During a press briefing on 26 April, Niti Aayog member, and head of the COVID task force, VK Paul said, "Please wear a mask, do not go out unnecessarily. Stay with your family. Even within the family wear masks."

He goes on to say,

“If there is Covid-19 positive case in the family, it is very important that the person wears a mask even indoors because the virus can spread to others in the home. I would rather go on to say that the time has come that we start wearing mask at home even otherwise.”
Dr V. K. Paul, Member (Health), NITI Aayog

What is the rationale behind this recommendation?

What should you know about indoor transmission of COVID? Do you really need to wear a mask at home too now?

FIT asks Dr Rahul Pandit, Director-Critical Care Fortis Hospitals Mumbai and Member of Maharashtra COVID Task Force.

Is the risk of COVID transmission higher indoors?

In a word, yes.

A recent study published in the journal Lancet says that the COVID virus is primarily airborne and not spread through droplets like it was previously thought.

What this means is that an individual could potentially be infected just by inhaling aerosols produced when an infected person exhales, speaks, shouts, sings, sneezes, or coughs.

The aerosols containing the virus is capable of being suspended in air for hours, making it particularly infectious in poorly ventilated spaces.

These findings have been supported by other studies as well, including a recent study published by the Massachusetts Institute of Technology (MIT) that found social distancing of 6 feet to be ineffective in curbing infections indoors.

“The risk (of COVID transmission) is always higher in a close confined non-ventilated area, there is no doubt about that. This is because the circulation of air makes a huge difference.”
Dr Rahul Pandit, Director-Critical Care Fortis Hospitals Mumbai

Moreover, "we also know from a couple of studies that when the droplets that fall onto surfaces dry up, because of the air, there could also be a circulation of these viruses."

"That is where the concern comes in," he adds. "Airborne makes it a whole other ball game in terms of your personal protectivity and masks. This is where wearing masks indoors becomes important."

Does that mean you have to wear masks even at home?

Knowing what we know about the virus being airborne, Dr Pandit recommends wearing a mask at home if someone at home is suspected to have COVID like symptoms, or has come into contact with a COVID positive person.

"We do practice it ourselves as well," says Dr Pandit. "If someone in the house has COVID related symptoms, we make sure to isolate that person, and they as well as others in the house wear masks."

It isn't enough to keep distance, because a virus that is suspended in air can easily travel in the air. And the risk of transmission will depend on how well or poorly the space is ventilated.

Speaking to Hindustan Times, Dr Gagandeep Kang, Virologist, Vellore’s Christian Medical College, says, "when that (infected) person, speaks, eats, sings, breathes in and out, she will be putting out viral particles even with the new infectious variant for about a week to nine days."

Do you need to wear a mask at home even if no one in the house has symptoms of COVID?

"If you are in contact with people that you do not know whether they are infected or not, it makes sense to stay masked (even at home)."
Dr Gagandeep Kang Virologist, Vellore’s Christian Medical College, to Hindustan Times

"If anyone in your family has been in contact with other people who might be potentially infectious and you want to be sure that they have not brought the infection home, then it makes sense to stay with a mask until you are sure that your family members have not been infected," she adds.

Since asymptomatic people could also be carriers, it can be difficult to know the status of the people we interact with.

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“Considering the very high rate of infections we have right now, it only makes sense that for the next month at least, we take full precautions as much as we can.”
Dr Rahul Pandit, Director-Critical Care Fortis Hospitals Mumbai

"Wearing masks indoors isn't exactly a new concept," says Dr Pandit, "we have been speaking about it, and also double masking for a few months now."

The US Centre for Disease Control and Prevention (CDC) has also listed masking up indoors, even at home, as one of their guidelines, and this has been so for a while now.

Why now? What has changed in the second wave?

The second wave of COVID in India has hit us with a velocity that we couldn't have foreseen. And the rapidly increasing cases has pushed health care experts to push for more stringent precautionary measures.

Dr Pandit says, "the second wave is so rapid that we need to take every possible care to make sure the cases come down."

According to Dr Kang, under less serious circumstances, wearing masks at home when no member of the family has symptoms of COVID may be unnecessary, but she says,

"This (wearing masks at home) applies at a time when there is very high transmission outside and you are really worried about the risk."
Dr Gagandeep Kang Virologist, Vellore’s Christian Medical College, to Hindustan Times

"Once the risk settles down, and you have less transmission in Delhi, then it might be time to rethink the intensive wearing of masks at home," she adds.

What is the best way to protect yourself from getting infected?

Like every health expert that we've been speaking to, Dr Pandit also reiterates that "the best way to protect yourself is to wear a mask whether you're indoors or outdoors, keep social distancing and keep hand hygiene."

“Following COVID appropriate behaviour very very religiously for the next two weeks at least, is the only way we can hope to see bring down the spiking numbers.”
Dr Rahul Pandit, Director-Critical Care Fortis Hospitals Mumbai

(Written with inputs from Hindustan Times)

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Published: 28 Apr 2021,11:40 AM IST

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