Do masks work?

N95 masks outperform all other types of masks

 

Are you up to the challenge? If you think you can make health decisions for you and your family independent of the advice given by experts -- maybe even going contrary to the opinions of the experts, answer the following question.

 

Do masks work for fighting covid-19? 

 

If you answered, "No, they don't", you flunked the test. Read on for the correct answer.

COVID-19 is a respiratory disease caused by SARS-CoV-2, and the main route of transmission is through the air—especially in the form of fine aerosols and respiratory droplets exhaled by infected people when breathing, talking, coughing, or sneezing.

• Masks filter inhaled and exhaled air. Depending on the mask type (cloth, surgical, N95/KN95/FFP2), the fit, and how consistently it’s worn, the degree of filtration varies. Even if not perfect, a mask always provides some reduction in exposure, both for the wearer and for others nearby.

• Effectiveness is a spectrum. A loose cloth mask is a weak barrier; a properly fitted N95 is a strong barrier. Poor fit, gaps, or wearing it under the nose reduce effectiveness, but even then there is partial protection.

The question isn’t whether or not masks work, but rather how well do masks work. The degree of benefit varies.

In “real-world” settings, much depends on how well the mask is worn (gaps, slipping, reuse, moisture), the type of mask, and for how long it is used or reused.

1. Masks reduce risk, but by how much depends on several factors.

• Wearing a mask is associated with a reduced risk of infection. The reduced risk is variable.

• Always wearing a mask or respirator in public settings is an improvement over never wearing one. The type of mask is important. Wearing an N95/KN95 mask is better than wearing a surgical mask and both are an improvement over not wearing a mask.

• Well-fitting respirators (N95/FFP2 etc.) outperform surgical and cloth masks in terms of filtering aerosol particles.

• It is believed that a “duckbill” N95 blocked almost all exhaled particles from infected individuals.

• Studies suggest that if many people wear masks, even moderately effective masks can have substantial community-level impact on transmission. 

The following is only anecdotal evidence but I am going to mention it anyway. 

During the peak of the covid-19 pandemic, I always wore an N95 in public. As the danger from covid waned, I switched to well-fitted surgical masks. I also got vaccinated. As the virus has mutated, I have gotten my covid-19 booster shots regularly. I have now had nine covid-19 vaccinations. 

Neither I nor my wife have ever had covid. And a good thing, too, as my wife and I are getting up in years.

There's a new normal.

I have some friends, who on returning to London from a cruise, self-isolated. They believe it's the best thing to do and at the end of two weeks it will be over. Life will return to normal. The danger will have past. Maybe not.

COVID-19 is highly contagious. Why? Because it hides. Consider the Diamond Princess. Tests of most of the 3,711 people aboard the large cruise ship confirmed that 634, or 17 percent, had the virus; 328 of them did not have any symptoms at the time of diagnosis.

“Children with very mild disease are probably going to be one of the major contributors to spreading the virus across the population,” says Graham Roberts, an honorary consultant paediatrician at the University of Southamptons. -- BBC Future

COVID-19 can spread quickly and quietly. The fact that it attacks the old in a dramatic fashion and not the young means in a youthful population it may go almost unnoticed. But let the virus get into a senior's home and all hell breaks loose. Again consider the Diamond Princess. On board the cruise ship those 70 and older were most vulnerable, with an overall fatality ratio of about 7.3 percent.

COVID-19 is ripping through our world. The number of infected spikes higher daily. The death toll continues to climb. Self-isolate, practise social distancing and you, even if you are old, get through this. Soon herd immunity will bring the numbers down. But the danger will not be over despite what my friends seem to think.

Until there is a vaccine, this new coronavirus will linger. Hiding in the young and the asymtomatic. It will make those younger than fifty mostly mildly ill, if at all, but it will infect our seniors and an uncomfortably large number will die.

In the near future going out to shop or attending a family gathering will carry a ominous undertone: COVID-19. The virus may well become endemic: a part of life until a vaccine is arrives to eradicate it.

70 or older? It's time to self-isolate.

Dr. David Williams, Chief Medical Officer of Health for Ontario, is instructing  all Ontarians over 70 and those of any age with compromised immune systems or underlying health condition to stop going out. Stay home. Avoid visitors. Practise self-isolation and social distancing. And do it now.

People in these categories should keep appointments and access services by phone or online, and have family, friends or neighbours run essential errands for them: groceries, prescription pickups, etc.

If you must go out, say to take the dog for a walk, keep 6-feet away from anyone you encounter. But strangers are not the only ones to steer clear of; avoid visits from loved ones.

The rules are tough but the danger from not following to them is tougher. You can die.

If you want one ray of hope in all this bleak news, check the case fatality rate for children up to age nine: 0%