Mask-Wearing Myths and Realities
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In the age of COVID-19, many businesses are requiring that their customers wear masks. The pushback against this rule has been extraordinary. Some places in the country have been very cooperative, while others are up in arms about the restriction.
I would prefer to allow customers to visit my business without a mask, so they're more comfortable. But that's not a decision I could make without knowing the facts. So I looked into the studies about mask-wearing. Here's what the experts said about the information being shared online.
“Wearing a mask stops microbes from entering your body and weakens your immune system. That will make your immune system unable to respond when real illness strikes.”
False. Unless you're wearing a specially fitted N95 respirator, there are still lots of microbes getting around and through that mask. That theory assumes there are no other ways for germs to enter your body.
In fact, a single apple contains about 100 million bacterial cells according to a study conducted by researchers at Graz University of Technology in Austria. A study in Microbiome showed that a 10-second intimate kiss transferred 80 million bacteria. Even if you wore a mask all day, every day, your body would still be challenged by hundreds of millions of bacteria from your environment.
There's another problem with this belief. How can you claim a mask will make your immune system weak because it stops germs, but also believe that masks WON'T stop COVID-19? You can't have it both ways.
“COVID-19 is so small, even the best masks can't stop it.”
Partially true. According to researchers, COVID-19 particles ranged in size from 0.06 microns up to 0.14 microns. The best masks are designed to stop things 0.3 microns in size and larger.
Since 0.14 microns is smaller than 0.3 microns, the COVID-19 virus should be able to easily pass right through all those masks we're wearing.
But the virus doesn't move like that. It moves around in drops of saliva and mucus called respiratory droplets. Respiratory droplets range in size from 5-10 microns in diameter, far larger than the 0.3 micron holes found in the best masks.
According to the World Health Organization, “...COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes.” Face masks using two layers of heavyweight “quilters cotton” and a thread count of at least 180 are really good at preventing those droplets from passing through.
However, even simple cloth masks can slow the spread. The CDC recommends, “the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.”
It's important to know that respiratory particles do build up on a mask. That's why you have to be careful taking your mask off. Remove it using the straps and immediately dispose of it or clean it after each use. Then thoroughly wash your hands so you don't accidentally transfer germs from the mask to your face.
“Masks can cause you to breathe in too much of your own carbon dioxide, or prevent you from getting enough oxygen, giving you headaches, making you dizzy and sick.”
Mostly false. Too much carbon dioxide in your blood is a condition called hypercapnia. Not getting enough oxygen in your blood is called hypoxia.
Masks made out of regular cloth and surgical masks are reasonably good at stopping infectious droplets, but gas molecules like carbon dioxide and oxygen are too small to be controlled by the majority of mask materials and simply pass right through.
An N95 mask has holes that are about 0.3 microns in size. That's 300,000 picometers. Carbon dioxide is about 116.3 picometers across and oxygen is approximately 152 picometers in size. That means mask holes are more than 1,900 times larger than needed for those gas molecules to pass through.
If regular masks did cause hypercapnia or hypoxia, you would quickly notice a problem with healthcare workers or any profession that requires regular mask-wearing.
That doesn't mean masks don't cause problems. They can trigger headaches, chaffing and allergic reactions depending on how they fit or the materials they're made out of.
Avoid these problems by wearing masks made out of materials you're not allergic to. Wash masks thoroughly so detergents aren't left behind. Avoid spraying bleach or other chemicals on masks. And finally, make sure your mask is properly fitted so it doesn't pull or pinch.
“You shouldn't wear a mask if you have breathing problems like COPD (Chronic Obstructive Pulmonary Disease) or Asthma.”
That depends on the type of mask. A tight-fitting and dense mask like N95 respirators can cause problems for people with respiratory issues. People with claustrophobia may feel panic attacks and hyperventilate. However, cloth masks or surgical masks allow plenty of airflow and generally aren't a problem. Talk to your doctor if you have concerns.
“Wearing a mask isn't an effective way to PREVENT ME from getting COVID-19.”
Mostly true. In a study carried out on passengers from the Diamond Princess Cruise Ship, researchers found that 17.9% of the people who had the disease, showed no symptoms. They are referred to as being asymptomatic. Because they didn't have any signs of being ill, they carried on with their regular life. Meanwhile, they unwittingly spread the disease. Everyone they came in contact with was being exposed to the virus.
That's where the mask-wearing comes in. The virus can become airborne in respiratory droplets when you cough, sneeze or talk to someone near you. A mask, even something as simple as a couple pieces of cotton cloth, will stop many of the droplets from leaving you and infecting the people near you.
That means MY mask protects YOU and YOUR mask protects ME. It's not about stopping you from getting the virus, it's about stopping you from infecting all those nice people you're around if you HAVE the virus and don't know it. Only a selfish or cruel person would willingly skip a mask and risk spreading the virus in places they shop, visit or worship.
“There's no proof wearing a mask will slow the spread of COVID-19.”
False. A very detailed study was released on April 22, 2020. It's called, “Universal Masking is Urgent in the COVID-19 Pandemic: SEIR and Agent Based Models, Empirical Validation, Policy Recommendations.” The authors compared countries with high levels of mask-wearing to ones with low levels. Using computer modeling and real-world data, they found masks could stop the virus.
The study concluded that if 80% of the population wore masks, there would be more than a 90% drop in infection rates.
As I write this article on May 19th, the United States has reported 93,533 COVID-19 deaths. Countries like Japan that put universal mask-wearing in place, have just 2% of the infection rate of the United States, after adjusting for population. All the while Japan's subways, bars and retail businesses didn't have to shut down.
The facts are clear. The sooner we all start wearing masks around each other, the faster we'll be able to beat COVID-19 and eventually throw those masks away.
Catherine M. Clase, MB BChir, MSc, Edouard L. Fu, BSc, Meera Joseph, MD, Rupert C.L. Beale, MB, PhD, Myrna B. Dolovich, BEng, PEng, Meg Jardine, MBBS, PhD, Johannes F.E. Mann, MD, PhD, Roberto Pecoits-Filho, MD, PhD, Wolfgang C. Winkelmayer, MD, ScD, Juan J. Carrero, Pharm, PhD
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