High-grade masks for vulnerable not recommended in Hiqa review

Health officials have decided against recommending higher-grade masks to protect vulnerable groups against Covid-19.

The evidence does not support a recommendation for the use of respirator masks by people who are at higher risk of infection, according to a review by the Health Information and Quality Authority (Hiqa).

The existing recommendation for the use of medical masks for this group, in place of cloth masks, should instead be reinforced, it says.

Germany, Austria and other EU countries require the use of high-grade respirator masks (FFP2 or equivalent) by the population to protect against Covid-19, while other countries preclude their use except by health staff.

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Disposable medical masks are recommended specifically for those at high risk in France, Ireland, Netherlands, Portugal and Spain.

In its review, drafted before the arrival of the Omicron variant, Hiqa found that the policy of reinforcing current public health and mask guidance was “the most efficient and appropriate means of managing the current situation”.

“The advice against a population-level recommendation for the use of respirators by those who are at higher risk from Covid-19 does not preclude their use at an individual level, for example, where there is an opportunity for individuals to discuss with their healthcare provider to what degree they are likely to benefit from the use of a respirator mask, and to obtain advice on appropriate usage.”

Those at higher risk include people aged 60 years and over and patients with specific underlying conditions.

Hiqa has also published summaries of the evidence on the transmissibility and virulence of Omicron and its capacity for immune escape, as well as a review of public health guidance from 23 other countries during the pandemic.

“There is evidence that the Omicron variant is associated with increased transmission and greater ability to escape immunity, compared with the Delta variant,” the agency states. “It is unclear if the severity of disease associated with Omicron is different to that caused by Delta.

"Even if Omicron causes less severe disease, any significant wave of infection will likely result in increased hospitalisations and deaths. International agencies have warned that Omicron is likely to cause high incidences of Covid-19 which could overwhelm healthcare systems within Europe unless action is taken."

Hiqa deputy chief executive Dr Máirín Ryan said there was an urgent need to reduce the impact of the Omicron variant in the coming weeks. “We advise the public continues to follow public health guidance, to minimise their contacts in the run-up to Christmas, to maintain physical distance when out and about and to keep up their hand hygiene and mask wearing.”

“Given the current high rates of infection, and the increasing threat associated with Omicron, it is important that masks are worn correctly and in all circumstances where they are recommended.”