Yesterday, Scottish leader Nicola Sturgeon advised Scots to wear face masks when shopping and travelling to minimise the risk of spreading coronavirus. Scotland is not the first country to issue such guidance and will not be the last.

Indeed, more than 30 countries have mandated the use of face coverings outdoors for the public during the pandemic. England however, much like with testing and implementing the lockdown in the first place, has dragged its heels and has been slow to suggest Brits follow the same measures.

Perhaps unsurprisingly, given the geographical origins of the virus and the more widespread use of masks in the continent, the face mask arms race started in Asia. Provinces in China made them mandatory and in South Korea, the government started purchasing 50% of the nation’s manufactured masks in February, selling them at discounted prices to meet demand.

In mid-March, the Czech Republic became the first European country to make the masks mandatory. Meanwhile, on 3rd April, the US and Singapore advised citizens to wear masks when they leave their homes – after the WHO U-turned on its previous position that they’re not useful. Authorities in Lombardy, the Italian region worst affected by coronavirus, were also quick to act – obliging citizens to wear face masks in public as early as 5th April. As of yesterday, masks are mandatory in all areas of the country. On 11th April, the Spanish government started distributing face masks at train and metro stations to allow some non-essential staff to return to work. While their use isn’t compulsory, it is advised to use them even if they are homemade. And on 27th April, Germany made the use of face masks mandatory on public transport and, in most regions, in shops. Authorities in Portugal have also said they will mandate face masks in open spaces if and when their lockdown is relaxed. And today, French Prime Minister Edouard Philippe has said the same – face masks will be mandatory on public transport and in secondary schools when it starts easing its coronavirus lockdown on 11th May.

England, therefore, is an international outlier yet again. Yippee.

▶︎ Statistics

April 30th, Article in “Der Spiegel” (translated)

There are also uncertainties in the number of deaths, especially in the recording of the ultimate cause of death of people with multiple pre-existing conditions. How do you count the case of an elderly patient with pre-existing conditions who suffers a stroke and is admitted to hospital and is found to be an asymptomatic sars-CoV-2 carrier?

As it is not always possible to clarify quickly and clearly in such cases whether covid-19 disease was also the ultimate cause of death, the RKI (Robert Koch Institute) reports the number of all deaths of people with a proven sars-CoV-2 infection. The health authorities then speak of “deaths associated with covid-19 disease”, which is different from “deaths due to covid-19 disease”. This may lead to an over-reporting of corona deaths. People who have died from their previous illness, but who were also infected with the corona virus, are included.

At the same time, there are also constellations in which under-coverage can occur. It is not possible to carry out a test on every deceased person. And in autopsies, the virus may no longer be detectable, even though the person has died from the infection. Often only the so-called excess mortality shows the full extent of the pandemic. It describes that the number of people who die in a certain period of time is higher than would normally be expected at this time of year. In Lombardy, Madrid and New York City, for example, around four times as many people died during the corona pandemic than usual. However, only in New York City did the additional number of deaths match the official Covid 19 casualty figures. In Lombardy and Madrid, the official statistics showed a considerable under-recording of Covid-19 deaths.

Despite such uncertainties, international comparisons based on death figures are probably more reliable than comparisons of infected figures. The distortions there due to the number of unreported cases and the different testing practices are likely to be greater.

The number of deaths is less suitable for assessing the current infection dynamics. This is because in the case of a fatal course of the disease, there is an average of about 20 days between infection and death.