Trump said the recommendations, which came after a week of lively White House deliberations, were voluntary and that he would not participate.
“I don’t think I’m going to do it,” he said, adding that it was difficult to envision such a thing in the Oval Office: “Wear a mask to greet presidents, prime ministers and dictators. , kings, queens – I just don’t see it. “
Behind the scenes, officials were divided over the wisdom of advising Americans to cover their faces in public, which some say could disrupt social distancing efforts that remain officials’ best hope of preventing further spread.
Speaking at the White House briefing on Friday, the American surgeon general admitted that the change of position had caused some uncertainty.
“It has been confusing for the American people,” said Dr. Jerome Adams. He described the change as spurred by new information suggesting that people without symptoms may be responsible for a significant amount of transmission.
The guidelines, Adams said, would suggest that Americans wear cloth masks in public places where social distancing guidelines are difficult to maintain, such as grocery stores.
Senior CDC officials told the White House this week that tougher guidelines are needed to prevent the virus from spreading between asymptomatic people, according to people familiar with internal discussions.
The agency has sent memos to the White House outlining their recommended advice this week, people familiar with the documents said. They said cloth cloth covers – not medical grade masks – were recommended.
But after receiving them, some of Trump’s advisers warned that a nationwide recommendation could have negative side effects and advocated for something more limited, potentially only in the hardest hit areas.
The debate took place during meetings of the coronavirus working group in the situation room of the White House, where the problem reappeared earlier this week. Officials have started a “serious discussion” on the subject, according to a source close to the conversations.
“This is the subject of very very active discussions. We are actively discussing it today in the task force and I can assure you that it will be on the agenda tomorrow, “said Dr. Anthony Fauci on CNN Thursday evening. “Since we know that asymptomatic people clearly transmit the infection, it just makes sense that it is not a bad idea to do so. “
The persistent shortage of medical-grade masks for front-line hospital workers, at the root of which states and the federal government have worked to resolve through disparate shipments and calls to the private sector, has been the basis of these internal round trips. Some White House officials feared that a general recommendation for Americans to use face covers would cause a rush on the much-needed medical masks, worsening the already dire situation for hospital workers and first responders.
While CDC guidelines call for something short like a medical mask, some officials still feared that any type of face mask orientation would lead Americans to seek out the type of masks still needed in hospitals.
And although Trump has publicly suggested using alternatives, the White House has not issued guidelines on the best fabrics or how to properly tie a loose cloth so that it covers the mouth and nose.
Debate on the recommendation
The debate was released to the public on Thursday as Trump shared his thoughts on wearing the mask, followed by warnings from the White House coronavirus response coordinator, Dr. Deborah Birx, who was one of the main internal opponents of the national recommendations on masks from the President’s task force. .
“If people wanted to wear them, they can,” said Trump when asked about potential new guidelines for wearing masks in public. “If people wanted to use scarves, what they have, a lot of people have them, they can. “
Birx then stepped onto the podium to offer a more cautious view, saying that she feared the masks could put some people to sleep in a false sense of security, causing them to ignore other directives.
“We don’t want people to feel” Oh, I wear a mask, I am protected and I protect others “, she said. “You may be protecting others. But don’t get a false sense of security that this mask protects you exclusively from infection, as there are other ways to get infected, due to the number of asymptomatic and mild cases that are out there. “
She said there is an “ongoing” debate over the masks and added that each time a new opinion is published, it will be “additive” to the social distancing guidelines, which Trump this week extended until April 30.
The notion of the general public wearing masks had appeared since last weekend, after the administration had passed a few days earlier in the crisis, claiming that they were unnecessary for most Americans.
The CDC said on its website last month that it “does not recommend that people who wear proper face masks protect themselves from respiratory illnesses, including Covid-19.”
And the officials said that the Americans were not going out to buy masks.
“Americans don’t have to go out and buy masks,” said vice president Mike Pence during a CNN appearance 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 cannot get them to care for sick patients, it puts them and our communities at risk! “
Officials said the requests reflected a concern within the administration that average Americans would start stocking N95 surgical masks or respirators, which would make it difficult for hospital workers to access the necessary equipment.
In other cases, some administration officials have gone so far as to suggest that wearing a mask may increase the risk of infection for the wearer.
“You can increase your risk of getting (coronavirus) by wearing a mask if you are not a health care provider,” Adams said in an interview with Fox & Friends on March 2. “People who don’t know how to wear them properly tend to touch their faces a lot and can actually increase the spread of the coronavirus. “
These concerns about mask hoarding have not necessarily changed, officials said, and the risk of infection for wearers remains. What has changed is new information suggesting higher levels of asymptomatic spread, which, according to CDC director Robert Redfield, led this week to revise the mask wearing recommendations.
The previous directive, said Redfield, was “under critical review, to see if there is potential additional value for infected individuals or individuals who may be asymptomatically infected.”
The White House has also been asked to reconsider the issue of masks after the American Enterprise Institute last weekend published a white paper proposing a “road map to reopen” the country after the epidemic, including a recommendation on the masks.
“People will initially be asked to wear non-medical cloth face masks in the community to reduce their risk of asymptomatic spread,” said the document, co-authored by Dr. Scott Gottlieb, former Commissioner of the Food and Drug Administration of Trump who went on to inform the White House informally during the coronavirus outbreak.
This week, the task force discussed, among other things, the best way to teach Americans to wear masks and calibrate public messaging to avoid a rush of medical-grade equipment.
Consideration has been given to calling the recommended masks “masks.” Some suggested that they should be referred to simply as “face covers” or “courtesy masks” to distinguish them from the medical masks that professionals need.
And officials have weighed the cultural change that would be the recommendation of masks, because Americans (unlike citizens of some Asian countries) are not used to wearing masks in public.
This story has been updated to include Trump’s CDC announcement.