Are Face Masks Effective at Preventing SARS-CoV-2
The simple answer is… No.
At least not for the general public who do not have symptoms of COVID-19-like illness.
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. 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’re told to follow the science.
Rather than getting your politicized science from the mainstream media that regularly mis-reports the actual science, I suggest you read the real science as detailed by the scientists themselves. What you’ll discover is the stories you read and hear in the mainstream media are oftentimes completely opposite of the actual results of the science itself.
The advice you’re getting from the so-called experts and public health officials is also un-trustworthy. One day they say one thing, the next day they say something opposite. The fake news reporters either don’t understand what they’re reporting or they think you are completely stupid and should listen to what they say the science says. Clearly, they don’t seem to have a clue about the science. On the other hand, they do have an agenda.
The bottom line here is whatever their agenda may be, masks do NOT work effectively to reduce the spread of SARS CoV 2. This whole mask wearing fiasco has nothing to do with your health or the health of your grandma, it has everything to do with Money, Control, and Jurisdiction.
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.”
Science Supporting Facemask Use
In support of wearing face masks, a research article was recently published in The Proceedings of the National Academy of Sciences (PNAS) by Texas A&M Distinguished Professor of Atmospheric Sciences,
In the papers conclusion the author writes, “The current mitigation measures, such as social distancing, quarantine, and isolation implemented in the United States, are insufficient by themselves in protecting the public. Our analysis reveals that the difference with and without mandated face covering represents the determinant in shaping the trends of the pandemic worldwide. We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with extensive testing, quarantine, and contact tracking, poses the most probable fighting opportunity to stop the COVID-19 pandemic, prior to the development of a vaccine.”
Sound good? Well, I don’t know about you but I’m always a bit skeptical when it comes to any study based on “projections” of data. Kinda like weather forecasters calling for rain next week. We were told early in the coronavirus pandemic, for example, that millions of Americans will die and a whole host of calamities if we do nothing. Who can forget that “flatten the curve” graphic shown over and over? As it turns out, those death projections fell short. Remember all those doom and gloom projections about global cooling, er., global warming, er… now climate change? Kinda, sorta didn’t happen.
I’m no whizzbang Professor of anything, only a mere mortal that fortunately still has a brain that works, but I’m left asking lots of questions about the methods and conclusions of this PNAS paper. I already mentioned how “projections” are mere speculation and predictions about the future that more often than not are not accurate. I’m left asking a whole host of questions about (a) testing method effectiveness for detecting infection, (b) incubation time between infection and date of testing, (c) projections that do not include the natural end of a virus, like actual data shows with most previous viruses, and (d) effects from other mitigation such as social distancing, school and business closures etc. on the downward cases of infection.
[UPDATE 7/16/20] Apparently, I was not alone in questioning the above study. CIDRAP reports a group of researchers posted a letter that they had sent to the Proceedings of National Academy of Sciences (PNAS) requesting the retraction of the study. The group of scientists, many from Stanford and Johns Hopkins universities, took umbrage with that conclusion and said it is verifiably false on several accounts: Other parts of the country had mandated mask use, and different parts of the United States had different degrees of “lockdown.” “While masks are almost certainly an effective public health measure for preventing and slowing the spread of SARS-CoV-2, the claims presented in this study are dangerously misleading and lack any basis in evidence,” they wrote.
Gosh, I hadn’t meant for this section of my article to be a debunking claim. I wanted to include the study in an attempt to keep everything fair and balanced by showing both sides of the debate. I just believe, as in just about everything else in life, you’ve got to question what you’re hearing and ask questions. Don’t take anybody’s word for it… think for yourself and draw your own conclusions.
CDC Director, Robert R. Redfield, cited two recent studies that suggest that universal mask policies reduce spread.
- The first study, published in JAMA, described an association between universal mask requirements and a reduction in COVID-19 infections among healthcare workers at Mass General Brigham, the largest healthcare system in Massachusetts. [NOTE: This study looks at healthcare workers in hospitals where I agree it makes sense masks should be worn, not the general public.]
- In a study published in the Morbidity and Mortality Weekly Report (MMWR), the authors described no infections among 139 clients of a hair salon in Missouri or their contacts after exposure to two symptomatic, masked stylists who had tested positive for COVID-19. The salon required face coverings for all stylists and patrons.
In another article titled, Meta-analysis on facemask use in community settings to prevent respiratory infection transmission shows no effect, the author states after reviewing the conclusions of ten clinical trials and case-control/retrospective observational studies, “there is enough evidence that medical facemasks are effective in community settings to prevent transmission of respiratory viral infections,” is not supported by their analyses. There were no significant differences between medical facemasks use only and controls in the odds of developing laboratory-confirmed influenza and influenza-like illness. Similarly, no differences in laboratory-confirmed influenza risk were observed when comparing mask use solely versus combined intervention of face mask and handwashing, indicating that facemask as solely intervention in community is not associated with reducing respiratory infection.
Reaching similar conclusions is a policy review published by the CDC as recent as May 2020, where they did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility. “In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks.”
Reality Check | Why Face Masks Don’t Work, According To Science
Spreading the 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.
In this Randomized Clinical Trial, N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel, involving 2862 health care personnel, there was no significant difference in the incidence of laboratory-confirmed influenza among health care personnel with the use of N95 respirators (8.2%) vs medical masks (7.2%). Their conclusion states, “Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.”
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.
In an example of how the mainstream media distorts and spins findings, the Los Angeles Times reported about this study with a headline reading, “Face mask trial didn’t stop coronavirus spread, but it shows why more mask-wearing is needed,” falsely claiming in their tweet that this was the first and only randomized controlled study of the use of face coverings to prevent the spread of COVID-19. Not true! If the LA Times readers would actually read the study reported here they would quickly find the fake news presented by the LA Times. This was definitely NOT the conclusion of Danish mask study! In the randomized controlled trial, Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers, a total of 3030 participants were randomly assigned to the recommendation to wear masks, and 2994 were assigned to control; 4862 completed the study. Infection with SARS-CoV-2 occurred in 42 participants recommended masks (1.8%) and 53 control participants (2.1%). The between-group difference was ?0.3 percentage point (95% CI, ?1.2 to 0.4 percentage point; P = 0.38) (odds ratio, 0.82 [CI, 0.54 to 1.23]; P = 0.33). Multiple imputation accounting for loss to follow-up yielded similar results. Although the difference observed was not statistically significant, the 95% CIs are compatible with a 46% reduction to a 23% increase in infection.
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.”
Two studies in university settings assessed the effectiveness of face masks for primary protection by monitoring the incidence of laboratory-confirmed influenza among student hall residents for 5 months. The overall reduction in ILI or laboratory-confirmed influenza cases in the face mask group was not significant in either study.
Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial.
Facemasks, hand hygiene, and influenza among young adults: a randomized intervention trial.
In 7 household studies, 1 study provided face masks and P2 respirators for household contacts only, another study evaluated face mask use as a source control for infected persons only, and the remaining studies provided masks for the infected persons as well as their close contacts. None of the household studies reported a significant reduction in secondary laboratory-confirmed influenza virus infections in the face mask group.
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.
5 NIH/National Library of Medicine studies from 2004-2020 all finding verifiable health effects from wearing a face mask, including scientifically verified reduction is blood oxygen level:
Do Cloth Masks Offer Protection?
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).
The aim of this study, A cluster randomised trial of cloth masks compared with medical masks in healthcare workers, was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.
Do Surgical Masks Offer Protection?
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.
One study evaluated the use of masks among pilgrims from Australia during the Hajj pilgrimage and reported no major difference in the risk for laboratory-confirmed influenza virus infection in the control or mask group.
A number of studies have shown the inefficacy of the surgical mask in household settings to prevent transmission of the influenza virus.
Disposable medical masks (also known as surgical masks) are loose-fitting devices that were designed to be worn by medical personnel to protect accidental contamination of patient wounds, and to protect the wearer against splashes or sprays of bodily fluids. There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure. Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.
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.
A Deep Dive into the Science of Face Masks
Ryan Cristián – Founder/Editor of The Last American Vagabond did a deep dive into the 50+ science papers of face masks in the following video. It is a long video and well worth your investment in time to learn the science behind face masks. I encourage you to visit his website where he provides links to all the studies and references contained in the video allowing you to research it for yourself, and come to your own conclusions.
The Mask Science Is Clear: If You Are Doubting The Science Behind Wearing A Mask Watch This Video
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.
What Does the Science Say?
Really simple… facemasks do NOT work to curb the spread of SARS-CoV-2.
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.
Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures
The Mask Science Is Clear: If You Are Doubting The Science Behind Wearing A Mask Watch This Video
Censored: A Review Of Science Relevant To COVID-19 Social Policy And Why Face Masks Don’t Work
COMMENTARY: Masks-for-all for COVID-19 not based on sound data
COMMENTARY: COVID-19 transmission messages should hinge on science
WHO Advice on the use of masks in the context of COVID-19
The surgical mask is a bad fit for risk reduction