Masks and research

Given that the evidence base for using masks is poor and indeed they can be harmful to overall health, plus some interventions make very little difference, my suggestion would be to use more recent evidence to inform what gets eased first.. ,

Why the contribution is important

An example of current knowledge would be Hunter et al. funded by Kings College London and University of East Anglia who suggest relaxing stay at home and reopening non essential businesses.

by aapeel on May 08, 2020 at 03:25PM

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Average rating: 4.5
Based on: 8 votes

Comments

  • Posted by ABurd888 May 08, 2020 at 17:08

    This is not a good idea. Let me tell you why.

    When I moved to Hong Kong twenty years ago the young government looking for the way ahead asked the Chief Medical Officer of Scotland to come and advise Hong Kong on how to develop the health services. The reason was that the populations of Hong Kong and Scotland were similar. HK 6.65 million, Scotland 5.067 million.

    Fast forward twenty years and the respective populations are HK 7.4 million and Scotland 5.5 million.

    Scotland and Hong Kong (as indeed the rest of the world) were notified about the developments in Wuhan at the same time. But there is a big difference. We had to deal with SARS. We learned that stopping the spread of the virus within the community was vital. How to you do that? Social distancing is not very practical in one of the most densely populated regions of the world. Schools were closed, sports, entertainment, public gatherings were curtailed. Restaurants were only allowed to set four at a table and the tables had to be far apart. But the idea of keeping six feet away from other people, it is only practical if you are being buried six feet under. So what do we do? We are obsessive about cleaning hands and surfaces but the other thing we have done is that everyone wears a mask. This is not to protect the wearer, this is to prevent the spread of droplets containing the virus.

    So what is the result? Today in Hong Kong we have a total of 1049 cases and 4 deaths. There has been no community squired infection since April 19th. New cases ironically have been found in people returning from the US and the UK and they undergo strict quarantine.

    What about Scotland? 12, 709 positive cases and Health Protection Scotland as many as 2927 deaths.

    To say that the "evidence base for using masks is poor" is dangerously misguided. Sometimes we do not have the science to guide us but we can still use logic and reason. I think the UK government has been reckless in its failure to respond to this global crisis. Not only that but but the politicians in the party in power are hiding behind the scientists and the medical advisers who are doing their best but many of them are out of their depth. Lying, deception, misinformation might achieve Brexit but it is no match for a virus.

    Nicola is doing her best and I would rate her response far, far higher than that of Mr Johnson and his wealthy friends who have very little understanding of the struggle of so many in the UK.

    So, respectfully I would suggest that it is still not too late to educate the public on the benefits of thinking of others. Wear a mask, it shows you care.

  • Posted by JanetMoxley May 08, 2020 at 21:08

    As far as I can see the vast majority of people using masks/face covering are not using them properly and therefore increasing risk. Mask/covering wearers constantly fiddle with their masks/coverings, then poke at things without sanitising. Also seen people with masks over mouth but not nose (which is useless), or face covering made of such thin, widely meshed fabric that they will not retain any droplets.

  • Posted by ABurd888 May 09, 2020 at 05:56

    @JanetMoxley I have heard this argument before and indeed it was a reason why WHO has prevaricated on the matter. They knew how poorly prepared too many countries were for this pandemic and PPE is just one example. Medical masks for healthcare workers. The problem is that they had not factored in the role of the mask when worn by the general public whilst in public. This is a containment role and the CDC came up with a compromise, adopted by the First Minister of referring to "face coverings". Simpler to refer to home-made masks.

    Now you cannot blame a mask if it is not being used properly. Think of when seat belts were introduced. there were some initial problems and protests but now I think the majority of the population wear seat belts without demure.

    Masks are a new concept for many people. There will be those who feel self conscious and wonder whether they have the mask on correctly. This is where education comes in and also leading by example.

    I would encourage you to take a look at this website: https://smartairfilters.com/cn/en/ when you get to the home page you will see a menu along the top with one item being "learn". click on that and it will give a list. Go to the 'clean air blog' and under masks you will find the detailed science behind making a safe and effective mask at home. You are not making things difficult for the healthcare workers. Indeed, if you, your family and friends make masks and then wear them when you go out in public, you will be making a significant contribution to the awareness of the importance of the need for everyone to do their bit in limiting the spread of the virus in the community. It needs a catchy slogan something like," wear a mask, show you care and help to save lives".. Good luck and keep safe.

  • Posted by freedom1 May 09, 2020 at 14:39

    World Health Organisation advice on the wearing of masks: They are NOT fans.
    Studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.13 There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure.14-23 However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.
    Medical masks should be reserved for health care workers.
    The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take...
    Studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.13 There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure.14-23 However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.
    Medical masks should be reserved for health care workers.
    The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take
    Studies of influenza, influenza-like illness, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else and potential contamination of the environment by these droplets.13 There is limited evidence that wearing a medical mask by healthy individuals in the households or among contacts of a sick patient, or among attendees of mass gatherings may be beneficial as a preventive measure.14-23 However, there is currently no evidence that wearing a mask (whether medical or other types) by healthy persons in the wider community setting, including universal community masking, can prevent them from infection with respiratory viruses, including COVID-19.
    Medical masks should be reserved for health care workers.
    The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take...

    https://www.who.int/publica[…]t-of-the-novel-coronavirus-(2019-ncov)-outbreak

  • Posted by Cmnotzs May 09, 2020 at 17:03

    We also have to consider that there are people who cannot wear masks for more than a minute or two. I spend a lot of effort in walking to keep my lungs conditioned having previously suffered lung injury through Pulmonary Embolism. As long as I keep moving my lungs are healthy and my blood gas stays in balance.

    I did a little test this afternoon - but stopped before it caused harm. If I wear a fabric mask across my mouth and nose for just 3 minutes my saturated oxygen starts to drop BUT more importantly I am not fully removing CO2 from my lungs. Surplus CO2 in our moist lungs forms an acid which causes damage. The damage leads to pain, shortness of breath and a dry cough which if not quickly addressed risks infections. It also reduces Oxygen in the blood causing the heart to speed up to try and fix it.

    I am otherwise well and do not need to shield against Coronavirus; I cannot avoid shops or Public transport but I choose to go at quieter parts of the day to minimise contact risk. I am monitoring my temperature as well as HR and O2 - I know if I am coming down with an infection upto 2 weeks in advance because my resting heart rate rises - I have 6 years data so I am confident in trends. I need to get out in fresh clear air to walk to stay well. I also now need to walk to finish healing a fractured vertebrae sustained just before Lockdown.

    I am happy for mask use to remain advisory and think that a priority should be on education to correctly use masks and gloves for those who choose to do so. They are at the end of the day tools that many people can use, along with other measures, and if used well they will contribute to limiting spread of disease. Prevention of one disease is not an acceptable reason to cause an exacerbation of another life limiting health condition.

  • Posted by ABurd888 May 10, 2020 at 14:05

    @Cmnotzs data is good. Do have a portable SpO2 monitor. Could you share details. Thanks. I think it would be fascinating to look at the effects of different masks and materials.

  • Posted by maybuds20 May 10, 2020 at 14:10

    Wearing masks seems to have more of a psychological benefit. May cause people to take greater risks. Don’t think that most people are using masks properly or understanding their limitations

  • Posted by ABurd888 May 10, 2020 at 14:13

    @Freedom1 "Medical masks should be reserved for health care workers.

    The use of medical masks in the community may create a false sense of security, with neglect of other essential measures, such as hand hygiene practices and physical distancing, and may lead to touching the face under the masks and under the eyes, result in unnecessary costs, and take..."

    This is what is referred to as a specious argument. I find comparative death numbers eg 4 in Hong Kong versus 3000 in Scotland quite powerful in the mask or no mask debate. The WHO is changing its perspective and the CDC has addressed the "medical mask" issue. Keep safe.

  • Posted by Netty May 11, 2020 at 16:46

    There are two distinct issues at work here which are confused and confusing everyone!

    1. Some masks are used to stop the wearer acquiring infection: waterproof, tight fitting, expensive and single use.
    2. Some masks are used to limit the transmission of infection to others : any material, looser/more comfortable, cheap , multi-use.

    Please don't confuse the two. There is pretty much nothing to LOSE by encouraging regular use of face coverings in confined spaces in order to PROTECT those who cannot wear masks or have poor lung function.
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