Dear Dr Tedros, WHO Colleagues, World Leaders and Public Health Experts

We, the undersigned, demand #Masks4All

We understand that all of the below are essential to fight back against this deadly COVID-19 pandemic:

• Physical distancing – two metres/six feet apart, everywhere possible
• Regular hand washing with water and soap for at least twenty seconds
• No touching of the face
• Self quarantine for 14 days if I came into contact with somebody with COVID-19
• Self-isolation if I have any symptoms suggestive of COVID-19 or any other respiratory illness for 14 days or until the symptoms end, whichever is longer
• Wide-spread and intensive contact tracing
• Wide-spread testing for all
• Disinfecting and sanitisation of surfaces
• Sneeze and cough into a bent elbow away from other people
• #Masks4All in public – don’t be alarmed, read on, please

We also understand that:

There is a critical global shortage of N95/FFP2 respirators and surgical/medical masks and we understand why these should currently be reserved for use only by those who need them the most.

For COVID-19 N95/FFP2 respirators should be reserved for use only by health workers, including community-based colleagues, especially when exposed to aerosol generating procedures, including swab collection.

Surgical/medical masks should be reserved for use only in healthcare settings, including community- or home-based care, by other frontline workers and by people who are ill with COVID-19 or possible COVID-19.

As members of the general public we therefore commit to not using these precious N95 respirators and surgical masks, unless we are providing care or ill. We promise. We also commit to returning or donating any N95 respirators or surgical masks that are so urgently needed at places of care. We need to care for our carers!

We also understand that masks work to reduce transmission of COVID-19, among many other infections which can spread if somebody speaks, sings, coughs, sneezes, cries or laughs. 

In short, masks work against infections that can spread if somebody breathes. 

Important other examples include tuberculosis (TB), which kills 1.5 million people every year (more than any other infection), and influenza, which kills another estimated half a million people a year.

You can, and should, agonise about droplet vs aerosol and about distances and sizes, about higher vs lower risk procedures and people and places. And even super spreaders, a ‘super power’ nobody wants.

But please stop telling us that masks do not work, when the evidence clearly shows that they do. 

When you recommend them for sick people and health workers and ‘precious’ politicians.

When you confuse supply shortages with shortages of facts and equipment costs with human costs.

Masks have value. We have value. And we demand #Masks4All!

Stop confusing demand as a problem and start seeing it for what it is: part of the solution.

We demand to be part of the solution.

We demand to use our skills and our creativity and our resources to help make #Masks4All.

We know these will be far from perfect. We also know they will be better than nothing.

We also know that our self-made masks will become safer every day if all the world’s experts start helping us. Give us guidelines, templates, materials, even. And teach us about correct and safe mask use.

Until then we will improvise and we will create and we will share, while always following all the other golden infection prevention and control rules too.

Dear Dr Tedros and fellow leaders, the way forward is simple and it is clear:

We demand #Masks4All. 

We demand to be part of the solution.

And we demand that you are too.

 

SIGNED: 

I. Organisations

Masks4All

TB Proof

PHACT

II. Individuals - via Change.org link

 

SELECTED REFERENCES & RESOURCES:

(under regular review - last update 2 April 2020)

Masks can reduce transmission: 

• Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population
• Cochrane: Can physical interventions help reduce the spread of respiratory viruses?
• Testing the Efficacy of Homemade Masks: Would They Protect in an Influenza Pandemic?
• Rational use of face masks in the COVID-19 pandemic
• The role of facemasks and hand hygiene in the prevention of influenza transmission in households: results from a cluster randomised trial; Berlin, Germany, 2009-2011
• Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households: A Cluster Randomized Trial
• Washington Post: Simple DIY masks could help flatten the curve. We should all wear them in public.

Transmission dynamics - focus on droplets vs aerosols:

• Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia
• Transmission Potential of SARS-CoV-2 in Viral Shedding Observed at the University of Nebraska Medical Center
• Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1
• Turbulent Gas Clouds and Respiratory Pathogen Emissions - Potential Implications for Reducing Transmission of COVID-19
• Violent expiratory events: on coughing and sneezing 

Asymptomatic, but detectable SARS-CoV-2:

• Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19)
• Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020
• New York Times: Infected but Feeling Fine: The Unwitting Coronavirus Spreaders

Useful other resources/links:

• Masks4All Reference Folder (work in progress)
• Video: Introducing #Masks4All by Petr Ludwig (3 minute video)
• Video: We need #masks4all by Jeremy Howard