President Donald Trump said Friday his administration was now recommending Americans wear “non-medical cloth” face coverings, a reversal of previous guidance that suggested masks were unnecessary for people who weren’t sick.
“I don’t think I’m going to be doing it,” he said, going on to suggest it was hard to envision such a thing in the Oval Office: “Wearing a face mask as I greet presidents, prime ministers, dictators, kings, queens — I just don’t see it.”
After weeks of insisting Americans should not wear face masks to prevent the spread of coronavirus — and even suggesting their use could increase the chance of infection — administration officials this week engaged in an internal debate over reversing course, according to people familiar with the matter.
Behind the scenes, officials were divided about the wisdom of advising Americans to cover their faces in public, which some fear could cause a lapse in the social distancing efforts that remain officials’ best hope of preventing further spread.
At stake was another turnabout for a White House that has sown confusion with its response to the coronavirus pandemic sweeping the nation. The debate over masks has come to encapsulate a federal effort marked by repeated reversals, conflicting recommendations, low stockpiles and competing for internal interests that often lead to muddled messaging.
Speaking at the White House briefing on Friday, the US surgeon general acknowledged the change in position had stoked some uncertainty.
“It has been confusing to the American people,” Dr Jerome Adams said. He described the change as spurred by new information suggesting people without symptoms may account for a significant amount of transmission.
The guidelines, Adams said, would suggest Americans wear cloth face masks in public settings where social distancing guidelines are difficult to maintain, such as grocery stores.
Senior officials at the CDC told the White House this week that stronger guidelines were necessary to prevent the virus from spreading between asymptomatic people, according to people familiar with the internal discussions.
The agency sent memos to the White House outlining their recommended guidance this week, people familiar with the documents said. They made clear that cloth face coverings — not medical-grade masks — were being recommended.
But after receiving them, some of Trump’s advisers cautioned a nationwide recommendation might have negative side effects and advocated something more limited in scope, potentially only in areas that are hardest hit.
The debate played out in meetings of the coronavirus task force in the White House Situation Room, where the issue first arose again early this week. Officials engaged in a “serious discussion” of the topic, according to a source close to the conversations.
“That is being discussed really very actively. We were discussing it actively today in the task force and I can assure you, it’s going to be on the agenda tomorrow,” Dr. Anthony Fauci said on CNN on Thursday evening. “Given the fact that we know that asymptomatic people are clearly transmitting infection, it just makes commonsense that it’s not a bad idea to do that.”
Underpinning the internal back-and-forth was the persistent shortage of medical-grade masks for front-line hospital workers, which states and the federal government have scrambled to resolve through patchwork shipments and appeals to the private sector. Some White House officials feared a blanket recommendation for Americans to use face coverings might cause a rush on the badly needed medical masks, aggravating the already-grave situation for hospital workers and first responders.
While the CDC guidelines advocate something short of a medical mask, there was still a fear among some officials that any kind of guidance on face coverings could lead to Americans seeking out the type of masks still needed in hospitals.
And while Trump has publicly suggested using alternatives, the White House has not issued guidelines on which fabrics are best or how to properly tie loose cloth so that it covers the mouth and nose.
The debate spilt into public view on Thursday as Trump offered his thoughts on mask-wearing followed by words of caution from the White House coronavirus response coordinator Dr Deborah Birx, who has been a leading internal opponent of nationwide mask recommendations on the President’s task force.
“If people wanted to wear them, they can,” Trump said when asked about potential new guidelines on wearing masks in public. “If people wanted to use scarves, which they have, many people have them, they can.”
Birx stepped to the podium afterwards to offer a more guarded view, saying she had concerns that masks could lull some people into a false sense of security, leading them to ignore other guidelines.
“We don’t want people to feel like, ‘Oh, I’m wearing a mask, I’m protected and I’m protecting others,’ ” she said. “You may be protecting others. But don’t get a false sense of security that that mask is protecting you exclusively from getting infected, because there are other ways that you can get infected, because of the number of asymptomatic and mild cases that are out there.”
She said a debate was “continuing” about masks, and added whenever a new advisory is issued it would be “additive” to the social distancing guidelines, which Trump this week extended to April 30.
The notion of the general public wearing masks had appeared a settled matter as recently as last weekend after the administration spent days earlier in the crisis insisting they were unnecessary for most Americans.
The CDC said on its website as of last month that it “does not recommend that people who are well wear a face mask to protect themselves from respiratory diseases, including COVID-19.”
And officials were vocal that Americans not go out to purchase masks.
“It is not necessary for Americans to go out and buy masks,” Vice President Mike Pence said during an appearance on CNN on March 1. In late February, the Surgeon General tweeted: “Seriously people — STOP BUYING MASKS! They are NOT effective in preventing the general public from catching #Coronavirus, but if health care providers can’t get them to care for sick patients, it puts them and our communities at risk!”
Officials said those entreaties reflected a concern inside the administration that average Americans would begin stockpiling surgical masks or N95 respirators, making it difficult for hospital workers to access necessary gear.