Travel health: masks and face coverings

We all look forward to travelling again but, even as restrictions lift, we need to understand the precautions that still need to be taken. Probably the most important is proper mask use. In the UK we are only told to wear a face covering yet although a thin silk scarf, buff, snood or a jumper pulled up over the face might catch some droplets if you cough, try blowing a match out through it to see how ineffective these are. Increasingly too, these are not accepted by airlines even for journeys within the UK.

Many people wear disposable medical masks. These are protective but some airlines stipulate that they should be changed every four hours; however, using such plastic-containing products that need to be discarded often are not a choice that environmentally conscious travellers should embrace. These masks are creating a new solid waste disposal problem as they find their way into rivers and the sea. Besides, who would want to fill their luggage space with disposable masks?

Many European countries and some airlines now expect people to wear KN95 masks, or its European equivalent FFP2. It is now important to check on the rules for your chosen airline before travelling, as well as any local stipulations on what must be worn when using public transport and when entering shops.

The World Health Organization states that three-layer cloth masks are protective and I feel that these are a good solution for those travelling long-term, especially in regions where there is a solid waste disposal problem. Such masks should be made with three different materials. The inner layer should be of a comfortable water absorbing cloth such as an old T-shirt and the outer of water- repelling synthetic cloth. The middle layer can be a changeable insert, another layer of spun fabric or polypropylene (like medical, sanitary and cleaning cloths), or paper towel.

Understanding hand hygiene is part of effective mask selection and use, which is why public health campaigns are emphasising the need for clean hands. Hand-washing with soap and water for 20 seconds is effective but washing facilities aren’t always immediately available; some taps – especially on board aircraft – deliver very little water, and then consider: how clean are the toilet door handles? Hand-sanitising gels are therefore a necessity back-up. Gels are not a super-efficient magical route to total sanitisation though: hands must be visibly clean and then gels must be rubbed in properly; to sanitise hands effectively gels must be in contact with the skin for a similar amount of time. All of which is perhaps a salutary reminder that we will need to keep thinking about prevention for a very long time yet if we are to regain our freedom and travel again.

• Hands must be cleaned before putting on your mask, as well as before and after taking it off, and each time you touch it

• Ensure it fits and covers your nose, mouth and chin

• Once a mask is removed, it should be stored in a clean plastic bag. If it is a fabric mask it should be washed daily; if it is a medical mask it should be thrown away

• The WHO say masks with valves should not be used, as they protect the wearer but may not protect others

Dr Jane now works on COVID-19 advice on Nepali radio and has launched an audiobook.