Why are masks still needed indoors?

The continuing requirement to use masks indoors against the Coronavirus pandemic, following the announcement by President Cyril Ramaphosa of the end of the National State of Disaster in South Africa on 4 April 2022, has had many people, including students, questioning the need for the indoor requirement.

In accordance with the Disaster Management Act, certain transitional arrangements are in place, which include the wearing of masks indoors.

Dr Joe Phaahla, Minister of Health in South Africa, published regulations in the Government Gazette earlier in May that stated that South Africans are not obliged to wear masks at outside gatherings, but they are still obliged to wear masks indoors.

During a press conference, Phaahla also said that students at schools do not have to wear masks, as it limits their social skills and hinder them to achieve their full potential in the academic environment. In a later statement published by the national Health Department, they called Dr Phaahla’s earlier statement an “unfortunate and regrettable human error”. School learners are, in fact, still required to wear face masks indoors at schools.

There has been much debate about the effectiveness of masks.

The American Journal of Infection Control analysed face masks’ prevention of the transmission of Covid-19, and found that aerosol transmission is the predominant route of transmission. Further research evidence showed that masks can filter sub-micron dust particles, and accordingly respiratory droplets as well.

According to Professor Cheryl Cohen of the national health laboratory service in South Africa, face masks reduce the chance of becoming infected, but they are not 100% effective. “They are most effective against the spread from larger droplets and we know Covid-19 is also spread by small droplets for which masks are less effective.” She added that if everyone wears masks, “there will be less transmission because of the partial reduction in both transmission and acquisition”.

Tanja du Plessis, medical technologist at Arwyp Medical Centre in Kempton Park, said that whether or not one should wear a mask depends on factors such as ventilation, the availability of 70% alcohol-based hand sanitiser and the ability to maintain social distance. “We have the responsibility to protect ourselves and others,” du Plessis said.

Dr Nkosazana Dlamini-Zuma, minister of cooperative governance and traditional affairs, also said that South Africans should ensure that they understand their responsibility towards others and that they cannot do as they please.

Prof Dewald van Niekerk, professor and head of the African Centre for Disaster Studies at the North-West University (NWU), responded to the transitional measures set in place by the government in April 2022, and said that it may be regarded as voluntary. “The wearing of masks has to be done in a certain risk context.”

Van Niekerk believes that, if the risk of contracting the coronavirus is low, it does not serve any purpose to wear a mask. He said if there is no national state of disaster, no regulations may, in fact, be applied. According to him not wearing a mask cannot be criminalised. 

The ventilation of indoor spaces is very important to curb transmissions and, according to Van Niekerk, it helps more than masks.

There is a good reason why people must wear face masks indoors, as Van Niekerk pointed out. In outdoor spaces, ventilation occurs naturally, thus people may remove masks. The risk of the virus spreading is lower outdoors. However, when indoors, the free flow of new, “fresh” air is limited, resulting in the same air being circulated over and over in a room. This air may contain traces of Covid-19, increasing the risk factor of people contracting the virus. That is why masks are still needed indoors.

The North-West University (NWU) still follows the government regulations by ensuring that students and employees wear masks indoors, for example in lecture halls.

As per the official Cornavirus-website of South Africa, the wearing of a face mask is mandatory for every person in an indoor public space. Persons in an open public space need not wear face masks but social distancing measures (1m) still apply.