Face masks and the latest advice: coverings will be compulsory on public transport - here are your options

Face masks will be made compulsory on all public transport in England from June 15, the Transport Secretary has announced.

Grant Shapps said that the use of face coverings will be "offer some, albeit limited, protection" against the spread of coronavirus as passenger numbers increase with the further easing lockdown measures.

Travel operators could refuse to let passengers on board if they are not covering their face from next week - and those who refuse to follow the new protocol could face a fine. Exceptions will apply for very young children, disabled people, and those who have breathing difficulties.

Previously, government advice urged the public to wear a face covering in crowded and enclosed places, but it was not made mandatory.

A face covering, such as a homemade cloth covering, should be worn “in enclosed spaces where social distancing is not always possible”, such as "some shops", according to Government guidance.

It adds that “homemade cloth face-coverings can help reduce the risk of transmission in some circumstances” as it clarifies that the purpose of the mask is not to help the wearer but instead to “protect against inadvertent transmission of the disease to others if you have it asymptomatically”.

Government guidance warns that if an individual has coronavirus symptoms they, along with their household, must still isolate at home and that “wearing a face covering does not change this”.  Hand washing should commence both before and after a facial covering is worn and removed. 

Official instructions on homemade face coverings can be found on the government website, which instructs the user the key thing is to ensure the mouth and nose are covered. The below video and graphic give a useful illustration of the process:

Masks are routinely worn in China, South Korea and other countries in the Far East, which have dealt with previous coronaviruses in recent memory. At the beginning of this outbreak, much of the talk in the West was of how mask-wearing was a cultural issue and the scientific evidence was scant. 

The Centers for Disease Control in the US, which previously followed the UK approach, is now recommending Americans wear "cloth-face coverings" when they are out in public. In Europe, the likes of Germany and Spain are all including face masks and other forms of personal protective equipment (PPE) in their lockdown exit strategies, with commuters in Madrid being handed masks as restrictions on movement slowly start to be lifted. 

According to Trisha Greenhalgh, a professor in primary health care at Oxford University, the evidence so far has focused on whether the masks can stop a wearer from being infected when in fact the realisation is gradually dawning that if we all wear even rudimentary masks there will be a lot fewer germs floating around in the first place. Here's how it works:

“It doesn’t have to be perfect,” Prof Greenhalgh says. "If you were wearing a mask to protect yourself from everybody else’s droplets it would need to meet official standards. But we are talking about everybody as good citizens wearing them to protect other people.”

So from home-made versions crafted out of hoover bags and panty liners (yes, really) to bandanas that transform even the most genteel Home Counties shopper to roadside bandit, to the urban cycle masks beloved by Gwyneth Paltrow that make the rest of us resemble a poorly equipped Power Ranger. The question, naturally, is what kind of face mask do you have to hand and how can you wear yours better?

The most common design that everyone clambered to buy from Amazon in the early days of lockdown. Effective to a point, protecting the wearer against large droplets although not so much with airborne particles due to the loose fit. They are also only useful for a limited period of time as once they become damp through a person’s breath – which can happen in as little as 15 minutes – they become permeable.

The masks also cannot be re-used and must be disposed of after wearing. Which is possibly bad news to all those you spot wearing theirs under their chin as they answer their phone/sip their coffee/go for a crafty cigarette: once removed from the mouth they cannot be put back on again.

Note to NHS and care home staff: current guidelines state the masks can provide some protection if standing more than a metre from infected patients. 

The most effective mask in circulation (although still in critically short supply). The masks take their name from their ability to screen out 95 per cent of airborne particles. Experts do not recommend the public use these masks as they are intended for healthcare workers in close contact with coronavirus patients and require careful fitting around the face. The mask is only properly effective if worn with full PPE.

Top of the range are the so-called "urban air masks" developed by Swedish firm Airinum, which sold out after Gwyneth Paltrow was spotted modelling one and are now being peddled for hundreds of pounds on online auction sites. Fredrik Kempe, the co-founder of the Swedish luxury brand, says daily sales have rocketed beyond 10 times what is normal. 

The rest of us must make-do with the sort of neoprene anti-pollution face masks first modelled by Hannibal Lecter and later taken up by overzealous cyclists in a rose-tinted pre-Covid age when all we had to worry about was dying early from air pollution.

The masks remain untested with regard to coronavirus and don’t have to abide by the same standards as medical equipment, so check their filters are N95 grade (or an equivalent).

They also need to be washed or have their filters changed regularly, depending on the design.

A 2013 study by Public Health England (PHE) looked at the various suitability of household materials to filter bacterial and viral aerosols when used as masks. Vacuum cleaner bags seemed to be particularly good; less so, breathable materials such as 100 per cent cotton, linen and silk.

However, there is no evidence that your mask needs to be made with any particular expertise or care to be effective for controlling the spread of germs. Professor Trisha Greenhalgh has created her own mask out of a walking bandana with a panty liner folded inside, which she currently wears when she leaves the house. “Waterproof, sterile and thin, they are just the thing,” she says.

The new advice from SAGE could recommend the public wear a face covering rather than a medical mask, in order to prevent a shortage for frontline workers in hospitals and care homes. 

A recent study conducted in South Korea found that if you have Covid-19 and cough on someone from eight inches away, wearing a cotton mask will reduce the amount of virus you transmit to that person by 36 times. At a press briefing earlier this month, US president Donald Trump even claimed scarves were frequently "better" than masks. In actual fact the Centers for Disease Control guidance states that scarves and bandanas (which are broadly deemed to be similarly effective) should be used as a last resort when masks are not available.

Now recommended for public use by the US health authorities, bandanas are also catching on in the UK. 

Joanne Millburn has started a new Birmingham-based business, Millie’s Masks, designing cotton bandanas inspired by her 10-year-old daughter. Joanne, who in normal times is a wedding dress maker, says she has received 100 orders since setting up. Disturbingly the skull pattern is so far the most popular, though she says other designs are available. “The masks are not going to stop people getting the virus but certainly they will help prevent its spread,” she says.

Where once you would don one for insulating your basement, suddenly the humble builder’s dust mask has created the sort of levels of demand that have led to hour-long queues even to access the B&Q website. 

They provide a tight fit, which scientists say is essential for blocking out airborne particles. As with other makeshift Covid masks, people have taken to spraying them with a high-percentage alcohol spray in order to sterilise them between use. However do so with care, as studies in China have suggested this can lower filtering efficiency.

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