October 17, 2021

To Mask Or Not To Mask

By Tom Gutowski | Oct. 9, 2021

I hate wearing masks; they tug at your ears, muffle your voice, and fog up your glasses. But they’re worth the inconvenience.

Masks work, even though they don’t catch every virus particle. Viral load matters; it isn’t just one virus particle and -- BOOM, you’re in the ICU. Scientists say that if someone gets sick and if so, how sick, is partly a function of how much of the virus they’re exposed to. During respiration, virus particles an infected person exhales are contained in droplets of varying sizes. Any decent mask properly worn catches a significant percentage of the droplets, and thus of the virus. Exactly what percentage it catches varies depending on the type and fit of the mask.

The biggest benefit from mask wearing is “source control,” i.e. stopping wearers from spreading the virus to others. People infected with COVID-19 can go weeks without symptoms, and it takes only a few unknowingly infected and unmasked people to put enough virus into the air to spread the disease. So for source control to work, masking has to be nearly universal.

A Denmark study cited as evidence that masks don’t work didn’t attempt to measure source control, and over half of the participants who were asked to wear masks reported being less than fully compliant, so no one really knows if those who caught the virus did so while masked or unmasked.

The authors of a May 2020 paper in the New England Journal of Medicine also cited as evidence that masks aren’t effective have said their work was misinterpreted, and that their intent “was to push for more masking, not less.” One of the authors of an MIT study complained that those citing it as evidence that masks don’t work were “wildly off base,” adding that, “Our study highlights the fact that efficient mask use provides an extremely effective means of limiting indoor transmission of COVID-19…”

A review of COVID growth rates before and after the implementation of mask mandates in fifteen states and the District of Columbia showed that mandates slowed the daily infection rate and might have prevented 450,000 cases.

Multiple studies have shown that masks don’t harm the wearer. A person in average health or better can wear a mask for hours at a time with no ill effect. The only exceptions are those who for whatever reason are incapable of removing their own masks, and people who have serious trouble breathing even without a mask.
 
A pediatric infectious disease specialist at the Mayo Clinic wrote: “Studies have unequivocally shown that there are no negative health effects on children from wearing a mask.” A study recently published in the pediatrics section of the Journal of The American Medical Association said masks do harm children by increasing the amount of carbon dioxide they breathe, but was quickly retracted because of “numerous scientific issues.” The most significant issue was the failure to take into account the fact that when a mask wearer inhales, the large majority of the air they inhale comes from outside the mask.

Mask mandates have not been found unconstitutional despite several challenges. In rejecting a challenge to state-mandated vaccinations, the Supreme Court noted in 1905 in Jacobson vs Massachusetts that “there are manifold restraints to which every person is necessarily subject for the common good.” In 2020, a Florida court cited Jacobson vs Massachusetts in rejecting a mask mandate challenge, saying that the pandemic “is precisely the sort of exigent circumstance that justifies governmental intrusion into individual autonomy.” This August, in Resurrection School vs Elizabeth Hertel et al, the Sixth Circuit Court of Appeals used similar reasoning to reject yet another challenge.

Despite hopeful developments, the health emergency created by COVID isn’t over. Infections, hospitalizations, and deaths began increasing again this summer due to the Delta variant. In some areas, ICU wards are at or near capacity. And while the unvaccinated continue to make up the majority of hospitalizations and deaths, breakthrough infections among the vaccinated have become more common. Rural America is getting hit the hardest: In September, the infection rate was 54 percent higher in those areas than in metropolitan areas.

And more young people are getting sick. In September, 27 percent of new infections in Michigan were among those 20 and younger. The pediatric COVID mortality rate is low, but no one knows if it will remain so as the virus continues to mutate, what the “long haul” effects will be, nor how many others in the community -- including teachers -- will catch COVID from infected youngsters.

The Mayo Clinic, the Cleveland Clinic, the University of Michigan Health System, and Massachusetts General (affiliated with Harvard Medical School) all recommend the wearing of masks, as do the American Academy of Pediatrics, the American Medical Association, the American Hospital Association, the American Nurses Association, and the CDC.

An article in the September 16, 2021 Scientific American entitled, “Masks Protect Schoolkids from COVID despite What Antiscience Politicians Claim” says “there are multiple lines of evidence from a variety of disciplines—including materials science, infectious diseases, pediatrics and epidemiology—showing that masks can help protect children and teachers from getting COVID in schools.”

The bottom line is that masks — along with vaccinations and social distancing — constitute an effective tool for getting the pandemic behind us.

Tom Gutowski is retired from the insurance industry.

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