Israelis Told to Wear Face Masks in Public. Here’s How to Do It

Americans also urged to wear masks as coronavirus pandemic worsens ■ Widespread mask use in the East may explain the slowing progression of the disease compared with the West

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Two women wearing protective masks pose for a selfie in Jerusalem's Mahaneh Yehuda market.
Two women wearing protective masks pose for a selfie in Jerusalem's Mahaneh Yehuda market. Credit: Emil Salman
Ruth Schuster
Ruth Schuster

On April 1, Prime Minister Benjamin Netanyahu called on all members of the public to wear face masks when leaving the house in order to diminish the coronavirus infection rate within the community. “If you don’t have a mask, use a scarf or any other face covering that will limit the spread of the virus to others,” the prime minister counseled.

>> UPDATE: Americans also urged to wear masks outside as coronavirus pandemic worsens >> Coronavirus in Israel updates

Official guidelines on how and when to wear protective masks to guard against the spread of coronavirus in IsraelCredit: Health Ministry

The Health Ministry explains in a video how to easily make your own masks at home using nothing but a sheet and hair ties, in case you can’t find any at a local store, or can’t afford them.

Take any clean, densely woven cotton or satin fabric, such as a sheet or pillowcase, that doesn’t stretch. Don’t use clothing or a towel, which have looser weaves. Take two hair ties (usually for pigtails or ponytails).

Cut into squares about the size of a bandanna, or as wide as your shoulders. Each square will be one mask.

Lay a square on a clean table. Fold the bottom third up. Now fold the top third down. It looks like a rectangle.

Slip a hair tie onto one end of the cloth rectangle and move it a third of the way along the cloth. Repeat with the other hair tie at the other end of the cloth. It looks like a cloth candy with twists at either end.

Fold the two ends of the rectangle towards the middle so the hair ties are at the edges. Insert one of the ends into the other. Now it looks like a package with the hair ties at either end.

Place the cloth over your mouth and nose and stretch the hair ties over your ears.

(Hebrew) Official Health Ministry video on how to easily make your own masks at home Credit: Health Ministry

Reusing your homemade mask

The purpose of the face masks is primarily to stop viral particles in the sputum of the sick from escaping into the air, potentially infecting people in a roughly two-meter radius. The mask should catch respiratory droplets emitted by coughing or sneezing.

Also, the mask can help a healthy person avoid infection by droplets emitted by other people. That is a key reason why masks should be worn once, in the case of disposable masks: After you go out, a mask may have viral particles on its outside. If you make your own, soak them in hot soapy water each wearing. Make sure it’s dry before you wear it again.

Face masks cannot categorically prevent you from catching COVID-19, the disease caused by the coronavirus SARS-CoV-2. But they can help prevent you from giving it to somebody else in the public domain if you’ve been infected. The evidence from countries where the general public did wear the masks strongly indicates that they significantly slow the spread.

Nearly a million infected

As of April 2, the global confirmed infection rate was 981,428 cases, according to Worldometers . The total number of cases in Hong Kong was 802; in Japan, 2,384; in Taiwan, 339 – all countries where mass outbreak seems to have been stymied, so far at least, and wearing masks in public areas during this outbreak is the norm. In South Korea where masks are common, the number of confirmed cases has flattened. Meanwhile in the West, where masks in public are not the norm, infection rates are spiking. In the United States, a hotbed for coronavirus spread, the Centers for Disease Control and Prevention (CDC) said on March 31 that it is considering recommending that everyone wear masks.

The World Health Organization has yet to provide a recommendation on widespread use of masks but is studying the question and is consulting with experts on this very issue today (Thursday). The Israeli government didn’t need to wait for the WHO to urge their use. It is becoming clearer that mass masking may well be cardinal to thwarting the virus’ spread and reluctance to require it may be based on other considerations, such as allocating the supply of masks to medical personnel, not the general public.

Hence it is excellent advice to make your own mask if you can’t get one otherwise, for the greater good.

A caveat about the numbers: We won’t know the truth about coronavirus mortality and morbidity until the dust settles, which could be months in the future. To know, the entire population would have to be tested, which is not feasible at this time. Mortality rates may well be skewed by asymptomatic people or people with mild cases who could be legion and unwittingly infecting others around them. If a lot of people have it but don’t even know, or have mild cases and never get tested, the suspected mortality rates could be lower than the current estimates of 1% to 2% of the sick (some places seemingly have much higher rates: Italy has 11%-12% while Germany’s rate seems to be less than 1%). In other words, mortality statistics are skewed toward the people who feel sick and get tested; the statistics are partly an artifact of what percent of the population are being tested.

But clearly many if not most countries around the world are experiencing “community spread,” which means that people who have become infected don’t know how they caught it. A corollary of community infection is that many people may be pre-symptomatic, unaware of exposure, and blissfully unaware that they harbor the disease. If these people go out into the public domain unmasked (and ungloved), they pose a risk to the general public.

Coronavirus facts and unknowns

How exactly this new coronavirus SARS-CoV-2 is transmitted remains under study. Being so new, scientists are learning about its specific characteristics practically from scratch. SARS-CoV-2 is thought to be spread chiefly person-to-person between people in close contact, but how far away is far enough remains unclear. The general rule of maintaining a two-meter distance from anyone else in the public domain, as required by the restrictions in Israel, errs on the safe side. Beyond that distance the healthy are not exposed to respiratory droplets produced when an infected person coughs or sneezes, which is the chief mode of the coronavirus’ transmission. Transmission via infectious aerosols is still uncertain.

Theoretically, the new coronavirus can also be caught from surfaces touched by an infected person bearing viral particles from the secretions on their hands. Studies on other coronavirus species that made the jump to humans, SARS and MERS, showed they persisted on metal, glass or plastic for up to nine days. The virus particles on surfaces can be eliminated by surface disinfectants such as solutions containing 70% ethanol (and waiting a minute).

There is no proof yet that SARS-CoV-2 can be transmitted by contaminated surfaces. Given the uncertainty, the CDC recommends that visibly dirty surfaces be cleaned and disinfected “as a best practice measure for prevention of COVID-19 and other viral respiratory illnesses in households and community settings.” The CDC elaborates that disinfecting a surface doesn’t mean it’s now clean and germ-free. The procedure is to first clean and then disinfect.

Regarding protection, it is useful to know that the new coronavirus can be transmitted through the eyes and tears of patients. It is not clear whether it can be transmitted through stool, though stool samples examined in some studies have shown evidence of coronaviral RNA. It is not sure whether there were active viruses in the stool.

Finally, a new study, albeit a very small one, suggests that infected people – with mild cases of COVID-19 - are at their most infectious during their first week of experiencing symptoms. There is no data on infectiousness when you don’t even know you have the virus. Hence the importance of the new Israeli directive: that everybody should wear masks. Judging by walking back and forth 100 meters from home today, this author can say that some are, some aren’t, some covered their mouths but not their noses, and some possibly exasperated by the discomfort had slung their masks below their chins and of those, some were smoking. The total number of cases in Israel as of Thursday mid-day was 6,360.

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