The World Health Organization is recommending that countries re-institute masking on long haul flights, tying the policy to the XBB.1.5 subvariant of Covid-19 and should apply to “passengers arriving from anywhere where there is widespread COVID-19 transmission”.
WHO does not, however, indiscriminately recommend pre-departure testing for Covid-19, which underscores a supposition that,
- testing is costly and arduous
- while masking is effortless (many long haul airline passengers would disagree)
It was unclear if XBB.1.5 would cause its own wave of global infections. Current vaccines continue to protect against severe symptoms, hospitalisation and death, experts say.
“Countries need to look at the evidence base for pre-departure testing” and if action is considered, “travel measures should be implemented in a non-discriminatory manner,” Smallwood said.
That did not mean the agency recommended testing for passengers from the United States at this stage, she added.
There are two ways masks might protect against spread of disease.
- You wear a high quality mask correctly and it may reduce your likelihood of inhaling a virus.
- Other people wear quality masks correctly and it may reduce the virus they emit if they’re infected.
Lower-quality masks that in most places have met requirements do little to prevent emitting or inhaling of virus. They were performative.
Without a mask mandate, anyone who wishes to protect themselves can wear a properly-fitted N95 (or P100!) mask.
Whether a mask mandate makes sense is less about whether any given passenger might be protected from others (and remember, most might protect themselves) and more about whether the flight itself is likely a superspreader event and the extent to which that matters for public health systems, whether it means that the virus is more likely to mutate and whether a flight is bringing the virus into a place where it’s not already spreading rapidly.
In a country free of Covid-19, where hospital systems could be easily overwhelmed, and coupled with intense restrictions on indoor gatherings throughout the rest of life (say, bars and restaurants and offices) along with testing and quarantine of new arrivals, mandatory mask regimes might make sense if the threat is a great one.
Against a backdrop where the number of people arriving by air represent a drop in the bucket of infections, against a backdrop of immunity and where few other precautions are being mandated, it makes less sense.
This is a temporary measure, which airlines initially introduced on their own outside of mandates in order to make passengers more comfortable flying. Maybe individual passengers didn’t want to wear masks, but they preferred seeing everyone else masked.
China certainly shows the problem of temporary measures that become near-permanent stopgaps, without taking interim steps. China didn’t sufficiently expand hospital capacity and import the best quality vaccines and treatments. When their Covid protection regime fell, the virus spread like wildfire in a mostly immunologically naive population.
What would most of the world be doing while they try to limit virus spread with the band aid of masking, but only on long flights? And does this recommendation make it more or less likely that the World Health Organization will successfully influence public health policy?