Letters to the Editor • Opinion
The coronavirus pandemic is not over
Letters to the Editor • Opinion
We already know how to prevent pandemics
President Trump told reporters April 3 that he did not plan to take a new Centers for Disease Control advisement that Americans wear non-medical face coverings. (Video: The Washington Post)

President Trump announced new guidance Friday that people in the U.S. wear face coverings in public to slow the spread of the coronavirus, a reversal of the administration’s earlier recommendations. But Trump immediately said he himself would not choose to do it, even though “it may be good” advice, reflecting the sharp debate in recent days between the White House and the Centers for Disease Control and Prevention.

White House coronavirus task force officials had debated whether to recommend universal use of face coverings such as cloth masks when people go out in public, or target the guidance more narrowly to areas with high community transmission of the virus that causes covid-19.

Some senior administration officials pushed to limit the recommendation because they argued that wide use of masks is unnecessary and might cause panic. Some of the president’s political advisers also warned against recommending masks for everyone, and had proposed to rewrite the agency guidance more narrowly, according to two senior administration officials who spoke on the condition of anonymity to discuss the guidance. The draft that went to the coronavirus task force on Friday limited the recommendation to high-transmission areas, they said.

But federal health officials, including experts at the CDC, say the guidance only makes sense if practiced broadly because it would be an additional way to contain the virus and prevent communities with low transmission from becoming areas with explosive spread. The CDC has been recommending widespread community use since late last week. The task force restored that original guidance during its meeting Friday after further push back from public health officials, said the administration officials.

The Centers for Disease Control and Prevention provided video instructions for how to create your own face covering to help prevent the spread of covid-19. (Video: Centers for Disease Control and Prevention)

Trump agreed to the new guidance but was not enthusiastic about it, they said.

White House officials had been privately contradicting CDC proposals for everyone to wear face coverings. The topic was part of spirited debate in the coronavirus task force meetings this week, and in Oval Office discussions with the president, according to the senior administration officials.

One of the main proponents for wider mask use has been Scott Gottlieb, a former Food and Drug Administration commissioner in the Trump administration who has been acting as an informal adviser to the White House and sometimes talks to Trump and regularly speaks with administration officials.

Trump’s remarks at Friday’s briefing also made clear the guidance applied broadly across the country, with a special emphasis on those in the most affected areas. The guidance posted on the CDC website states:

“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies) especially in areas of significant community-based transmission.”

The guidance was updated later Friday to highlight the word “especially” in bold. The CDC website also includes links to the proper way to wear one, directions on how to make one, and a mask-making video demonstration by U.S. Surgeon General Jerome Adams.

The guidance makes clear that wearing face coverings or cloth masks is an additional public health measure to prevent the spread of the virus, not a substitute for social distancing. Social distancing of at least six feet is still recommended even when wearing a mask. Guidance and internal memos from CDC emphasize that a cloth facial mask is intended not so much to protect the wearer but to help prevent people who do not know they are infected from spreading of the virus to others.

A recommendation for people to wear face coverings in public represents a major change in CDC guidance that healthy people don’t need masks or face coverings. Internal memos and guidance had previously made clear the coverings are not medical masks, such as N95 respirators or surgical face masks, which are needed by front-line health-care workers and are in extremely short supply. Those must continue to be reserved, they say.

Separately, U.S. officials are weighing a plan to distribute reusable cloth face masks — not medical masks — to U.S. households, starting with locations hardest hit by covid-19, the disease caused by the novel coronavirus, according to a federal official involved in the response and documents shared with The Post.

The new CDC guidance was prompted by increasing evidence that infected people without symptoms can spread the coronavirus. Simple cloth masks that cover the mouth and nose can prevent virus transmission from such individuals when they are out buying groceries, when people may come into closer contact, for example.

“We now know from recent studies that a significant portion of individuals with coronavirus lack symptoms (“asymptomatic”) and that even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus to others before showing symptoms,” the guidance states. “This means that the virus can spread between people interacting in close proximity — for example, speaking, coughing, or sneezing — even if those people are not exhibiting symptoms.”

Health and Human Services Secretary Alex Azar said in a statement that Trump “relied on the advice of America’s best scientists throughout this crisis, and that science-based approach drove our new guidance around face coverings.” He added: “While we don’t have evidence that a cloth mask protects you from acquiring the virus, the science suggests it will help prevent you from spreading it to others—a key way to protect the most vulnerable, slow the spread, and save lives.”

Many state, county and city officials have suggested that people should wear face coverings, such as cloth masks or bandannas, when going out in public. The latest recommendation came from Pennsylvania Gov. Tom Wolf (D), who recommended Friday that all people in the state wear a mask any time they leave their homes.

“Masks help prevent people from sharing illnesses,” he said. “But, they don’t do a great job at keeping people from getting sick; and, they’re not foolproof, so it is critical that our first act is to ask ourselves if we really need to leave our house. If we don’t really, truly need to leave, then we shouldn’t.”