MASK WARS: What Does the Science Say?

July 18, 2020 5:22pm

Many cities and states require people to wear masks while in public. Why? With a virus that spreads via airborne particles and exhaled droplets, it seems reasonable that a mask would prevent both ingress and egress of the virus and thus would prevent infections. But paradoxically, that is not necessarily the case.

The Centers for Disease Control released a new report titled "Effectiveness of Cloth Masks for Protection Against Severe Acute Respiratory Syndrome Coronavirus 2" (Volume 26, Number 10 - October 2020). It is an early release article that is subject to change before its official release in October. But it does provide some insight into the effectiveness and risks of cloth masks worn by the public in community settings. I wrote about some of these points on May 17th at www.TheMikeBatesShow.com/blog/200517-1316

The CDC report, which can be read at https://wwwnc.cdc.gov/eid/article/26/10/20-0948_article, repeats the CDC's current recommendation that masks should be worn in public. But it doesn't state that doing so will actually reduce exposure to the Coronavirus or prevent infection for the mask wearer or those around him. Like every study and medical article - and I have read literally hundreds of pages of such information - the CDC report is filled with so many weasel words and warnings of incomplete data, that no conclusion can be drawn from them. But they are presented to the public as if they are the peer-reviewed, infallible, Nectar of the Gods.

In fact, the report makes numerous statements about how masks "may" work and about how masks have significant deficiencies that actually increase risk of infection.

If you are interested in the actual science and not just what the news media spoon-feeds you, I encourage you to read the entire report. But here are a few excerpts (words in ALL CAPS have been capitalized from lower case by me for emphasis):

"THE GENERAL PUBLIC SHOULD BE EDUCATED ABOUT MASK USE BECAUSE CLOTH MASKS MAY GIVE USERS A FALSE SENSE OF PROTECTION because of their limited protection against acquiring infection."

"The filtration effectiveness of cloth masks is generally lower than that of medical masks and respirators; however, cloth masks MAY provide SOME protection IF WELL DESIGNED AND USED CORRECTLY."

"Multilayer cloth masks, designed to fit around the face and made of water-resistant fabric with a high number of threads and finer weave, MAY provide reasonable protection."

"In community settings, however, cloth masks may be used to prevent community spread of infections by sick or asymptomatically infected persons, and the public should be EDUCATED ABOUT THEIR CORRECT USE."

"To our knowledge, only 1 randomized controlled trial has been conducted to examine the efficacy of cloth masks in healthcare settings, and THE RESULTS DO NOT FAVOR USE OF CLOTH MASKS."

"Rates of infection were consistently higher among those in the cloth mask group than in the medical mask and control groups. This finding suggests that risk for infection was higher for those wearing cloth masks. The mask tested was a locally manufactured, double-layered cotton mask. Participants were given 5 cloth masks for a 4-week study period and were asked to wash the masks daily with soap and water. THE POOR PERFORMANCE MAY HAVE BEEN BECAUSE THE MASKS WERE NOT WASHED FREQUENTLY ENOUGH OR BECAUSE THEY BECAME MOIST AND CONTAMINATED." Cloth masks get moist very quickly.

"Filtration effectiveness of wet masks is reportedly lower than that of dry masks."

"Filtration effectiveness of cloth masks varies widely; some materials filter better than others. Filtration effectiveness of cloth masks depends on many factors, such as thread count, number of layers, type of fabric, and water resistance."

"Protection is affected by proper mask use as well as by selection of fabric and design of the masks for water resistance, filtration, and fit. Current evidence suggests that multilayered masks with water-resistant fabric, high number of threads, and finer weave may be more protective. Several studies have examined filtration, but fewer have examined fit or water resistance."

"The degree of fit affects effectiveness because air flows in the direction of least resistance; IF GAPS ARE PRESENT ON THE SIDES OF THE MASK, AIR WILL FLOW THROUGH THOSE GAPS INSTEAD OF THROUGH THE MASK."

If people fail to properly decontaminate cloth masks frequently enough, they "MAY RISK SELF-CONTAMINATION."

"Some randomized controlled trials have shown masks to be efficacious in closed community settings, with and without the practice of hand hygiene. Moreover, in a widespread pandemic, differentiating asymptomatic from healthy persons in the community is very difficult, so at least in high-transmission areas, universal face mask use MAY be beneficial."

"Correctly putting on and taking off cloth masks improves protection. Taking a mask off is a HIGH-RISK PROCESS because pathogens may be present on the outer surface of the mask and MAY RESULT IN SELF CONTAMINATION during removal."

"The filtration, effectiveness, fit, and performance of cloth masks are inferior to those of medical masks and respirators."

"Protection provided by cloth masks may be improved by selecting appropriate material, increasing the number of mask layers, and using those with a design that provides filtration and fit. Cloth masks should be washed daily and after high-exposure use by using soap and water or other appropriate methods."

So that's what the Centers for Disease Control says. What does the World Health Organization say?

In April, the World Health Organization acknowledged that "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." SOURCE: https://apps.who.int/iris/bitstream/handle/10665/331693/WHO-2019-nCov-IPC_Masks-2020.3-eng.pdf?fbclid=IwAR0q0zgix1O5krfLG1_sMD6XQ-oWgbWSnYsbsnqud_rZu-8-kArncOZtExw (bottom right corner on page 1).

Updated guidance on the use of masks by the general public is at https://apps.who.int/iris/rest/bitstreams/1279750/retrieve. Its information on the efficacy of mask usage by the public begins on page 6 of the report.

If you read it, pay particular attention to the paragraph that says, "Many countries have recommended the use of fabric masks/face coverings for the general public. At the present time, THE WIDESPREAD USE OF MASKS BY HEALTHY PEOPLE IN THE COMMUNITY SETTING IS NOT YET SUPPORTED BY HIGH QUALITY OR DIRECT SCIENTIFIC EVIDENCE AND THERE ARE POTENTIAL benefits and HARMS to consider."

That same WHO document lists among the potential benefits to wearing a mask is that they help in "making people FEEL they can play a role in contributing to stopping spread of the virus" and that "fabric masks can also be a form of cultural expression, encouraging public acceptance of protection measures in general."

Depending on the material, homemade masks have a filtration rate of 1.1% - 26%. And that assumes proper fit and usage, which almost nobody does. In addition to the very low filtration rate of air moving THROUGH cloth, the air leaking AROUND the cloth has a filtration rate of zero. Next time you're wearing a mask, check the gaps at the chin, cheeks, and below the eyes. You'll find there is a lot of air going around the cloth not through it. Mask wearers with glasses often complain that their glasses get fogged up. Why is that? Because the warm, moist, exhaled breath is escaping through the massive gap at the top of the mask and causing condensation on the lenses. That gap is not filtering any air at all.

But let's assume proper fit and usage in these examples: 1) If a non-medical mask is worn by an infected person, 74% - 98.9% of virus-laden particles escape to the air; 2) If a mask is worn by a healthy person in an infected area, 74% - 98.9% of virus-laden particles would be inhaled. But what about the 1.1% - 26% of the virus-laden particles that do get filtered? They remain on the mask, and every time a mask wearer touches his mask, his fingers become contaminated! So, unless hands are cleaned after EVERY touch of the mask, the risk of infection increases!

If you wear a mask in public, do you decontaminate your hands after every touch of your mask? When you put it on? When you pull it down to your chin to eat? When you raise it back over your nose and mouth after eating? When you adjust its fit? When you scratch an itch through it? When you take it off? If you answered "yes" to all those, I'm calling you a liar - because I know you don't wash your hands that often. And you know also, so quit lying. Dishonesty benefits no one.

Risk of infection is affected by both the intensity and the duration of exposure. So do masks allow you to be in an infected environment longer than if you didn't wear a mask. Yes, but it's marginal. If a mask has a filtration rate of 26% (which is the highest rate among cloth masks), a masked person would inhale/exhale the same amount of viruses in 60 minutes that a maskless person would in 44.4 minutes. With a mask filtering 1.1%, that masked hour equals 59.3 minutes unmasked. This comparison also applies to the time it would take for an infected person to contaminate his surroundings.

How often do you see masks pulled down beneath the nose? Or on the chin covering neither the mouth or nose? They don't do much good there.

Masks provide zero eye protection, of course. But the eyes are a conduit for infection from contaminated hands or contaminated air. So what's the next government mandate? Goggles or space helmets?

The World Health Organization has cautioned that masks provide a false sense of security and may actually increase risk of infection. The WHO lists among the possible harms of mask use by healthy people in the general public "potential increased risk of self-contamination due to the manipulation of a face mask and subsequently touching eyes with contaminated hands," "potential self-contamination that can occur if non-medical masks are not changed when wet or soiled. This can create favourable conditions for microorganism to amplify," "potential headache and/or breathing difficulties, depending on type of mask used," "a false sense of security, leading to potentially lower adherence to other critical preventive measures such as physical distancing and hand hygiene." And it cites numerous mask problems for "those living in hot and humid environments" Summer in America, anyone?

To minimize the dangers of mask usage, single use masks must be discarded after being worn for a few hours. Most people don't toss them daily; even fewer dispose of their masks more frequently. And what about cleaning reusable cloth masks? Cloth masks should be washed DAILY in soapy 140°F water, boiled for one minute, or soaked in a chlorine solution for one minute then thoroughly rinsed with clean water. How many people do that? If it is not zero, it's almost zero.

That same WHO report cautions that "a non-medical mask is neither a medical device nor personal protective equipment" and that because of lower filtration and breathability, "the use of non-medical masks, made of woven fabrics such as cloth, and/or non-woven fabrics, should only be considered for source control (used by infected persons) in community settings and not for prevention," and "their use should always be accompanied by frequent hand hygiene and physical distancing." Why? Because frequent hand cleaning and physical distancing are far more effective in preventing the spread of the Coronavirus than masks are.

So if masks aren't really as effective as people believe, why are so many cities and states mandating masks? It's theater. And it's being directed by politicians who want to look like they're doing something even though they're not. Well, I refuse to be cast as a lemming in their stage plays.

I obviously haven't read every mask law in the country. But I have read Pensacola's (which uses the exact same verbiage as some other jurisdictions). Section 1(b) of that order defines a face covering as "a material that covers the nose and mouth and that fits snugly against the sides of the face so there are no gaps. It can be secured to the head with ties or straps or simply wrapped around the lower face. It can be made of a variety of materials, such as cotton, silk, or linen. Coverings with materials made of multiple layers is highly encouraged. A cloth face covering may be factory-made or sewn by hand, or the cloth face covering can be improvised from household items. The CDC has posted additional information regarding how to make, wear, and wash a cloth face covering at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html"

Under this definition, wearing underwear on the head would be in compliance. And since there's no minimum thread count requirement, a mask made from sheer lace lingerie would also be legal. Or for that matter, a mask made from a fishing net. But don't take my word for it, read it yourself. The full order is at https://www.cityofpensacola.com/DocumentCenter/View/19673/Declaration-of-State-of-Emergency-20-03_062620

An oft-cited article in the British Medical Journal recommends universal masking but acknowledges it does so based upon the Precautionary Principle, which they define as "a strategy for approaching issues of potential harm when extensive scientific knowledge on the matter is lacking.” The BMJ has taken the position that policy makers should apply the precautionary principle now and encourage people to wear face masks on the grounds that we have little to lose and potentially something to gain from doing so. I respect their opinion and commend them for their honesty.

Why do most American publications hide their lack of evidence in small print in the appendix (or entirely omit it) but amplify their recommendations as indisputable fact? I find such unjustified, holier-than-thou, authoritarianism to be dishonest, disgusting, and detrimental. Anytime scientists hide facts, their motives should be suspect.

There is still a lot we don't know about the COVID-19 Coronavirus. And we are similarly ignorant about the efficacy of masks to prevent its spread. The bottom line is that the scientific evidence neither supports universal masking nor says universal masking is pointless.

So if someone wants to wear a mask, they should be able to wear one without ridicule.

And if someone doesn't want to wear a mask, they should be able to go maskless without condemnation.