The evidence against masks

In times of overwhelming disaster and limited resources, ingenuity and repurposing can save lives.  For example, the use of stapling wounds on the suture-poor battle fields more than a century ago was game changer. It worked because the purpose of a suture and a staple were similar – to hold two opposing surfaces together.

Wrap a scarf over your face to cover your mouth and nose and wear glasses.

The same is not true of surgical masks and community use. Surgical masks are in low supply and are desperately needed by healthcare providers.  Moreover, unlike sutures and staples, the repurposing of surgical masks for the general population is not only ineffective, we all have more effective barriers in our closets and drawers such as scarves.

Besides, surgical masks are designed primarily to protect the environment from the wearer, not the wearer from the environment.

That is, masks are best if worn by people who have airborne transmissible diseases – not healthy people. Simply put, masks are designed to stop infections getting out, not to prevent them from getting in.

Even if you want to wear a mask, no one can tell you how often you should change it.  There is very little evidence about long term use of masks as they were initially designed to be used in the short term. Evidence from operating theatres shows that contamination – on the outside, not inside of the mask, became more severe with extended wearing time.

Even the best of masks is no more than a series of random fibrous webs. They have interconnecting open areas that were designed to remove a percentage of particules from liquid or gas streams flowing through them.

They cannot prevent inhalation of small airborne particles and at best they can protect users from large droplets and sprays. Bacteria, the original culprits that masks were designed to protect against, are giants compared with even large viruses like coronavirus.

Our breath is moist and even the most effective face masks become wet and clog the microfibres to make the pores larger. There is some evidence that talking whilst wearing a mask can speed up the clogging process. Once clogged, masks are worse than useless.

So, if you are healthy and want to protect yourself, wrap a machine-washable scarf over your face to cover your mouth and nose.

Even a mask or scarf may not be enough to protect ourselves from infection. Our eyes are another source possible transmission. The tears that wash them clear drain into our noses. So, if you are going to wear a mask or scarf to protect yourself, add some protective eyewear.  Sunglasses work well.  And beware windy days when the CoVID-19 can sail further.

Of course, there is one benefit to all of us wearing masks. If everyone puts on a mask in public places, it would help to remove stigmatisation that has hitherto discouraged masking of symptomatic patients in many places.

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