The simple answer is… No.
At least not for the general public who do not have symptoms of COVID-19-like illness. The widespread practice of wearing masks did not work in Hubei province, China before and during its mass COVID-19 transmission experience earlier this year, and it won’t work here either.
We first saw the use of cloth masks used in US healthcare settings starting in the late 1800s. It came from the realization that surgical wounds need protection from the droplets released in the breath of surgeons. The technology was applied outside the operating room in an effort to control the spread of infectious epidemics. In the 1918 influenza pandemic, masks were available and were dispensed to populations, but they had no impact on the epidemic curve. They failed in stopping the 1918 influenza pandemic then, and they will have little impact on the SARS-CoV-2 pandemic today.
U.S. Surgeon General Dr. Jerome Adams said that “the data doesn’t show” that wearing masks in public will help people during the coronavirus pandemic. “What the World Health Organization [WHO] and the CDC [The Centers for Disease Control and Prevention] have reaffirmed in the last few days is that they do not recommend the general public wear masks.” A month later, the CDC seemed to reverse its guidance on nonmedical masks, urging the general population to wear them as a “voluntary public health measure.”
Writing for Technocracy Dr. Russell Blaylock said that since there have not yet been any studies of the effectiveness of masks in slowing or preventing COVID-19 transmission, the best thing that can be done is to look at what impact masks have been proven to have against the flu. He cited a 2012 analysis on this point:
As for the scientific support for the use of face mask, a recent careful examination of the literature, in which 17 of the best studies were analyzed, concluded that, “None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”
Current information suggests that the two main routes of transmission of the COVID-19 virus are respiratory droplets and contact. Respiratory droplets are generated when an infected person coughs or sneezes. Any person who is in close contact (within 1 m or 3.2 ft.) with someone who has respiratory symptoms (coughing, sneezing) is at risk of being exposed to potentially infective respiratory droplets. Droplets may also land on surfaces where the virus could remain viable; thus, the immediate environment of an infected individual can serve as a source of transmission (contact transmission). There is also the “possibility of aerosol transmission in a relatively closed environment for a long time exposure to high concentrations of aerosols” according to the Chinese Center for Disease Control and Prevention.
For front-line medical workers or those working in an infectious environment, proper face protection is somewhat effective and is recommended. If you’re taking care of an individual with SARS-CoV-2, it would be best if both you and the patient were both wearing face protection. Notice, I said “face protection”. That is not only a mask that covers your mouth and nose, but you also need to cover the eyes. If you want to be protected, you’ll need a full face mask or N95 respirator and goggles.
Healthcare workers, whose work brings them close to more people with SARS-CoV-2 symptoms in relatively enclosed spaces, are at more risk than the general public at being exposed to infectious particles that could lead to infection. Given the current extreme shortages of respirators needed in healthcare, it is not recommend to use of N95 respirators in public or household settings, instead keeping them available for those who need them most. WHO stresses that it is critical that medical masks and respirators be prioritized for health care workers.
There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure against SARS-CoV-2. However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.
The US National Academy of Sciences declared in 2010 that, in the community setting, “face masks are not designed or certified to protect the wearer from exposure to respiratory hazards.” A number of studies have shown the inefficacy of the surgical mask in household settings to prevent transmission of the influenza virus.
In an annex to the Canadian pandemic influenza preparedness plan covering public health measures, the Public Health Agency of Canada (PHAC) does not recommend the use of masks by well individuals in pandemic situations, acknowledging that the mask has not been shown to be effective in such circumstances. Masks worn by ill individuals may protect uninfected individuals from virus transmission, but little evidence exists that mask use by well individuals avoids infection.
The National Institute for Occupational Safety and Health (NIOSH) conducted a study of the filter performance on clothing materials and articles, including commercial cloth masks marketed for air pollution and allergens, sweatshirts, t-shirts, and scarfs. N95 respirators had efficiencies greater than 95%. For the entire range of particles tested, t-shirts had 10% efficiency, scarves 10% to 20%, cloth masks 10% to 30%, sweatshirts 20% to 40%, and towels 40%. All of the cloth masks and materials had near zero efficiency at 0.3 µm, a particle size that easily penetrates into the lungs.
Another study evaluated 44 masks, respirators, and other materials with similar methods and small aerosols (0.08 and 0.22 µm). N95 FFR filter efficiency was greater than 95%. Medical masks exhibited 55% efficiency, general masks 38% and handkerchiefs 2% (one layer) to 13% (four layers).
Surgical masks don’t perform much better than their cloth cousins. In fact, clinical trials in the surgery theater have found no difference in wound infection rates with and without surgical masks. There is evidence from laboratory studies with coughing infectious subjects that surgical masks are effective at preventing emission of large particles.
What about N95 respirator masks used by the public? They fail to provide adequate protection mainly because untrained users will not wear respirators correctly, and because non-fit tested respirators are not likely to fit correctly. An N95 respirator on coughing human subjects showed greater effectiveness at limiting lateral particle dispersion than surgical masks (15 cm and 30 cm dispersion, respectively) in comparison to no mask (68 cm).
For healthcare workers on the frontline, the CDC recommends ensuring all of their workers are fit-tested and have respirators. With the supply shortages, the CDC changed its recommendations to allow the use of medical masks instead of respirators, saving the latter for aerosol-generating procedures. Healthcare organizations must return to using respirators for confirmed and suspected COVID-19 patients when supply chain problems are resolved.
In this study, it was found that nurses’ risk of SARS (severe acute respiratory syndrome, also caused by a coronavirus) was lower with consistent use of N95 respirators than with consistent use of a surgical mask. Consistently wearing a mask (either surgical or particulate respirator type N95) while caring for a SARS patient was protective for the nurses, and consistent use of the N95 mask was more protective than not wearing a mask. Risk was reduced by consistent use of a surgical mask, but not significantly. Risk was lower with consistent use of a N95 mask than with consistent use of a surgical mask.
What can we conclude from this?
Given the limited information about their performance, along with the extremely low efficiency of cloth masks as filters and their poor fit, there is no evidence to support their use by the public or healthcare workers to control the emission of particles from the wearer. Wearing surgical masks in households appears to have very little impact on transmission of respiratory disease. One possible reason may be that masks are not likely worn continuously in households. These data suggest that surgical masks worn by the public will have no or very low impact on disease transmission during a pandemic.
I suppose if you want to wear a mask – go ahead – but with the understanding it’s providing very little protection. Something is better than nothing, right? Why certain jurisdictions are requiring their citizens to wear masks is not based in science and their ulterior motives are yet unknown. One thing seems obvious to me, mandating the wearing of masks will not reduce SARS-CoV-2 transmission and only gives the wearers a false sense of security.
That cutie cloth mask is pretty worthless at preventing infection or spread. A surgical mask is a little better. And the N95 does best when you wear it properly. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted. There is some evidence the combination of good hand hygiene and early initiation of mask use by ill individuals reduced influenza transmission within households and among university students in residence.
Wearing mask may actually do more harm than good.
U.S. Surgeon General Dr. Jerome Adams not only suggests people to not wear masks to prevent the coronavirus, but warns that you actually might increase your risk of infection if facemasks are not worn properly. “You can increase your risk of getting it by wearing a mask if you are not a health care provider,” Adams said. “Folks who don’t know how to wear them properly tend to touch their faces a lot and actually can increase the spread of coronavirus.” Washing your hands, staying home when sick and other “everyday preventive actions” are the best protections, he said.
“If the public wear face masks, they run the risk of infecting themselves with flu because every time you touch an infected surface and then you touch the mask, which is on your face, you increase the chances of infecting yourself. Most people do not know how to wear the mask properly and not everybody is aware of it,” said Dr Hend Al Awadhi, head of health promotion and education section at the Dubai Health Authority’s Public Health Protection Department. Instead of wearing a face mask, Dr Al Awadhi said that it is better to wash your hands thoroughly for at least 20 seconds and avoid close contact with anyone showing the symptoms.
Patrick Woods writes, when a healthy person wears a face mask, they continuously re-rebreathe a portion of the CO2 that comes out of their lungs. Of course, there are many different types of masks that vary in such CO2 concentration, but the principal remains the same. Breathing air that is too rich in CO2 has its own negative health effects! Humans breathe in air that is approximately 20.95% oxygen, 78.09% nitrogen, 0.93% argon, and 0.04% (400 ppm) of carbon dioxide. Upon exhaling your breath contains approximately 3.8% CO2.
When CO2 enters the lung, is dissolves in water, forming carbonic acid which makes the blood more acidic, lowering blood pH. At the same time, excessive CO2 concentrations leaves less oxygen to be absorbed. Other aspects of body chemistry are affected as well. When wearing face masks, especially for an extended period or during higher-than-normal physical activity, some people will experience symptoms like rapid breathing, rapid heart rate, dizziness, muscular weakness, emotional upsets and fatigue.
What can we be doing?
It makes sense we should avoid crowded spaces, wash our hands, and stay home when we’re sick. Since medical masks and respirators are most important for protecting healthcare workers, the public should not be buying or hoarding them.
The public should not be wearing respirators in public when they are experiencing respiratory symptoms, but instead staying home.
COMMENTARY: Masks-for-all for COVID-19 not based on sound data
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WHO Advice on the use of masks in the context of COVID-19
The surgical mask is a bad fit for risk reduction