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Let’s look at the 2 camps in the debate: The benefit is greater than the riskProponents of face masks use the following arguments: 1. We can prevent sick or asymptomatic infected people from infecting others by wearing masks - There may be some credible evidence to suggest this, but in doing so the infected person wearing the mask may be making their infection much worse as a result. The “wear them only in a medical setting” arguments below will prove this out. N-95 masks have been shown to block 95% of airborne particles with a median diameter >0.3 μm2, whereas standard face masks may block 50-70% of particles depending on the mask. http://medcraveonline.com/JLPRR/JLPRR-01-00021.pdf 2. If healthy people wear face masks, they will be protected from those that may be infected- The counterpoint in the next section will make the argument against that logic. 3. If you wear a mask, you are less likely to touch your nose, mouth or eyes, which is where the vast majority of infections begin- Some claim this to be true, but an argument can be made that people handle their mask frequently when adjusting them on their face and to remove them and put them on. All this touching of the mask raises the potential that viral transmission to the mask can then transfer to the nasal and oral cavities. Recent video of the Coronavirus Task Force news conferences have underscored this, as Dr Fauci and others from the task force are seen frequently fiddling with their masks in the background. The risk is greater than the benefit- (except in a medical setting) Detractors from the regular use of face masks cite the following: 1. Face masks do not protect the wearer from transmission by othersa. The American Medical Association just released a position paper on masks. From the paper…“Face masks should be used only by individuals who have symptoms of respiratory infection such as coughing, sneezing, or, in some cases, fever. Face masks should also be worn by health care workers, by individuals who are taking care of or are in close contact with people who have respiratory infections, or otherwise as directed by a doctor. Face masks should not be worn by healthy individuals to protect themselves from acquiring respiratory infection because there is no evidence to suggest that face masks worn by healthy individuals are effective in preventing people from becoming ill. Face masks should be reserved for those who need them because masks can be in short supply during periods of widespread respiratory infection. Because N95 respirators require special fit testing, they are not recommended for use by the general public.” Journal of the American Medical Association (JAMA); April 21, 2020 Volume 323, Number 15 https://jamanetwork.com/journals/jama/fullarticle/2762694 b. A recent careful examination of the literature, in which 17 of the best studies were analyzed, concluded that, “None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.” bin-Reza F et al. The use of mask and respirators to prevent transmission of influenza: A systematic review of the scientific evidence. Resp Viruses 2012;6(4):257- 67. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/ 2. Face masks restrict the elimination of virus, recirculating the virus into the nasal/sinus and upper respiratory passages. “By wearing a mask, the exhaled viruses will not be able to escape and will concentrate in the nasal passages, enter the olfactory nerves and travel into the brain.” Article by Russel Blaylock M.D., published May 14,2020 in Technocracy News & Trends. Dr. Blaylock is a prominent retired neurosurgeon and author of health-related books. “We know that people who have the worst reactions to the coronavirus have the highest concentrations of the virus early on. And this leads to the deadly cytokine storm in a selected number.” https://www.technocracy.news/blaylock-face-masks-poseserious-risks-to-the-healthy/ https://www.technocracy.news/blaylock-face-masks-pose-serious-risks-tothe-healthy/ b. This direct re-breathing of the virus back into the nasal passages can contribute to the migration of the virus to the brain. “Newer evidence suggests that in some cases the virus can enter the brain. (1,2) In most instances it enters the brain by way of the olfactory nerves (smell nerves), which connect directly with the area of the brain dealing with recent memory and memory consolidation. By wearing a mask, the exhaled viruses will not be able to escape and will concentrate in the nasal passages, enter the olfactory nerves and travel into the brain.” (3) 1) Baig AM et al. Evidence of the COVID-19 virus targeting the CNS: Tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci 2020;11:7:995-998. https://pubmed.ncbi.nlm.nih.gov/32167747/ 2) Wu Y et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behavior, and Immunity. https://pubmed.ncbi.nlm.nih.gov/32167747/ 3) Perlman S et al. Spread of a neurotropic murine coronavirus into the CNS via the trigeminal and olfactory nerves. Virology 1989;170:556-560. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7130896/ 3. Wearing a face can cause headaches and reduce oxygen levels- A recent study involving 159 healthcare workers aged 21 to 35 years of age found that 81% developed headaches from wearing a face mask… That is, a reduction in blood oxygenation (hypoxia) or an elevation in blood C02 (hypercapnia). It is known that the N95 mask, if worn for hours, can reduce blood oxygenation as much as 20%. Ong JJY et al. Headaches associated with personal protective equipment- A cross sectional study among frontline healthcare workers during COVID-19. Headache 2020;60(5):864-877. https://headachejournal.onlinelibrary.wiley.com/doi/epdf/10.1111/head.13811 And proper oxygenation of the blood is essential for energy, mental clarity, focus and emotional well-being. 4. Wearing a face mask can increase your risk of infections- The last point discussed the drop of oxygen levels after mearing a mask. A drop in oxygen levels (hypoxia), is associated with an impairment in immunity. Studies have shown that hypoxia can inhibit the type of main immune cells used to fight viral infections called the CD4+ Tlymphocyte. This occurs because the hypoxia increases the level of a compound called hypoxia inducible factor1 (HIF-1), which inhibits T-lymphocytes and stimulates a powerful immune inhibitor cell called the T-regs. This sets the stage for contracting any infection, including COVID-19 and making the consequences of that infection much graver. In essence, your mask may very well put you at an increased risk of infections and if so, having a much worse outcome. In addition, reduced oxygenation can accelerate cancer growth. 4) Shehade H et al. Cutting edge: Hypoxia-Inducible Factor-1 negatively regulates Th1 function. J Immunol 2015;195:1372-1376. https://ratical.org/PandemicParallaxView/1372.full.pdf 5) Westendorf AM et al. Hypoxia enhances immunosuppression by inhibiting CD4+ effector T cell function and promoting Treg activity. Cell Physiol Biochem 2017;41:1271-84. https://pubmed.ncbi.nlm.nih.gov/28278498/ 6) Sceneay J et al. Hypoxia-driven immunosuppression contributes to the premetastatic niche. Oncoimmunology 2013;2:1 e22355. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583916/ 5. Wearing face masks is a constant reminder that we should fear this invisible enemy or “monster” as some politicians have called it- There is no doubt that wearing a mask reinforces the worry and fear about COVID-19. Even being in public mask-less and seeing that most people are wearing masks leaves one with a sense of angst. Fear, worry and anxiety are powerful immune suppressing emotions. This is another factor relating to the immunosuppressive effects of face masks. This is a link to a section of a 2007 book titled, Cytokines: Stress and Immunity- Second Edition 2007. You can read Chapter 2 titled Worried to Death? Worry, and Immune Dysregulation in Health and HIV. Interestingly, HIV is a viral infection as is SARS-C0V-2 (COVID-19). https://books.google.com/books?hl=en&lr=&id=2DvMBQAAQBAJ&oi=fnd&pg=PA17&dq=the+immunosuppressi ve+effects+of+fear+and+worry&ots=ZNbmH2FBXA&sig=0FwVcXAxtEBeHT78_EV90NWl91g 6. What are some government agencies that are taking a balanced and science-based approach saying? On April 27, 2020, the Ventura County California Public Health Department has released a Pros and Cons one sheet about face masks (link at end of this section). One thing they warn against is the general public buying and using N-95 masks, because of the shortage of PPE for medical personnel. This is very wise advice. It also cites some other limited benefits of preventing transmission, pretty well characterized by this quote: There is a “very slight protective advantage” to wearing a medical mask as opposed to wearing nothing at all in a community setting. The risk of acquiring a viral infection is reduced by 6%. When both ill and well wear a medical mask in a household, the risk is reduced by 19%. There is more “evidence to support the use of medical masks for short periods of time by particularly vulnerable individuals when in transient high-risk situations.” But what else does it say? And what scientific evidence do they present that describes the effectiveness of masks and that warns against the use of face masks by the general public? Here is a good sampling… • With near universal use of cloth and medical masks worn in public in Wuhan, China during the 2019-2020 flu season leading up to the COVID-19 outbreak, the outbreak spread virtually unchecked. • “Available evidence shows that (cloth masks)… may even increase the risk of infection due to moisture, liquid diffusion and retention of the virus. Penetration of particles through cloth is reported to be high.” “Altogether, common fabric cloth masks are not considered protective against respiratory viruses and their use should not be encouraged.” https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html • “Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. The virus may survive on the surface of the facemasks. Self-contamination through repeated use and improper doffing is possible.” https://bmjopen.bmj.com/content/5/4/e006577 • Textile materials (that can be used for cloth masks) can contain harmful chemicals and dyes (i.e.formaldehyde). There is no research available regarding the safety of breathing through such materials, but formaldehyde is a gas that can irritate a person’s eyes, nose, throat and lungs, or trigger an asthma attack, even at low concentrations. Prolonged exposure to formaldehyde can cause cancer. https://ww2.arb.ca.gov/resources/fact-sheets/formaldehyde https://www.gao.gov/new.items/d10875.pdf • Wearing cloth masks in public can create a false sense of security and complacency in which people may neglect other hygiene practices. https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-homecare-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak • Frequent washing and drying of a cloth mask can decrease the filtration capacity of the mask. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6599448/ • “Neither surgical nor cotton masks effectively filtered SARS–CoV-2 during coughs by infected patients… the size and concentrations of SARS–CoV-2 in aerosols generated during coughing are unknown. Oberg and Brousseau demonstrated that surgical masks did not exhibit adequate filter performance against aerosols measuring 0.9, 2.0, and 3.1 μm in diameter. Lee and colleagues showed that particles 0.04 to 0.2 μm can penetrate surgical masks. The size of the SARS–CoV particle from the 2002–2004 outbreak was estimated as 0.08 to 0.14 μm; assuming that SARS-CoV-2 has a similar size, surgical masks are unlikely to effectively filter this virus.” https://annals.org/aim/fullarticle/2764367 In total, the document presented 18 arguments and studies against the effectiveness and use of masks and 10 showing some limited benefit. After careful scrutiny of the pros and cons, I am landing squarely against the use of them other than by medical personnel in a clinical setting, or if an individual that is in close proximity of an infected person with the risk of being directly coughed or sneezed on, as in when caring for or visiting a sick person. Source: https://vcportal.ventura.org/CEO/VCNC/2020-05-05_VCNC_Masks_Pros_and_Cons.pdf The conclusion of the Russell Blaylock M.D. article states the following: “It is evident from this review that there is insufficient evidence that wearing a mask of any kind can have a significant impact in preventing the spread of this virus. The fact that this virus is a relatively benign infection for the vast majority of the population and that most of the at-risk group also survive, from an infectious disease and epidemiological standpoint, by letting the virus spread through the healthier population we will reach a herd immunity level rather quickly that will end this pandemic quickly and prevent a return next winter.” “During this time, we need to protect the at-risk population by avoiding close contact, boosting their immunity with compounds that boost cellular immunity and in general, care for them. One should not attack and insult those who have chosen not to wear a mask, as these studies suggest that is the wise choice to make.” ... View more