COVID Masks

Fauci maskedWearing masks in public has become a hot topic and it’s not just because we have different opinions.  The media messaging has become very intense and Governors are mandating it.   Trying to decide whether you ought to be wearing a mask in public is becoming somewhat of a dilemma.

On the one hand, wearing a mask seems like a good idea because masks provide a barrier that could block SARS-Cov-2 or other viruses from entering or exiting your nose and mouth.   And if you block viruses then you won’t contract or spread a disease, so wearing a mask seems harmless and potentially helpful.

On the other hand, masks are uncomfortable, and they stink and wearing one makes it harder to breathe and more difficult to communicate.  The masks might not even help much when you consider that the COVID virus is only 0.125 microns in size which is much smaller than the pores in an N95 mask (0.3 microns)  or a surgical mask (2-10 microns), so the mask shouldn’t stop the virus very much at all.  Then again, the virus is carried on a respiratory droplet which is about 5 microns, so the mask fibers might stop something that size, so maybe they do help.  But if your soggy mask traps all those virus/droplets and you keep wearing it, then wouldn’t you inhale and exhale a lot of the viruses?  What if you touch your annoying mask and then touch something or someone else and spread your COVID germs?  There are obviously a lot of factors to consider.

In deciding about whether you should wear a mask, the most logical first step is to look at the science to help determine how effectively masks prevent the spread of disease caused by a contagious respiratory virus.  Fortunately,  we can turn to science because the efficacy of masks has been studied extensively.  Influenza and Corona viruses are spread in a similar way and when the CDC looked at studies on Influenza, this is what they concluded:

“In our systematic review, we identified 10 RCTs that reported estimates of the effectiveness of face masks in reducing laboratory-confirmed influenza virus infections in the community from literature published during 1946–July 27, 2018. In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks ….  Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.”

If you have Linkedin, go here because James Lyone-Weiler has a good summary of other studies, all of them concluding that masks don’t slow the spread of Influenza or other respiratory viruses.  The World Health Organization also recommended that we not wear masks in public to prevent the spread of COVID.

The one study I am aware of that actually looked at the effect of wearing cloth masks was done in Vietnam on 1600 Health Care Workers in 14 different hospitals during Influenza season.  The results were published in the British Medical Journal in 2015 showing that wearing a cloth mask actually INCREASED your risk of catching a Flu-like illness.

The scientific evidence indicates that wearing a mask in public does not prevent the spread of Influenza or other respiratory viruses, but the CDC, the media and scientists like Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases are repeatedly telling us that we should wear them (even cloth ones) in public.  What is going on?

For one thing, we should admit that there are reasons to wear a mask that don’t have anything to do with science or with preventing the spread of a virus.  Dr. Fauci likes the non-scientific and symbolic reasons.  He says that masks let people know that we are doing the kinds of things that seem helpful.  He also thinks that the leaders in government should mandate mask wearing and he wants to be sure that we send a unified message about them, and not a mixed message showing that we have different opinions.  One opinion piece in the NEJM also points out that masks are ineffective, but useful because they provide psychological comfort.

So, the evidence from scientific studies does not support the idea that masking will protect us or slow the spread of the virus, so I think we should stop emphasizing it so much.  We should spend our energies on more common- sense behaviors that have been shown to help:

    1. Stay home if you are sick
    2. Keep your hands clean and away from your mouth
    3. Respect social distancing

And please remember that COVID is particularly deadly to the elderly and they should be protected.

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