There has been much debate globally about whether it is recommended to make use of a facemask during the COVID-19 pandemic.

A policy guideline developed by the Department of Health, for sectors other than Health, indicates that as the epidemic unfolds, the wider use of masks is indicated even for people who are not ill, especially if they move around in the public.

The Western Cape Department of Health has worked together with leading independent scientists in South Africa, Professor Shaheen Mehtar and Dr Kerrin Begg of the College of Public Health Medicine Guidance task team, to provide clear advice for our residents on the appropriate and safe usage of masks – and who should use what kind of masks where and when.

The Golden Rules of Good Hygiene

Firstly, a mask is not a solve-all solution in the fight against COVID-19 and should never be used as a replacement for basic good hygiene considerations. The most important thing every resident should do is:
• Wash your hands regularly for at least 20 seconds with soap and water
• Do not touch your face with unwashed hands
• Cough or sneeze into a tissue or the corner of your arm, and safely throw away the tissue
• Keep a distance of 1,5m from others
• If you are ill, stay at home, and if needs be call a medical facility to arrange for clinical assessment

This should be adhered to at all times, regardless of whether you have a mask or not.
Wearing a mask does not make you safe from COVID-19 and members of the public must at all times follow these basic hygiene golden rules. They remain our most effective tool for the public to fight the spread of this virus.

Do not use N 95 Respirators and Medical masks:

At the outset it is important to distinguish between medical masks, or N95 respirators, and cloth masks (either home-made or procured).
One of the Western Cape Department of Health’s top priorities is to ensure that our front-line healthcare workers, who are caring for those with COVID-19, have the required N95 respirators and/or medical masks so that they are protected when undertaking their duties and helping us save lives.
There is a global shortage of these masks so we please urge all residents to not obtain or use these, so that we can ensure enough supply to the frontline healthcare workers in our hospitals and clinics.

Cloth masks:

A cloth mask, if appropriately used, and cleaned, can offer the following protection for residents:
• The mask will reduce the transmission of droplets from the source (any person coughing or sneezing)
• It will reduce inhaling a large number of droplets from others
• Will reduce exposure in overcrowded areas such as taxis, shops of government buildings
• Will create awareness around COVID-19
• Inexpensive and can be produced in large quantities under clear specifications
• Strict usage guidelines must be applied

When could a cloth mask be used:

Cloth masks can be used by both the community and non-healthcare workers and where there is no physical contact. This includes:
• Travel to and from work in public transport
• When stepping outside the house to go shopping or seeking healthcare
• In self isolation when contact with others is necessary (keeping a distance is still very important)
• When stopping and talking to members of the public (for example, traffic police)
• When conducting interviews during house to house visits (for example, Community workers)
• When cleaning the streets/ disposing of domestic rubbish

How to properly use a cloth mask:

The usage of any type of mask should be accompanied by strictly adhering to safe use guidelines. Wash your hands before applying and after removing a mask, never touch the cloth part, never fiddle with it whilst wearing it, and refrain from touching your face. Discard disposable masks. Wash cloth masks with warm soapy water and iron when dry.

It is very important that residents use a cloth mask properly. If they do not, it might result in them putting themselves at risk of spreading COVID-19. The simple guidelines to use are:1. Only use a mask that has been cleaned & ironed
2. Place the mask with the correct side facing your nose and mouth and covering both well
3. Tie the strings behind your head, or if you are using elastic bands, make sure these are tight
4. Make sure it fits well. Move it around to get the best fit. Never touch the cloth part.
5. Once you have put on the mask, DO NOT TOUCH YOUR FACE again until you take it off
6. When you take it off, undo the ties, and carefully fold the mask inside out, hold it by the strings/elastic and place the mask in a container preserved for washing the cloth mask.
7. Wash hands thoroughly and dry before doing anything else

Maintaining the mask:

You must have at least two cloth masks per person so you will be able to wash one and have a clean one ready for use.
• Wash the mask daily in soap and hot water (tolerated during hand wash).
• Rinse thoroughly and dry
• IRON THE MASK- this is the best means of disinfection!

How to make a mask:

A cloth mask can be made in any non-industrial or domestic setup, and is relatively simple to make. There are many videos on YouTube demonstrating a step by step guide on how to make a cloth mask of varying designs.
The following is the Western Cape Government approved cloth mask standard:
A cloth mask typically comprises square pieces of cloth with three pleats that can cover the face from ABOVE the nose to BELOW the chin and almost up to the ears.

1. Outer layers:
Two layers, an inner and outer surface of the mask:
a. Made from thick weave cotton like denim, calico or upholstery cotton fabric that can be easily washed
b. Comprising two different patterns on the cloth – if possible – to distinguish between inside and outside of the cloth mask
2. Inner layers:
a. Two layers of ordinary cotton typically used for linen;
b. If possible – between the two inner cotton layers – a laminate breathable layer of non-woven fabric which is washable at high temperatures – or if you don’t have that, something like a jacket lining inner.
3. Strings or straps which can be tied behind the head

DO NOT USE STRETCHY MATERIAL WITH A LOOSE WEAVE such as T-shirt material. These offer no protection at all.

Premier Alan Winde: “I want to call on the people of the Western Cape to only make cloth masks in line with our approved cloth mask standard – and to please make sure they follow these guidelines on their proper use. If you cannot make them properly or use them properly, it is safer to not use them at all.
Many homes have the materials required and can make masks immediately. So make for your home – and then make more to donate to others can’t make their own. I will announce where and how we can get those masks from you shortly.

Anybody who receives a mask should wash and iron it before use.

In addition, I call on our textile industry to make these approved masks too – and for our civil society organisations – already working hard on helping us in many ways – to also help in the production of masks for all.
Cloth masks, when made and used properly, are one of the ways to keep all of us safe and healthy – and in these difficult and trying times – an opportunity for all of us to contribute to the cause of keeping everyone safe and healthy too.

As the epidemic unfolds and more research findings become available, we will keep the public abreast of these developments. In the meantime, our communications team will be creating and distributing easy to understand guides for cloth mask usage.”