It’s funny how the further I travel my path in life, the more convinced I am that the important lessons are learned in the early years. Who remembers the game “Simon Says”? It’s another one of those silly games that young children play — except it perhaps is not that silly.
A quick review: one person, Simon, is in control of the group. The players are put into a formation and Simon barks orders at them to do random and complicated tasks. “Simon says, rub your belly and pat your head”. The goal is for Simon confuse the players. The orders come more quickly. Simon gives the orders improperly. Players are eliminated as they fail in the tasks. The “winner” is the last person left, who is able to comply with Simon’s mandates.
Well, Simon has left the playground and now inhabits the everyday world around us. Except he has taken on a new persona. Simon has become Science. Now, Science Says what we are allowed or expected to do.
Science says don’t wear a mask unless you’re a medical professional.
Science says everyone wear a mask.
Science says wait for the vaccine before you interact with other humans.
Science says antibodies don’t last after you get the vaccine.
Science says Corona virus spreads through droplets.
Science says Corona virus floats in the air and spreads by aerosol.
Science says wear a mask in your home.
Science says the N95 respirator is only needed by healthcare professionals.
Science says wearing a face covering that you make out of any cloth will protect others from you.
Science says… rub your belly and pat your head
Unfortunately, science has become dogma. Dogma does not answer questions — it controls behavior.
It’s time to put the mask (face covering) issue to rest. We need to declaw the mask zealots, politicians, public health officials, and the woman on the street who maces the non-mask wearer.
The following is from the CDC’s website titled “Use of Cloth Face Coverings to Help Slow the Spread of COVID-19”
That page tells you — Your cloth face covering may protect them. Their cloth face covering may protect you.
Notice the weasel word “may”. Anytime you see the word “may” in a statement, stop and replace it with “may not” because either condition is equally likely unless evidence to the contrary is presented. The CDC presents no evidence. Instead take the next step in your search for the evidence.
It is evolving as more questions are answered, but the foundational evidence is solid and predates the current frenzy of our surreal COVID world.
The CDC tells us — How COVID-19 Spreads
The virus is thought to spread mainly from person-to-person.
- Between people who are in close contact with one another (within about 6 feet).
- Through respiratory droplets produced when an infected person coughs, sneezes, or talks.
- These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
With this in mind the CDC also tells us how to stop the spread of this kind of infectious threat. This is published in the CDC’s Infection Control Manual (the guidance here applies to healthcare settings, which have a higher risk of transmission than in the community) That site has a new tab that was added just this year:
There you will find-
From there you go back to the infection control manual to learn about Standard and Transmission-based Precautions
and you find this:
Use PPE to protect the mucous membranes of the eyes, nose and mouth during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions and excretions. Select masks, goggles, face shields, and combinations of each according to the need anticipated by the task performed.
There is no science to support the use of cloth face coverings. Quite to the contrary: Here is what the real evidence supports- (not science says)
Filters do NOT act as sieves. One of the best tests of a filter’s performance involves measuring particle collection at its most penetrating particle size, which ensures better performance for larger and smaller particles. Further, the filter’s collection efficiency is a function of the size of the particles, and is not dependent on whether they are bioaerosols or inert particles.
Because fit is so important, NIOSH recommends and OSHA requires that each respirator wearer receive an initial fit test and annual fit tests thereafter. It is not possible to predict how well a respirator will fit on a particular face, even for respirators that fit well on a broad range of facial sizes.
Respirator fit depends on two important design characteristics:
- Whether the respirator operates in a “negative pressure” or “positive pressure” mode
- The type of facepiece and degree of coverage on the face
Respirators that operate in a “negative pressure” mode require the wearer to draw air through an air-cleaning device (filter or chemical cartridge) into the facepiece, which creates a pressure inside the respirator that is negative in comparison to that outside the facepiece. A “positive pressure” respirator, on the other hand, pushes clean air into the facepiece through the use of a fan or compressor, creating a positive pressure inside the facepiece when compared to the outside. Negative pressure respirators inherently offer less protection than positive pressure respirators, because inward leakage occurs more easily in the former.
A recent laboratory study of five surgical masks with “good” filters found that 80–100% of subjects failed an OSHA-accepted qualitative fit test
So, we know that surgical masks are a very poor substitute for an N-95 respirator.
Now we need to consider this-
Respirator filters are rated as N, R, or P for their level of protection against oil aerosols. This rating is important in industry because some industrial oils can remove electrostatic charges from the filter media, thereby degrading (reducing) the filter efficiency performance. Respirators are rated “N” if they are not resistant to oil
The “N” in N-95 indicates that this respirator cannot be used if it is exposed to oils. Consider whether you’ve seen someone in public touch his face covering. Do you ever touch yours? Oils from the skin get into the fabric of the mask and make it ineffective. If you reuse your face covering do you use a degreaser to clean it?
Now for the next critical piece of guidance:
1.The respirator filter needs to be highly effective at capturing particles that pass through it,
2.The respirator must fit the user’s face snugly (i.e., create a seal) to minimize the number of particles that bypass the filter through gaps between the user’s skin and the respirator seal; and
3.The respirator must be put on (donned) and taken off (doffed) correctly before and worn throughout the exposure.
I refer you to item 3 above. The particulars of that statement are: you wash your hands before applying your face covering. Once it is in place it is not touched until it is removed and disposed of. When you touch it the second time, your hands are contaminated and you wash them before you do or touch anything else.
Next- the entire justification for mandating the public to wear face coverings is due to every person being suspected of potential infection. SO… this is the CDC guidance on such a situation:
OSHA requires healthcare workers who are expected to perform patient activities with those suspected or confirmed to be infected with COVID-19 to wear respiratory protection, such as an N95 respirator. N95 respirator refers to an N95 filtering facepiece respirator (FFR) that seals to the face and uses a filter to remove at least 95% of airborne particles from the user’s breathing air.
Unfitted face coverings are not respirators.
All of the OSHA and NIOSH standards above are designed to protect the wearer of the mask from contamination, but contamination flowing out from the wearer would behave similarly.
Everything outlined above presumes droplet spread of the virus that we are concerned about. If, as is being suggested, SARS-CoV-2 is spread by aerosol then even more stringent control measures would be needed to mitigate the spread. That is not possible in the general population. It is even difficult to approach in controlled healthcare settings:
Inconsistent use of personal protective equipment is commonly reported among healthcare professionals and substantially reduces protection. Unfortunately, observational studies have shown that healthcare professionals frequently do not put on or remove respirators correctly, take their respirators off when they should be wearing them, or do not wear them at all. (CDC publication)
This is what I leave you with. Never accept what “Science Says” without truth testing the declaration. No expert or organization of experts has all the answers, and many have an agenda (which usually involves managing a population).
This is not so complex that you cannot determine for yourself what the evidence suggests. From that point you can make your own best decisions.
Troy Ross, MD, MPH