White House expected to recommend Americans wear cloth masks to prevent coronavirus spread

WASHINGTON — The White House is expected to announce a new policy, based on guidance from the Centers for Disease Control and Prevention, that would urge Americans to wear cloth masks in an effort to prevent coronavirus spread, according to a federal official familiar with the policy.

In a draft document obtained by STAT, the CDC recommended that the public use homemade face coverings when in public, reserving higher-grade protective equipment like N95 masks for hospitals and health care workers, who have faced severe shortages in personal protective equipment as the coronavirus pandemic has accelerated through the United States.

Such face coverings, according to the draft guidance, would not be intended to protect the wearer, but rather prevent the wearer from unknowingly spreading the disease when in public. Individuals should wear face coverings in public settings like grocery stores, the guidance said. Children under the age of 2 and people experiencing trouble breathing would be excluded from the mask guidelines.

The guidance would serve as an attempt to prevent Americans from unknowingly spreading coronavirus before they experience symptoms. Evidence has shown that those infected with coronavirus are sometimes contagious two days before the onset of symptoms.

The official cautioned that the recommendations were not yet final, and that the White House could still alter its final recommendation.

A White House spokeswoman cautioned in an email to STAT that the Trump administration’s guidance would apply only to Americans in areas in which the novel coronavirus is quickly spreading through communities, in contrast to the CDC draft guidance to recommend masks for all Americans.

“I think they’re going to be coming out with the regulations on that,” President Trump said at a White House press briefing on Thursday, adding that the advisory would not be mandatory.

“If people wanted to wear them, they can,” Trump said. “If people wanted to use scarves, which they have, many people have them, they can. In many cases the scarf is better, it’s thicker.”

Vice President Mike Pence said the guidance would be issued in the coming days. He and Trump did not elaborate — Trump, at one point, told reporters “We’ll see what that recommendation is.”

Deborah Birx, the physician and diplomat helping to lead the administration’s coronavirus response, expressed concern that Americans might take a mask advisory to mean they could go about business as normal thanks to the mask’s protection. If and when an advisory is issued, Birx said, it would stress that it was a precaution to be taken in addition to — not instead of — existing social distancing and handwashing guidelines.

In the draft guidance, the CDC acknowledged that wearing face masks in public is a highly unusual behavior in the United States, even though the tactic has long been employed as a personal hygiene measure in countries that have successfully slowed their coronavirus outbreaks, like Japan and South Korea.

A recent article published in the Lancet suggested that, while there is limited evidence for the effectiveness of widespread mask use, the tactic nonetheless could prove helpful in preventing transmission from people infected but not yet displaying symptoms. The analysis, however, referred largely to higher-grade equipment like N95 respirator masks, not homemade facial coverings fashioned from shirts or dish towels.

Other health experts have recommended a similar directive, citing data showing that asymptomatic spread could be a major driver of new Covid-19 cases.

World Health Organization officials on Wednesday said evidence was mixed regarding use of masks among the general public, and stressed that public health officials should remain focused on providing masks to doctors, nurses and other health care workers treating coronavirus patients.

“There’s an ongoing debate about the use of masks at the community level,” said WHO Director-General Tedros Adhanom Ghebreyesus during a press conference on Wednesday. “WHO recommends the use of medical masks for people who are sick and those caring for them.”