Mask-wearing a key health initiative

Taking precautions: People wearing face masks as they walk along a pedestrian crossing in Kuala Lumpur. Many experts support making the use of face mask mandatory as scientific evidence shows that it helps control the source of infection.

PETALING JAYA: Public health experts are for making the wearing of face mask in public mandatory, as the majority of detected Covid-19 cases were asymptomatic.

Prime Minister Tan Sri Muhyiddin Yassin on Monday said the government was considering making it mandatory for people to mask up in public.

Consultant respiratory physician Prof Dr Roslina Manap was for the mandatory use of masks, saying that scientific evidence pointed to its use in primarily helping to control the source of infection.

“This is a key public health initiative as a sizeable number of Covid-19 infections occur in the asymptomatic phase. The impact is further enhanced by mass public masking, where small personal benefits accrue a greater public good when the practice is widespread, ” she said.

“The advice can be easily emphasised to the general public. In considering mandatory masking, we must also weigh the repercussions of punitive action.”

Similarly, consultant anaesthesiologist Prof Dr Chan Yoo Kuen said masks are physical barriers and an asymptomatic patient wearing it will limit the spread of the virus unknowingly to others nearby.

“Like all infections, it is the viral load that is important. The load that comes out following a cough is more than when the person is speaking because the airflow and pressure created by a cough are higher and hence will spread further. “Masks will limit the contamination of the air and reduce the viral load to the person near them, ” she said, encouraging the use of masks especially in environments where social distancing of at least 2m is not possible.

Malaysian Medical Association (MMA) president Dr N. Ganabaskaran supported any move to make the use of face mask mandatory, as it is the responsible thing to do.“The majority of Covid-19 cases detected are asymptomatic. A person can be a carrier of the virus without even knowing. We should be protecting each other by wearing face masks, ” he said.

He said authorities must also ensure affordability, accessibility and sustainability, especially for low-income groups that may not be able to afford face masks over the long-term.

Dr Ganabaskaran said that while wearing face masks was among measures to curb the spread of Covid-19, other measures such as maintaining personal hygiene and practising physical distancing should not be neglected.

Public health expert Prof Datuk Dr Lokman Hakim Sulaiman said that in high-risk areas, the authorities might not have much choice but to enforce it if the public was not complying voluntarily.

He, however, believed that a blanket enforcement might not be effective, especially in low-risk areas or situations.

He said individual and community empowerment may be the best approach, with continuous advocacy and targeted risk communication being essential.

“It is also about attitude and responsibility. We have a collective responsibility to ensure the community is safe. Ignorance and selfishness don’t help and are dangerous, ” he said.

Health policies expert Dr Khor Swee Kheng said making it mandatory for the public to wear masks, such as making it punishable under Prevention and Control of Infectious Diseases Act (Act 342), may be counter-productive and disproportional when there were other ways of achieving the objective.

“The costs outweigh the benefits because of the administrative, enforcement and legal complexities of monitoring the masking practices of 32 million Malaysians daily, ” he said.

He said measures to achieve the objectives include visible leadership by example of leaders at all levels including popular personalities, operators of public spaces making wearing of masks mandatory for entry and public education.