
Professor Peter Bradshaw
Professor of Health Policy
Professor of Health Policy Peter Bradshaw considers whether it is a case of too little, too late or the right move at the right time.
“The hapless Secretary of State for Health and Social Care Mr Matt Hancock – Mattbeth as he is now known colloquially in his Department – had the indignity of telling us on 14 July that we must all wear a mask or face coverings when entering shops. Failing to comply incurs a fine of £100 and Mr Hancock says his new measure will, “give people more confidence to shop safely and enhance protections for those who work in shops”.
But why an indignity? Simply because the Minister was compelled to admit to yet another excruciating U-turn in his administration’s confused management of the pandemic. Yes, a seemingly good idea but not one for immediate introduction; rather let us wait 10 days as if the virus had offered us a reprieve that it would cease infecting anyone until 24 July. Hence his decision is seen by the opposition as yet more ponderous and cluttered thinking on the entire management of this catastrophe.
The case for and against face masks
Giving Mr Hancock his due, he has now, as his leader has professed all along, been guided by what science there is on this matter. Certainly, the evidence is equivocal, meagre and contestable. Yet, confronted with a disease causing an unpredictable level of lethality, with no prophylaxis and no known cure, it seems entirely sensible to adopt the so called ‘precautionary principle’ that weighs a strategy for the reduction of harm when total scientific proof is lacking. Wearing a mask could arguably lessen aerosol and airborne transmission and save lives and given the seriousness of this pathogen, it offers us little to lose and plenty to gain and is thus advisable.
Naturally, the libertarian reaction is that the wearing of masks infringes personal autonomy. At the apex of the infection it would have been rationally comprehensible yet why should ministers leave it so late in the day to introduce what are referred to variously as muzzles or face nappies? This libertarian argument is that such an infringement hinders people returning to work or induces overconfidence that is counterproductive. Such beliefs are also reinforced by members of the Cabinet who distrust the despotic vacillations of the Chief Scientific and Chief Medical Advisor, and by Michael Gove, who insists mask wearing should be merely optional and just a matter of good manners.

Wearing face masks cannot be enforced
Ultimately however, enforceability may well be the enemy of Mattbeth’s cunning plan. This depends on legal interpretation and ultimately non-compliance becomes a matter for the police. But, as with lockdown regulations, those on face coverings were drawn up in haste and police forces lack the administrative resources as overall crime rates are restored to normal. Like all minor crime, the police will just not want to know – so compliance will thus rely on personal scruples.
Infection rates are in decline, but we cannot conveniently forget the recent learned prediction from the Select Committee Hearings and the Academy of Medical Sciences that forecast a possible 120,000 deaths in a possible second wave. To wait therefore, for faultless evidence on this simple matter that is employed internationally is not an option.
Face masks – a significant step in the UK’s battle with COVID-19?
Like the use of parachutes, we cannot wait for the results of a randomised control trial to see for certain if masks work. We are looking at an inexpensive, modest and potentially effective change in behaviour and attire that when worn in appropriate circumstances could have a significant effect on virus spread, with only minor bearing on our individual lives.
Mr Hancock may seem prickly on occasions and he may be rightly jaded by his task, but regarding face masks he has a hard sell, but it is one that is surely worth his while.
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