Why Face Masks Don’t Work: A Revealing Review

oralhealthgroup.com ^ | October 18, 2016 | John Hardie, BDS, MSc, PhD, FRCDC

[ransomnote]

Yesterday’s Scientific Dogma is Today’s Discarded Fable

Introduction
The above quotation is ascribed to Justice Archie Campbell author of Canada’s SARS Commission Final Report. 1 It is a stark reminder that scientific knowledge is constantly changing as new discoveries contradict established beliefs. For at least three decades a face mask has been deemed an essential component of the personal protective equipment worn by dental personnel. A current article, “Face Mask Performance: Are You Protected” gives the impression that masks are capable of providing an acceptable level of protection from airborne pathogens. 2 Studies of recent diseases such as Severe Acute Respiratory Syndrome (SARS), Middle Eastern Respiratory Syndrome (MERS) and the Ebola Crisis combined with those of seasonal influenza and drug resistant tuberculosis have promoted a better understanding of how respiratory diseases are transmitted. Concurrently, with this appreciation, there have been a number of clinical investigations into the efficacy of protective devices such as face masks. This article will describe how the findings of such studies lead to a rethinking of the benefits of wearing a mask during the practice of dentistry. It will begin by describing new concepts relating to infection control especially personal protective equipment (PPE).

Trends in Infection Control
For the past three decades there has been minimal opposition to what have become seemingly established and accepted infection control recommendations. In 2009, infection control specialist Dr. D. Diekema questioned the validity of these by asking what actual, front-line hospital-based infection control experiences were available to such authoritative organization as the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Association (OSHA) and the National Institute for Occupational Safety and Health (NIOSH). 3 In the same year, while commenting on guidelines for face masks, Dr. M. Rupp of the Society for Healthcare Epidemiology of America noted that some of the practices relating to infection control that have been in place for decades, ”haven’t been subjected to the same strenuous investigation that, for instance, a new medicine might be subjected.” 4 He opined that perhaps it is the relative cheapness and apparent safety of face masks that has prevented them from undergoing the extensive studies that should be required for any quality improvement device. 4 More recently, Dr. R. MacIntyre, a prolific investigator of face masks, has forcefully stated that the historical reliance on theoretical assumptions for recommending PPEs should be replaced by rigorously acquired clinical data. 5 She noted that most studies on face masks have been based on laboratory simulated tests which quite simply have limited clinical applicability as they cannot account for such human factors as compliance, coughing and talking. 5

Covering the nose and mouth for infection control started in the early 1900s when the German physician Carl Flugge discovered that exhaled droplets could transmit tuberculosis. 4 The science regarding the aerosol transmission of infectious diseases has, for years, been based on what is now appreciated to be “very outmoded research and an overly simplistic interpretation of the data.” 6 Modern studies are employing sensitive instruments and interpretative techniques to better understand the size and distribution of potentially infectious aerosol particles. 6 Such knowledge is paramount to appreciating the limitations of face masks. Nevertheless, it is the historical understanding of droplet and airborne transmission that has driven the longstanding and continuing tradition of mask wearing among health professionals. In 2014, the nursing profession was implored to “stop using practice interventions that are based on tradition” but instead adopt protocols that are based on critical evaluations of the available evidence. 7

A December 2015 article in the National Post seems to ascribe to Dr. Gardam, Director of Infection Prevention and Control, Toronto University Health Network the quote, “I need to choose which stupid, arbitrary infection control rules I’m going to push.” 8 In a communication with the author, Dr. Gardam explained that this was not a personal belief but that it did reflect the views of some infection control practitioners. In her 2014 article, “Germs and the Pseudoscience of Quality Improvement”, Dr. K Sibert, an anaesthetist with an interest in infection control, is of the opinion that many infection control rules are indeed arbitrary, not justified by the available evidence or subjected to controlled follow-up studies, but are devised, often under pressure, to give the appearance of doing something. 9

The above illustrate the developing concerns that many infection control measures have been adopted with minimal supporting evidence. To address this fault, the authors of a 2007 New England Journal of Medicine (NEJM) article eloquently argue that all safety and quality improvement recommendations must be subjected to the same rigorous testing as would any new clinical intervention. 10 Dr. R. MacIntyre, a proponent of this trend in infection control, has used her research findings to boldly state that, “it would not seem justifiable to ask healthcare workers to wear surgical masks.” 4 To understand this conclusion it is necessary to appreciate the current concepts relating to airborne transmissions.

MORE AT LINK

[Fai Mao]

The opposing viewpoint:
https://www.npr.org/sections/health-shots/2020/06/21/880832213/yes-wearing-masks-helps-heres-why?utm_source=pocket-newtab

So, I guess, pay your money and take your choice?

[rktman]

The only thing a mask does is keep your exhalations from being dispersed over a wide area. As far as intake...... Yeah, not so much. For intakes with all these masks, it ain’t a HEPA filter. And all the folks wearing the home made masks and bandanas? How often do they get cleaned/sanitized? As far as outside, pretty sure our friend Mr. Sun tosses out some UV rays that will take care of the nasties floating around.

[UNGN]

Face masks only work in the one case of where one person, who HAS THE VIRUS is talking, coughing or sneezing in close proximity to another person.

If people do not have the virus wear a face covering, they are touching there face WAY MORE than they would if they were not wearing a mask.

For somebody who does not have the virus, a face shield or even safety glasses would protect them more than a mouth/nose covering.

[Wonder Warthog]

NO mask (or any other item of PPE) gives perfect protection.
Masks DO decrease the possibility of transmission, but not to zero. But wearing one is certainly much better than not.

[BitWielder1]

If a mask wearer sneezes or coughs, the mask captures some, but not all, of the mucus.

The mask protects the wearer against dirty looks.

That's about it.

[edwinland]

Another case of a headline that doesn't match the article.

The article does not even argue that face masks don't work, just that their adoption was based on a common-sense idea (catching droplets that could contain TB) that has not been proven.

The correct headline would be:

"Medical Officials Assume Face Masks Work But That Has Not Been Proven."

[SunTzuWu]

Your choice of sources to support your view is interesting.

[steve8714]

Certainly? Is that “scientific consensus”? We’ve seen that before.

[NorthstarMom]

It’s going to be about 90 degrees this evening. I will be working, hustling around out there wearing the required mask. It’s not fun. I get headaches from wearing one so every time I go inside away from customers I pull down my mask for a bit. This means I am touching it constantly.

I don’t like it at all and have to work on my attitude to keep from becoming irritated at being forced to wear one.

[Flick Lives]

...just that their adoption was based on a common-sense idea (catching droplets that could contain TB) that has not been proven.

—

Much like several hundred years ago people thought lighter objects fell more slowly than heavier objects of the same shape. Scientific experiment proved that to be false.

[shanover]

It’s about 1000 x smaller than a grain of sand measured in microns. The mask thing is just a “respectful” measure the way I see it. The true way to battle this is for it to run its course and have science work a way to kill it or at least control it. I work in a mask for 10 hours a day and it’s not easy.

[rockrr]

Thanks for the link.

So far what I’ve seen of The Great Mask Debate resolves to:

1. Wear a mask - it’s the responsible thing to do. (because I said so)
2. Wear a mask - even if it doesn’t help it might....maybe
3. Wear a mask - even though it poses several significant risks to wearers.
4. Wear a mask - because science.
5. Wear a mask - because we can’t think of a viable way to manage this virus so we’re just gonna inconvenience everybody.

I’m less than impressed...

[crusty old prospector]

Then, your mask is full of goobers. Who would sneeze into a mask on purpose?

[budj]

The article (from 2016) is accurate in that there are no controlled clinical studies showing the effectiveness of the masks.

Yet Dr Faucci wears his mask and tells us we also should.

There are no controlled clinical studies showing the effectiveness (or lack) by taking HCl+Zinc at the first sign of COVID-19, although there are significant positive results reported by good doctors.

Yet Dr Faucci warns us against HCl.

Hmmmmm ... ... ... I wonder why we don’t trust Dr Faucci.

[metmom]

I hang mine out in the sun for the day after I use it.... a few times.

[Valpal1]

The anti-mask faction makes perfect the enemy of good. It’s like rabid environmentalists for whom 0 is the only acceptable level of what the evil chemical of the day is.

[manc]

I do not wear one due to my asthma. If a business will not let me in because I do not wear a mask would that be based on discrimination under the ADA?

[EEGator]

So you argue a false dichotomy to disprove a false dichotomy?...

[RummyChick]

It boggles my mind why people dont understand the concept of viral load

Some people get Covid but it never reaches the stage of a positive Test because T cells fight it off according to one theory/study. There are T cells tests that can be done but I dont think many are done.

In 4 days your nose can grow 10 million of the virus.

So how about keeping the viral load as low as possible

That said, I do think masks are problematic and could cause issues for people that have to wear them all day

Luckily, I just wear my face shield and mask for a quick in and out at the store

. Underarmour has come out with a new mask to deal with microbe issues...that is getting good reviews but sold out.

meanwhile , checking in with Rebel Chaz who is 28 years old refuses to wear and mask and parties on... and has now lost his sense of taste and smell...still doing okay