"Does the WHO recommend wearing masks in public settings? Simple answer. No," claims an August 5, 2020 Facebook post featuring an image with the WHO logo and information about scientific studies said to back the assertion.
The same image was shared more than 540 times from the Facebook page of Robert Foster, a unsuccessful Republican candidate for governor in the US state of Mississippi, with the claim: "You are being lied to."
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Other Facebook pages and Twitter accounts shared a Canadian website that featured the image with the headline, "WHO Admits No Evidence for Universal Masking, Recommends it anyway."
The claim also circulated on Instagram.
However, WHO spokeswoman Margaret Harris told AFP in an email: "This is not a WHO document, but whoever has created it has cherry-picked some materials out of context from some WHO documents."
The incomplete picture painted by the highlighted studies was also pointed out by Dr Roger Chou, Professor of Medical Informatics and Clinical Epidemiology, at Oregon Health & Science University.
"It is a lot of cherry-picked evidence and ignores studies looking at filtration effects and diffusion of droplets, as well as ecological studies indicating that masks have been effective," Chou said.
The image makes four claims related to mask wearing which are misleadingly presented.
Claim 1: There is no direct evidence "on the effectiveness of universal masking (from studies on COVID-19 and in healthy people in the community)."
This claim was shared with a citation for the 2012 study "Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial."
Although that study was conducted during the 2007–2008 influenza season, and not the COVID-19 pandemic, the authors found that both students wearing face masks, and students who wore face masks and practiced increased hand hygiene, reduced the rate of influenza-like illness.
They concluded: "These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic."
The US Centers for Disease Control and Prevention (CDC) also recently pointed to this study, which found that universal mask wearing helped to mitigate the spread of the novel coronavirus in a Missouri hair salon where two hair stylists came into contact with 139 clients before realizing they were symptomatic. No clients were known to become infected.
Erin Silverman, Clinical Research Coordinator at the University of Florida College of Medicine, told AFP by email: "The overwhelming weight of the evidence supports the use of face masks for prevention of airborne and droplet transmission."
Claim 2: "Health care workers using cotton cloth masks were at an increased risk of influenza-like illness compared with those who wore medical masks."
This claim was shared with a citation for the 2015 study titled "A cluster randomised trial of cloth masks compared with medical masks in healthcare workers."
The study did find that the workers wearing only cloth masks had higher rates of infection -- but its authors still affirmed the necessity of protection. They published a special note in light of the COVID-19 pandemic advocating that health care workers only be exposed to patients when adequate respiratory protection is made available.
Claim 3: Wearing a mask may provide the general public a "false sense of security, leading to lower adherence to other critical preventative measures."
This claim is offered as direct evidence, without a study.
Oregon Health & Science University's Chou, however, pointed to emerging evidence from Germany that "people physically distance slightly more when masking is made mandatory."
Similarly, an April 2020 publication in The Lancet medical journal said, "We are unaware of any empirical evidence that wearing masks would mean other approaches to infection control would be overlooked."
Claim 4: "A recent study of 455 individuals showed that asymptomatic people are not causing infectivity."
This claim is shared with a citation for a 2020 study titled: "A study on infectivity of asymptomatic SARS-CoV-2 carriers."
The University of Florida's Silverman and a team of researchers have raised major concerns about the methodology of the study and argued: "The authors should have taken steps to ensure that their findings not be misconstrued as 'proof' that SARS-CoV2 is poorly, or non-, infective."
In an email to AFP she explained: "The authors acknowledged that their work was limited by the fact it was a single case study, but then they turned around and posed what seemed like a bit of a sweeping statement."
The authors of the study did not respond to a request for comment from AFP.
In a June 2020 review of evidence, Daniel Oran and Eric Topol of the Scripps Research Translational Institute found: "Asymptomatic persons seem to account for approximately 40 percent to 45 percent of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days."
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Mask-wearing recommended
The wearing of face masks has been the subject of changing guidance from the WHO since the outbreak began in Wuhan, China, in 2019, with initial recommendations focused on reserving medical masks for health care workers and the sick.
On June 5, 2020, the WHO changed its advice to recommend governments encourage the general public to wear masks.
"In light of evolving evidence, WHO advises that governments should encourage the general public to wear masks where there is widespread transmission and physical distancing is difficult," said WHO chief Tedros Adhanom Ghebreyesus.
Other health agencies also support mask-wearing.
On July 14, CDC Director Dr Robert Redfield said in a statement: "Cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus – particularly when used universally within a community setting."
Dr Theresa Tam, Canada's Chief Public Health Officer, has recommended the use of face coverings since May 20, 2020.
Silverman told AFP: "It's unfortunate that so many preventable deaths occurred before mask use was considered by most to be effective, or at least worthwhile."
AFP Fact Check has debunked numerous false and misleading claims about face masks. A complete list in English is available here.