Intended for healthcare professionals

Letters Face coverings for covid-19

Covid-19: public messaging on vaccination must heed warnings from confused face mask messaging

BMJ 2020; 370 doi: (Published 30 September 2020) Cite this as: BMJ 2020;370:m3775
  1. Simon E Kolstoe, senior lecturer
  1. School of Health and Care Professions, University of Portsmouth, Portsmouth PO1 2UP, UK
  1. simon.kolstoe{at}

One reason face coverings have become a contentious issue is the medical community’s failure to make clear why people are being asked to wear them.1

At the beginning of the pandemic, people were “panic buying” products including toilet roll, so it made sense not to promote the buying of medical masks by the public, especially as the medical community was experiencing shortages of personal protective equipment (PPE).2 But the impression that the public were being encouraged to make their own PPE at home did not help.3 Many people rightly pointed out that homemade masks could never replace properly manufactured and tested PPE. Consequently, recommendations to make and wear homemade masks sounded more like a cynical attempt to manipulate the public in the absence of enough PPE to go around.

This impression was entirely unnecessary because the argument for wearing homemade masks should never have been about PPE in the first place. The main purpose of wearing a face covering is simply to divert the wearer’s breath. Homemade or non-standardised face masks cannot stop the wearer breathing the virus in or out, but they can limit the spread of potentially infectious droplets.4

The message that homemade face coverings are a simple, pragmatic, and effective method of disease control got lost in the politics surrounding shortages of medical PPE. This is an important lesson as to what can happen when health messaging is unclear. These errors must not be repeated as we the face next challenge—encouraging public uptake of potential covid-19 vaccines.


This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.


View Abstract