Current recommendations by the US Centers for Disease Control (“CDC”) and the World Health Organization (“WHO”) state that masks provide significant benefit in the fight against Covid-19. Leading medical experts, such as Dr. Jerome Adams, the US Surgeon General, and Dr. Anthony Fauci and Dr. Deborah Birx of the White House Coronavirus Task Force, support this conclusion. With such unanimity of agreement, media outlets and members of the public have taken to what is termed “mask shaming” those who do not wear masks, chastening them as selfishly presenting a significant threat to public health. Is this fair? As is often the case, the matter is a bit more complicated.
Many of the same government agencies and medical leaders who currently advise that masks are essential had only a couple of months ago rebuked such recommendations as not only unnecessary, but actually dangerous. Much of their concern related to the improper use of masks by the general public. Doctors are trained to never touch their masks. In fact, prior to surgeries nurses often place them on for them. Doctors are also trained to not lower their mask to their chin, or take them off and then on again, or store them on surfaces, or re-use them absent proper sterilization. However, in California for example, the public is required to wear masks at all times inside restaurants except when eating or drinking. Gym goers are required to wear masks when walking around the gym but not while exercising. These guidelines require people to take their masks off and put them on again throughout the day. Not only is the general public forced to repeatedly touch their masks, but to store them in unsanitary places such as pockets or purses, or on tables. It was this unavoidable misuse of masks, as well as the low quality of many of the masks worn by the general public, that drove many experts to, until recently, caution against their use. Dr. Jerome Adams warned the public against wearing masks, stating “You can increase your risk of getting it by wearing a mask if you are not a health care provider,” because “folks who don’t know how to wear them properly tend to touch their faces a lot and actually can increase the spread of Coronavirus.” In an interview on CBS News Dr. Fauci expressed a similar concern about the risks posed by improper mask usage, noting, “There’s no reason to be walking around with a mask . . . often there are unintended consequences, people keep fiddling with their mask, and they keep touching their face.” Dr. Mike Ryan, Executive Director of the WHO Health Emergencies Program stated in late March, “There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit. In fact, there’s some evidence to suggest the opposite in the misuse of wearing a mask properly or fitting it properly.” England’s Deputy Chief Medical Officer, Dr. Jenny Harries, stated in regards to wearing a mask, “For the average member of the public, it is not a good idea” as the manner in which many people wear their masks could “actually trap the virus.”
So, why have so many medical experts changed their opinions of mask wearing from it being dangerous, to being essential? When pressed with this question, three main reasons are given. First, that the transmissibility of the virus by asymptomatic individuals was not known at the time these original recommendations were made. However, a google search about asymptomatic spread of Covid-19 retrieves hundreds of articles warning about the serious risk of such transmission beginning in late February and throughout March, including a CNN article dated March 9, stating “It’s easy for asymptomatic people with coronavirus to spread the illness.” Recent evidence suggests that asymptomatic transmission is actually less of a risk than previously thought, with Dr. Maria Van Kerkhove of the WHO stating that such transmissions are “very rare,” although later clarifying amid great political pressure that such rates are actually not known yet. Whether you choose to believe her initial statement, or the clarification, neither suggests that asymptomatic transmission is more severe than previously believed.
The second answer often given is that significant new science has emerged. However, the most comprehensive research on the efficacy of wearing a mask to prevent the spread of viral infections was recently published in The Lancet, on June 1, 2020. The study was a meta-analysis of 172 previously performed observational studies and 44 relevant comparative studies across 16 countries. The researchers concluded with “low certainty” that wearing a mask does help prevent the spread of a virus, depending upon the quality of the mask. To this point, one of few studies to compare the usefulness of masks of different quality in preventing viral transmission concludes that masks of low quality, such as the cloth masks often worn by members of the general public, could actually be dangerous. Laboratory tests showed that penetration of particles through cloth masks was as high as 97%. The researchers conclude “moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.” This conclusion is consistent with the medical communities’ original warnings that due to low-quality masks and improper usage, the general public should not wear masks. There is no evidence of a contradictory or evolving conclusion on this issue, nor did the recent Lancet study mention any emerging or contradictory evidence.
The suggestions that asymptomatic spread is much worse than previously thought, or that previous scientific research on the efficacy of masks has been contradicted by new emerging data, appear to lack any credibility upon close examination. Therefore, we are left with the third, and by far the most troubling reason given for the change in public policy, which is that the original warnings that the public not wear masks was given in order to protect the supply of masks for health care workers who were in short supply. If this is true, that would mean that leading members of the medical community, the CDC, and WHO all conspired to knowingly conceal the truth from the public. As previously noted, multiple leading experts warned that masks were dangerous, when in fact they actually knew masks were necessary to protect the public from Covid-19?
Why public policy regarding masks has changed so dramatically may never be known. Whether it be for political reasons, or the result of a misinformation campaign by the medical community, we are left to wonder if we can trust those who are tasked with protecting public health. I would urge those who seek answers to do their own research. What I have found is as follows: If you wear your mask like a doctor does during surgery, sterilizing it after each use, never touching it, removing it, or storing it on unsterile surfaces, never pulling it down to your chin, never touching your face before placing your mask on, then science indicates, albeit with “low certainty”, that you may indeed be providing you and others some benefit against the transmission of Covid-19. However, if you wear your mask improperly, evidence suggests, and many leading medical experts have warned, you may be unwittingly spreading the virus to yourself and others. Should you wear a mask? Ask yourself: will I wear it properly? The mask has been described as a symbol of unity and mutual respect, but the shaming of those who choose to not wear masks, without true knowledge of their efficacy, is creating a divide among friends, families and strangers. We need to come together and collectively demand clear and honest answers from our leaders.
Written by Brett Oppenheim
Edited by Yasmine Tanres