As a scientist, I question the efficacy of paper surgical masks in preventing the transmission of COVID-19, as my hospital reintroduced a mandate for healthcare providers to wear them.

Although many debate the effectiveness of paper masks, I am more interested in the evidence supporting wearing one rather than the politics surrounding masking.

Mixed Feelings

I remember wearing a paper surgical mask during a particularly busy shift at the hospital last winter.

As I moved from one patient’s room to another, I couldn’t help but notice the discomfort caused by the mask’s straps constantly tugging at my ears.

Despite the inconvenience, I also couldn’t ignore the sense of protection and responsibility that came with wearing it.

I work in cancer medicine, after all.

It’s a strange juxtaposition — the physical discomfort versus the mental reassurance.

Moreover, my patients prefer to see my face.

Moments like these make me reflect on the true effectiveness of these masks and whether they are truly making a difference in preventing the transmission of viruses.

Overview

While we adopted widespread mask use as a public health measure, the evidence supporting their effectiveness remains contested.

Observational studies (and even some randomized controlled trials) suggest a benefit, but there is no high-level, conclusive evidence that masks reduce COVID-19 transmission.

You may be surprised to hear this doctor admit that.

Today, I want to examine a recent study that hails the effectiveness of masking.

The big reveal: We need more rigorous investigations to determine the precise role of paper surgical masks in mitigating the spread of the virus.

A New Study

Atle Freithem and colleagues report the results of a pragmatic randomized control trial in the British Medical Journal:

Personal protective effect of wearing surgical face masks in public spaces.

www.bmj.com.

The take-home message is this:

Wearing a surgical mask for two weeks during the winter of 2023 reduced the spread of self-reported viral illness.

This research proves that paper masks work, right?

Study Details

Purpose: This study aimed to see if wearing a surgical mask in public places like stores, streets, and public transport for two weeks could protect people from getting sick with respiratory infections like colds or the flu.

How the study worked: Researchers randomly divided almost 4,700 adults in Norway into two groups. They told one group of participants to wear surgical masks in public for two weeks while asking the other group not to.

What researchers examined: The scientists were mainly interested in whether people got sick with respiratory infections. They also looked at whether people reported getting COVID-19 or had it confirmed by a doctor.

Important note: The investigators did not tell subjects to wear masks at home or work, only when in public.

Study Results

Here are the study results:

Over the study period, about 9 percent of those who wore masks reported cold or flu-like symptoms, compared to 12 percent of those who didn’t.

This finding suggests that wearing masks might slightly lower your chances of contracting a respiratory infection.

My Take

First, kudos to the researchers for completing a practical, randomized clinical trial evaluating paper mask effectiveness.

We can do randomized clinical trials in the COVID-19 realm.

Second, the study does not prove that paper masks reduce COVID-19 transmission.

Many people believe masks are effective, and this study didn’t use a placebo or fake mask to account for that belief.

The results may reflect that people feel better because they wear a mask rather than a mask that prevents illness.

We Need Studies With Objective Measures

I hope we get a study that uses objective measures of infection.

I wish the authors had used regular virus tests or blood tests checking for COVID-19 antibodies.

And mandated mask wearing for more than a couple of weeks.

The study, as conducted, tells us that people wearing masks reported fewer illnesses, not that they were actually sick less often or felt better overall.

While the study didn’t find a benefit in confirmed COVID-19 cases, it might not have been large enough to detect a small difference.

Bottom Line

This study does not prove masks reduce COVID-19 transmission; the study’s primary endpoint was self-reported illness.

After so much trumpeting of the value of paper masks to reduce COVID-19 contagiousness, we still need high-level evidence to convince me.

Per my hospital’s mandate, I will continue to don my paper mask faithfully in designated places in my workplace.

But am I better off donning a mask year after year for a virus that has diminished in lethality for healthy individuals like me?

If I had a big upcoming event, I would wear an N-95 mask.

Many counterfeit N-95 and K-95 masks are out there, and many don’t fit them properly.

But that is another story.

Do you regularly wear a paper surgical mask? What motivates you to do so?

Effectiveness of Face Mask or Respirator Use.

This report describes face mask or respirator effectiveness in helping protect against COVID-19 infection.

www.cdc.gov.

The post Do Surgical Masks Protect You Against COVID? appeared first on Medika Life.

“If you’re going to the grocery store or you are an essential worker coming in contact with a lot of people, I recommend wearing a cotton mask over a surgical mask which can catch more than 90% of respiratory aerosols.” — Joseph Allen, Harvard University

Ever want to be a superhero? Today, it’s as simple as wearing two masks, not one, during the COVID-19 pandemic. The move from calls for simply covering your face with a bandana or a folded t-shirt has now caught up with the science. One mask isn’t sufficient to protect you and us.

The idea that a single, homemade facemask would be adequate protection was thought of as a good idea by Dr. Jerome Adams, the Surgeon General of the United States. He encouraged people to follow his demonstration of a DIY mask that was uploaded to Youtube. “With items, you can find around the house.”

Making your own masks may be the only option for some people, but here it’s a matter of quality of the material.

“If you’re making a cloth mask from 600-thread-count Egyptian cotton sheets, that’s different than making it from a cheap T-shirt that’s not very finely woven,” according to Dr. Ramzi Asfour, an infectious-disease physician.

Sorry, doc, that that ain’t good enough and it never was good enough. You tried, but it was a failed effort.

The N95 mask and other masks, used in healthcare settings and difficult to find in stores, were seen as the protection needed. But was it sufficient? Studies are now revealing that even this mask may not be adequately protective.

“…an N95 mask reduces the droplet leakage around the mask edges during the cough. However, the pressure inside the mask increases during coughs and the turbulent jet is directed through the front. Although both surgical and N95 masks decelerate the turbulent jet, none of them will prevent the droplets entirely from penetrating or escaping the mask, i.e., droplet transmission.”

Both mask leakage due to material construction and the saturation of the mask are prime factors requiring consideration in preventing droplet dispersion. Here, in the delicate interplay of weave and fiber characteristics, i.e., the smoothness or fuzziness of fiber, the true dynamics of a cough or virus spread must be calculated. While the CDC recommends cloth masks for the public, are they sufficient? Seemingly not.

What other factors besides the material of the mask must be considered? Numerous elements are brought into play, such as cough volume, droplet size, distance from an infected person, and the mask’s fit.

The mask-to -face fitting is important. Even in the case of a tight-fitting scenario, if there exist some small openings, this can lead to additional leakage of droplets around the mask, which cannot be ignored.

The Case for Doubling Masking

The case has been made for the need to wear a mask and the seriousness of transmission of a virus. Even wearing a mask, depending on the type, nothing appears to provide 100% protection, and many masks offer more than slightly 50% to the wearer.

Concern is now being expressed regarding the new variants of the COVID-19 virus, its virility, and its high transmission rate. Both of these together may indicate that a smaller quantity of material may be just as deadly or result in more infections. The secret to this increased infection by variants lies in its molecular shape, which affords a more efficient bonding and access to cells.

The N501Y mutation seems to refine the shape of the puzzle piece, allowing a tighter fit and increasing the chance of a successful infection.

Whether or not this is the case, it makes sense to increase our protection as an additional measure to maintain health. Present vaccines may prove to have decreased effectiveness in treating these new variants. Masks need to be more efficient, and therein lies the rationale for double masking.

Based on these (research) findings, we recommend a three-layer mask consisting of outer layers of a flexible, tightly woven fabric and an inner layer consisting of a material designed to filter out particles. This combination should produce an overall efficiency of >70% at the most penetrating particle size and >90% for particles 1 μm and larger if the mask fits well.

The research may not have caught up with the variants yet. Is a three-layer, single mask the solution, or should a more aggressive approach be taken? The new attack of the virus variants has been a game-changer. Seemingly, the thinking is that two masks, not one, may be the answer even if it has three layers.

The reasoning is that wearing more than one mask may inhibit the viral blobs’ pathway that reaches you. If the masks can trap those particles, you may be safe, but they remain in the mask, don’t they? This, then, makes a case for changing your mask and not continuing to carry around a mask full of viruses.

Isn’t it worth your health to change your mask and not hang on to it?

The post Not Simply Masking, But Double Masking Is Needed appeared first on Medika Life.