Mask against Covid went from being inadvisable to essential in the pandemic

From an item considered inadvisable to the general population to the main barrier of protection against the virus, masks had a central trajectory in the fight against the pandemic in Brazil. Amid controversies and the comings and goings of rules, the protection is now starting to have its use free in several parts of the country, even in the face of criticism from experts.

In March 2020, with the Covid pandemic just declared, the mask was still far from people’s faces.

At the time, there was a widespread indication from health authorities that face protection should only be used by people with symptoms or who were in the same environment as sick people. A Folha report on March 18, 2020 pointed out that President Jair Bolsonaro (PL) and then Minister Luiz Henrique Mandetta were, in public, wearing a mask, despite the contrary indications – at that moment. It also pointed to their contact with a recently infected person and, consequently, the need for them to be in isolation.

There was a rush for masks and other items, such as hand sanitizer, at the beginning of the pandemic, even without official guidelines for their use. In some parts of the world, there was a shortage of masks for healthcare workers. The WHO (World Health Organization) has warned of the shortage of protective equipment in the world and, in the US, surgeon general (equivalent to the minister of health) Jerome M. Adams has even asked the public to stop buying masks.

Towards the end of that March, the situation had already started to turn, and experts around the world were starting to re-evaluate the use of masks by the general population.

In an interview with Science magazine at the time, George Gao, director general of the China Center for Disease Control and Prevention, said that the biggest mistake the United States and Europe made in fighting Covid was that people were not wearing masks.

Later, the indication was corroborated by the director of the CDC (Centers for Disease Control and Prevention of the United States), Robert Redfield, to NPR (National Public Radio). “It’s important because we now have individuals who may not have any symptoms and contribute to transmission.”

On the first day of April 2020, the situation, at least in Brazil, was already drawing to a world closer to what we know today.

“Wanderson [Oliveira, então secretário de Vigilância do Ministério da Saúde], tomorrow morning, please post this on the Ministry of Health page, very large. It shows the scientific work that already proves that droplet virus mask, mechanical barrier mask works very well. Anyone can make their cloth mask and use it because it will work and will be helping the health system”, said Mandetta, during a press conference.

Then the Ministry of Health already had plans for a social media campaign to encourage the population to make their own cloth masks.

But it was only in May that mandatory masks actually started in Brazil. In the state of SP, mandatory use began on May 7. In the state of RJ, the requirement came only in June, but the use was already mandatory by law in the municipality of Rio since April 23.

While shops temporarily closed in an attempt to stop Covid and people stayed more at home, to protect themselves from the virus and try to “flatten the curve”, industries – even some that made underwear – began to produce protective masks and street vendors. and other people started selling the items, which became part of the population’s basic dressing room.

The use became customary to the point that, in August 2020, nine out of ten Brazilians claim to wear masks whenever they are out of the house — despite this, only half claimed to see other people always using protection — according to a Datafolha survey, which heard 2,065 people from across the country and had a margin of error of two percentage points.

The popularity of protection remained high and, in September 2021, 91% believed that the mask should be mandatory while the pandemic was not fully controlled, according to another Datafolha survey with 3,667 people and a margin of error of two percentage points.

While all this was happening, knowledge about the transmission of Covid by aerosols (smaller droplets that remain in the air longer and reach greater distances) evolved, which only increased the importance of masks to contain the pandemic.

Even with the data pointing to the protection offered by the masks, President Jair Bolsonaro (PL) began to belittle the item – and also vaccines -, in addition to refusing to use them. Bolsonaro even went so far as to lower the mask of a child.

With the passing of the pandemic and with the clarity of the essentiality of face protection, the question came whether any type of mask would have a protective effect. Logically, no. Different manufacturing materials and more than one layer also offered different levels of protection.

The discussion about the ability to protect gained even more body as new, more transmissible variants emerged and swept across countries —as did the range in Brazil, even leading to the collapse of the health system—​, experts began to point out that, in certain situations, risk, PFF2, masks with a much higher degree of protection, could be important.

The broad mandatory requirement in Brazil, including on streets and other open areas, however, was not necessarily a standard around the world. The requirement to use outdoors, in general, started to fall more recently in Brazil — in São Paulo, for example, just in the last week. In other countries, the release of masks occurred much earlier, still in 2021.

Now the country sees numerous capitals removing the mandatory use of the mask in closed places. The release, however, coincides with an increase in cases in some countries. Despite agreeing on some degree of flexibility in the item that has become essential in protecting against Covid, experts are concerned about the fall of masks in closed places.