Face masks have become essential for many Nigerians following the recommendation by the country’s infectious disease agency, NCDC, that people wear them in addition to other measures to curb the transmission of the coronavirus such as social distancing and regular handwashing.
The NCDC said while a general use of face masks is recommended but optional, they should be used when in large gatherings.
Despite strong advice by the NCDC about the dangers of inappropriate use and disposal of face mask, the Nigerian Infectious Diseases Society (NIDS) said it observed many Nigerians misusing and abusing the facial gear.
NIDS, a group of experts on infectious diseases, said it observed that face masks are being disposed inappropriately on the streets, on walkways, and everywhere in the environment.
“This practice could lead to widespread contamination of the environment if the face masks were already contaminated by droplets from an infected person,” a statement on Tuesday by the group’s President, Dimie Ogoina, said.
The observation by NIDS, a multidisciplinary society of practitioners in the field of infectious diseases, builds on that of other health experts raising concern over the use of face masks by Nigerians.
A trending video from Saturday’s burial of President Muhammadu Buhari’s Chief of Staff, Abba Kyari, showed one of the attendees taking off his face gear and cleaning his face, mouth and nose indiscriminately with a piece of cloth which he put back into his pocket. This practice could result in self-contamination of the user’s face, experts said.
NIDS listed what it described as inappropriate habits and practices regarding the use of face masks for COVID-19 prevention in Nigeria.
According to NIDS, the following are the inappropriate habits and practices of many Nigerians using masks:
1. Medical masks such as surgical masks and N95 respirators are being routinely used for non-medical purposes by members of the general public and government officials, even as these medical masks are not available in sufficient quantities in our hospitals.
2. N95 respirators with exhalation valves are being used indiscriminately by top government officials and wealthy personalities. It should be noted that this type of respirator is not appropriate for use as a means of source control since they do not prevent the release of exhaled respiratory particles from the wearer into the environment. Unfortunately, many unsuspecting Nigerians may be exposed to infected droplets from those who wear these respirators and do not know that they are infected.
3. The Nigeria media is awash with images of members of the general public, including top ranking government officials, wearing face masks on their jaws and neck without covering their mouth or nose, or covering only their mouth while the nose is left opened. This practice could lead to exposures of the uncovered areas to infected droplets especially when the wearer is in close proximity with an infected person that has respiratory symptoms.
4. People are also observed to repeatedly touch the front of their face mask in a bid to adjust the face masks, to remove it or touch their face masks during reflex touching of their face. This practice could lead to contamination of the hands of the wearers especially as the front and inside of the masks are the most potentially contaminated parts of the masks.
5. Some remove their face masks inappropriately without practicing hand hygiene and then hold these masks with their bare hands or keep them inside their pockets or with personal belongings. This practice could lead to contamination of hands, clothing and surroundings of the wearer if the face masks were already contaminated before removal.
6. It is also observed that some people wear one single face masks for prolonged periods during the day without replacing when they are wet or damp or when they are required to be washed and reused. When face masks are used for prolonged periods without replacement, they no longer protect the wearer and may serve as a medium for the growth of micro-organisms including viruses.
7. Face masks used for prevention of COVID-19 by the general public are being disposed inappropriately on the streets, on walkways and everywhere in the environment. This practice could lead to widespread contamination of the environment if the face masks were already contaminated by droplets from an infected person.
To mitigate the negative and unintended consequences of misuse and abuse of face masks in the prevention and control of COVID-19 in Nigeria, the NIDS makes the following recommendations.
1. The federal and state governments, the NCDC and other relevant agencies of governments, and their partners, should heighten awareness creation on when to use, how to use and how to dispose of face masks appropriately.
2. To preserve medical masks for use by healthcare workers in the face of global scarcity, surgical masks and respirators such as N95 masks should be reserved for healthcare workers and those caring for suspected or confirmed COVID-19 patients. The federal and state governments are advised to adopt a policy banning use of medical masks by the general public except during care of a patient with respiratory symptoms.
3. Where face masks use by the public has been made mandatory by a state government, sufficient quantities of homemade masks must be made available for use by the populace and strategies should be instituted to enable appropriate use and disposal.
4. Relevant federal and state government agencies should ensure all locally produced face masks are safe, they do not significantly affect breathing when worn, and are wide enough to completely cover the nose and mouth.
5. When using face masks, the general public should learn to always cover their nose and mouth, not to touch the front or inside of the masks, adjust and remove the masks using the straps when necessary and dispose used masks in a closed waste bin where available or store used face masks safely inside a polythene bag for later disposal. Preferably, hand hygiene should be practiced every time the masks is touched.
6. The ministries of environment in the various states and the Federal Capital Territory should devise strategies to mitigate indiscriminate disposal of face masks by making provisions for covered waste bins in public spaces, proactively and safely removing used face masks from the environment, decontaminating areas contaminated by used face masks and applying appropriate sanctions on defaulters where necessary.
7. The NIDS recognises that prolonged wearing of face masks is not comfortable and appropriate use may not always be feasible outside healthcare settings. The general public is advised to comply with guidelines provided by the NCDC and to adopt strict social distancing measures such as staying at least 1metre from other persons, avoiding crowds and staying at home when use of homemade masks may not be feasible.
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