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Coronavirus: do airport screenings and face masks work?

Sarah Newey
Commuters wearing protective masks walk through a subway station ahead of the Lunar New Year in Shanghai - Bloomberg

The decision to quarantine some 50 million people in 14 cities in China – including Wuhan, a regional capital that is larger than London – has triggered both praise and condemnation across the globe. 

Some experts argue that restricting travel is the only real way to stop a virus spreading further – especially considering upcoming Chinese New Year celebrations, which usually see millions of people moving across the country and region.

But others say that the draconian intervention – which is one of the largest quarantines in global history – will only spread panic and drive cases underground. 

“Involuntary quarantines have a questionable track record and can often be counterproductive,” said Jeremy Konyndyk, a senior fellow at the Center for Global Development and former Obama era director of USAID’s Office of US Foreign Disaster Assistance.

“A quarantine… will be challenging to enforce, and past precedents suggest it could lead to more hiding of cases and less voluntary compliance with public health measures.”

Others have told The Telegraph  that the move is like “shutting down London at Christmas.”

But if a quarantine is not the answer, what can be done to stop the virus spreading?

Do face masks work?

People wearing face masks have become a defining image of large disease outbreaks, and this one is no different, with cities in Asia already reporting shortages as masks fly off the shelves

But in reality, the thin material masks do little to stop a respiratory virus spreading. 

“The face masks that we see people wearing are surgical face masks,” said Dr Mark Parrish, regional medical director of the medical and travel security firm International SOS. “As you breathe in and out you're breathing air from outside the face mask. So it will stop a little bit but not hugely.”

Jonathan Ball, professor of molecular virology at the University of Nottingham, added that face masks were proven to be effective in hospitals.

“There are reports in literature that face masks in a hospital setting can protect health care workers. But there, they are being used for short periods by trained professions,changed frequently and properly disposed of. Those staff are also adopting good personal hygiene. 

Pedestrians wearing protective surgical masks in Shanghai, China Credit:  Qilai Shen/Bloomberg

“But in the general population it may even be the case that they’re not helpful at all,” he added.

“If you don’t change them regularly enough, they could potentially start to trap viruses and eventually they can move through that mask into your respiratory tract.”  

Dr Parrish added that heavy duty masks, called N95's, are far more effective than simple surgical masks for the general population. But these aren't fool-proof either. 

“These cause a tight seal around your nose and mouth so becomes harder to breathe air in - you don’t really want to give people with respiratory systems,” he said. 

Is screening at transport hubs the best way to control the coronavirus?

Numerous countries across the globe, including the UK, have introduced screening at airports in an attempt to identify people who may have coronavirus symptoms. 

But the limit here is that only those who are already ill will be picked up. So health experts say the most effective way to control the spread of viruses is an alert health system and high standards of infection control.

Professor David Heymann, infectious disease expert at the London School of Hygiene and Tropical Medicine, said that perhaps the most valuable element of airport screening is telling passengers about the signs and symptoms of a disease and what they should do if they’re worried.

“Educating the public is key,” he told The Telegraph.

“The measures we have to adopt are diagnosing and isolating cases as quickly as possible so they are unable to transmit onwards,” added Professor Neil Ferguson, a disease outbreak scientist at Imperial College, London. “Contact tracing and [either] isolating them or tracking them daily is important.”

Prof Ball added that even large epidemics can be controlled if the basics are in place. 

“What we do know that works is just good personal hygiene, regular hand washing and for people to use a tissue when they have a cold,” he said.

“We know even when an outbreak gets reasonably large you can bring it under control with infection control – think back to the severe acute respiratory syndrome (Sars) outbreak with 8,000 cases.”

But Prof Ball added that more information about the coronavirus itself is also needed to develop the best containment strategies. 

“To stop this thing in its tracks there are basic virology questions that need answering – so we need to know the original source and if there were any cases of additional animal to human spillover events, and better understand how it’s being transmitted in humans.”

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