Science Under Siege About Wearing Face Masks

June 25, 2020 – Since the first advice to don masks when going outside or into stores was issued by Health Canada back in March, my wife and I have been wearing masks. At the beginning, the problem was finding masks. One of our neighbours made washable cloth masks for us. Later on we were able to secure a supply of disposable paper masks. When I leave our apartment the mask has become standard equipment.

Why?

The science of disease spread and prevention strongly supports wearing a mask when outside or going into a store. The problem, however, has been with those who have been advising the public on this issue.

Back in January at the outset of the pandemic, the U.S. Centers for Disease Control (CDC) released guidelines advising the healthy public that wearing a mask was unnecessary. At the end of February, the U.S. Surgeon General put out a tweet telling the public to stop buying masks. At the same time here in Canada our national authority was issuing similar guidance. But early in April, the CDC revised its mask-wearing guidelines suggesting they be worn in public when social distancing wasn’t possible. Health Canada started talking about it being advisable.

Why was the Surgeon General telling the public to not buy masks at the end of February? The explanation was that there was insufficient inventory of masks for health workers and that what was in the supply chain should be prioritized for them. That message was similarly conveyed in Canada. But the explanation fo the U.S. doesn’t hold water with politics in play.

The current President didn’t seem to think masks were his thing while Canada truly faced a shortage exacerbated by Donald Trump trying to hold up Canadian purchases from American producers and suppliers.

At the time, the science around COVID-19 was far from exact. Many in the scientific community thought that this virus was like its cousin, SARS, which spread on surfaces. It turns out that COVID-19 was airborne and easily spread through communication between those infected and people nearby. States Renyi Zhang, Texas A&M Distinguished Professor of Atmospheric Sciences, about COVID-19:

“Our results clearly show that airborne transmission via respiratory aerosols represents the dominant route for the spread of COVID-19.” 

Since that revelation, the scientists have been trying to reassert themselves about masks as a primary preventive. A report published in The Lancet on June 1, 2020, lists 172 studies in 16 countries and shows that face masks reduce the risk of infection along with other protective measures like social distancing, eye protection, and the frequent washing of hands and face.

Comparing face masks versus no face mask, the study concluded that the former would likely result in a significant double-digit reduction in virus transmission and infection. It classified three types of masks: medical (like the ones I currently wear), surgical, or ones equipped with respirator cartridges (N95).

The Lancet report also reviewed physical distancing measures noting that a separation of more than one meter results in large reductions in risk of exposure, and adding an additional meter increases the effectiveness by more than a factor of two. And eye protection versus none, using face shields or goggles is also seen as effective in reducing infection risk.

So why were the CDC, the U.S. Surgeon General, Health Canada, and other national authorities around much of the world so reluctant to invoke the “precautionary principle” of safety first to reduce transmission when we see from this report that all 172 studies agree about masks and other isolation measures to protect the public?

The Lancet report states in its conclusions: “Our comprehensive systematic review provides the best available information on three simple and common interventions to combat the immediate threat of COVID-19, while new evidence on pharmacological treatments, vaccines, and other personal protective strategies is being generated.”

So we can wait for pharmacological solutions to reduce the worst symptoms of COVID-19, and ultimately for a vaccine or vaccines that will protect us from the virus in the future, but in the interim, we can make ourselves, our families, our neighbours, and coworkers much safer by wearing masks.

Zhang concludes, “This inexpensive practice, in conjunction with social distancing and other procedures, is the most likely opportunity to stop the COVID-19 pandemic.” 

So why, in the face of this message from science, are 55% of Americans, and likely an equal number of Canadians, not wearing protective face coverings? In a Forbes article written by John Brandon and published on May 6, 2020, he quotes Henry Redel, Chief of Infectious Disease at Saint Peter’s University Hospital in New Jersey:

“I think people are hesitant to wear masks due to our culture and humans are used to using their faces to express emotions and communicate. It is a big change. Cultures in Asia, where respiratory viruses have caused epidemics in the past, have adapted culturally to the practice, and had better results during this pandemic.”

Redel goes on “The more masked people in public, the less opportunity for the virus to spread. Much of the spread comes from asymptomatic hosts, so masking even without symptoms is still protective.”

An interesting statistic to comprehend. When someone nearby coughs they release as many as 3,000 aerosol droplets into the air. These droplets can stay in the air for as much as 15 minutes with live viruses contained within them. When a person is speaking nearby he or she can release thousands of droplets as well. When a runner or cyclist who is asymptomatic flies by you as you walk, the plume released from sweat and breathing can contain thousands of viruses trailing behind.

If the cougher, talker, runner, and cyclist are all wearing masks they lessen the amount of aerosol with virus from their mouths. And if you are wearing a mask you are protected from inhaling the virus. This is basic science, not rocket science, and should not be ignored.

A final note:

Today, The Washington Post reports that “the number of Americans…infected with the novel coronavirus is likely 10 times higher than the number of cases reported” according to CDC Director, Robert Redfield, with 92 to 95% of Americans still susceptible to the virus. If that doesn’t convince you that a simple act, wearing a mask, is worth it, I don’t know what will.