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New Delhi, Jul 21: The Centre has written to all states and union territories warning against the use of N-95 masks with valved respirator by people, saying these don't prevent the virus from spreading out and are "detrimental" to the measures adopted for its containment.

The Director-General of Health Services in the Ministry of Health, in a letter to the Principal Secretaries of health and medical education of states, said it has been observed that there is "inappropriate use" of N-95 masks, particularly those with valved respirator, by the public other than designated health workers.

The DGHS referred to the advisory on the use of homemade protective cover for face and mouth available on the website of the Ministry of Health.

"It is to bring to your knowledge that the use of valved respirator N-95 masks is detrimental to the measures adopted for preventing the spread of coronavirus as it does not prevent the virus from escaping out of the mask. In view of the above, I request you to instruct all concerned to follow the use of face/mouth cover and prevent inappropriate use of N-95 masks," DGHS Rajiv Garg said in the letter.

The government had in April issued an advisory on the use of homemade protective cover for face and mouth, asking people to wear it, particularly when they step out of their residences.

The advisory stressed such face covers must be washed and cleaned each day, as instructed and states that any used cotton cloth can be used to make this face cover. 

The colour of the fabric does not matter but one must ensure that the fabric is washed well in boiling water for five minutes and dried well before making the face cover. Adding salt to this water is recommended, it said.

It also listed the procedures of making such homemade masks, asking to ensure it fits the face well and there are no gaps on the sides.

It urges people to wash hands thoroughly before wearing the face cover,  switching to another fresh one as the face cover becomes damp or humid, and never reusing it after single use without cleaning it. 

"Never share the face cover with anyone. Every member in a family should have separate face cover," the advisory stated.

New Delhi, May 15: Union Health Minister Harsh Vardhan has appealed to all states and Union Territories to ban the sale of smokeless tobacco products and spitting in public places in line with the orders of the Rajasthan and Jharkhand governments to prevent the spread of coronavirus infection.

In a letter to all state health ministers, Vardhan said smokeless tobacco users have a tendency to spit in public places or otherwise and therefore, increase health risks especially those of spreading contagious diseases like COVID-19, tuberculosis, swine flu, encephalitis and others.

"Use of smokeless tobacco also creates an unhygienic environment which further spreads the diseases. The large gathering at the retail outlets where smokeless tobacco products are sold, also pose the risk of spread of COVID-19," he said.

In the letter dated May 11, the Union minister underlined that tobacco use is a major threat to public health globally. He also mentioned the Indian Council of Medical Research's (ICMR) appeal to the public not to consume and spit smokeless tobacco products in public places.

Chewing tobacco products and areca nut increases the production of saliva followed by a very strong urge to spit. Spitting in public places could enhance the spread of the COVID-19, Vardhan said.

"By banning spitting in public places, states and UTs can help in achieving not only Swachh Bharat but also Swasth Bharat (Clean India and Healthy India)," he said.

Vardhan also mentioned the May 1 guidelines issued by the Union Home Ministry under the National Disaster Management Act, 2005, which stipulate that "spitting in public places shall be punishable with fine as may be prescribed by the state/UT local authority and consumption of liquor, pan, gutkha, tobacco etc in public places is not allowed".

Appreciating the efforts of Rajasthan and Jharkhand in this direction, the Union Health Minister urged all states to take similar measures and create widespread awareness regarding the harm of spitting in public places.

The Rajasthan government had by an ordinance banned spinning in public places and sale of paan, gutka and tobacco in the wake of the coronavirus outbreak. The Jharkhand too has imposed a complete ban on all types of tobacco products to prevent spitting in public places that could increase the spread of coronavirus infection.

"I am happy to note that the governments of Jharkhand and Rajasthan have already completely banned the sale of tobacco products and spitting in public places. Therefore, I urge upon you to take similar measures and also create widespread awareness in your state/ UT regarding harms of spitting in public places.

"It is also requested that the directions of Ministry of Home Affairs in this regard may be implemented scrupulously and effectively," Vardhan said in the letter.

Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of related diseases. A review of studies by public health experts convened by WHO on April 29 found that smokers are more likely to develop severe diseases, compared to non-smokers, said Binoy Mathew, senior programme officer of Voluntary Health Association of India.

It is one of the main risk factors for a number of chronic ailments, including cancer, lung and cardiovascular diseases, he said, adding that according to the Global Adult Tobacco Survey, with 268 million or 28.6 per cent of all adults in India, the country has the second largest number of tobacco users in the world.

At least 12 lakh die from tobacco-related diseases every year, Mathew said.

Those keen to quit smoking and smokeless products can avail of free of charge telephone-based services launched by the government. The Ministry of Health has set up a National Tobacco Quit Line Services to provide counselling services to help tobacco consumers quit the habit.