone wears a mask in public.”

1. Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Sciences (2020). https://www.pnas.org/content/117/26/14857
2. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html
3. https://covid19.healthdata.org/united-states-of-america
4. https://coronavirus.jhu.edu/map.html