1042 replies to this topic

[Hip]

Western medical authorities and the WHO have repeatedly stated that the populace do not need to wear masks or respirators, and that for the general public these offer no protection from coronavirus.

The WHO say:

There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit.

Source: here
 
It's rather annoying when scientists hide behind deceptive statements like that; technically the statement may be correct, there may be no specific evidence; but you don't have to be a genius to work out that if masks are vitally important for protecting doctors and nurses in a hospital coronavirus ward, then they are almost certainly going to be useful when an infected person coughs in your face in a crowded train, bus or supermarket.

Avoiding mask shortages for frontline medical workers was probably the main reason for the WHO and Western medical authorities to make such less than truthful and deceptive statements about masks having no protective benefit for the general public. They no doubt wanted to prevent panic buying of masks.

But rather than tell white lies, a better option might have been to get industry massively ramp up mask production, so that there would be enough for everybody. We could have started this at least two months ago, when containment of Chinese coronavirus epidemic looked like it might it could well fail.

If you think about it, coronavirus only generally transmits if it enters the mouth, nose or eyes, so it's quite extraordinary that with our high-tech and high-output manufacturing capabilities, we have not organized ourselves supply suitable mask protection for the populace that prevents the virus from getting into these areas.



One mathematical modeling study determined that if 80% of the population were to wear masks, this would stop an influenza outbreak in its tracks. That's only a mathematical model, but it's interesting to note that in Hong Kong, which was not that far from the pandemic epicenter but has only had 4 deaths so far (cf: London's 600 deaths), 97.5% of the adult population wears masks when leaving the house. Ref: 1

So it's possible if everyone had a proper mask or respirator and was made to wear it by law, we might be able to halt or dramatically slow this pandemic. But instead we partially close down the entire world economy to control coronavirus spread, at a cost of $trillions. I am not criticizing the lockdowns, but pointing out that getting everyone to wear masks may work just as well as a lockdown, and this mask strategy would not close down the economy. 



According to one paper, you don't need expensive respirators: simple surgical masks were just as effective as respirators in preventing influenzavirus transmission in hospitals.

And if you cannot get hold of a surgical mask or respirator, one study found that a mask made from a cotton T-shirt filtered viral particles to some extent, but is not as effectively as a surgical mask (51% filtering efficiency for the T-shirt, versus 89% efficiency for the surgical mask).

Filtration of viral particles is not the only function of a mask though: a mask will also stop you from touching your mouth and nose, which helps prevent viral transmission. And it will stop large droplets that are ballistically ejected from an infected person's mouth (when they are talking or coughing) from directly landing on your mouth and nose. Plus if you yourself are infected, a mask stops you from ballistically ejecting such droplets.
 
The West may have screwed up by not ramping up mask production, and it will take some time to ramp it up even if we start now; but even in while we wait for the masks to be made, governments could instruct people to fabricate and wear home-made masks from T-shirts.

Remember, to halt an epidemic you do not necessarily need 100% foolproof protection; you just have to reduce the transmission so that each infected person on average infects less than 1 other person.



I believe it clouds our thinking to accept the official WHO statement which implies masks offer no protection to the general public. When I first heard that statement months ago, my thought was that it's probably not true, but is being said for good reasons: to protect the supply of masks for frontline health workers.

So I guess unconsciously agreed with the statement, because I could see that even if false, it was being said to help the frontline medics. The same implicit acceptance of this potentially woefully wrong statement has probably occurred in many people's minds, including in decision-making politicians and journalists.

But if you read the WHO's statement properly, it says we actually have no evidence of whether public mask wearing is of benefit or not during a pandemic, because nobody has formally tested this. Which means public mask wearing could well be very effective. So really the WHO should say that.

 

I just think that because many key decision-makers in the West have assumed the WHO's statement means masks cannot help stop this pandemic, the idea of mass producing masks is not on the table.

So the WHO's statement, although made for good reasons, may potentially be very misleading and very damaging in terms of trying to control this pandemic. I don't know any Western leaders who are thinking in terms of massively ramping up mask production. We are focused on ramping up ventilator production, but nobody is thinking about masks for the general public.

In Taiwan, they greatly ramped up their mask production as a response to the pandemic, so that everyone in the country was well supplied with them, and are now producing so many masks that they plan to donate millions to the West. So far in Taiwan, there have only been 5 deaths.



This CNN article comes to the conclusion that:

Asia may have been right about coronavirus and face masks, and the rest of the world is coming around

As the evidence increasingly comes round in favor of masks, we must ask how many infections might have been avoided if in January, instead of saying masks wouldn't help, officials and the media had instead lobbied for factories to ramp up domestic production, provided guidance on how to make masks at home, and asked other countries to donate surplus materials?

Edited by Hip, 02 April 2020 - 03:51 PM.

[Florin]

Better late than never....

 

LA County Urges Use Of Homemade Masks, Asks Public Not To Buy Surgical Masks
https://losangeles.c...face-masks-flu/

 

Riverside County Health Officials Recommend Widespread Face Mask Use Amid Coronavirus Pandemic
https://losangeles.c...sk-coronavirus/

 

$1,000 fine to residents caught without a mask in Laredo, Texas
https://abc13.com/la...vid-19/6070657/

[ymc]

Singapore is doing worse than Hong Kong in cases.

 

The main difference between the two in containment policy is that Singapore discourages masks use but Hong Kong encourages it. 

 

As of April 3rd, cases per million are

 

Singapore: 197.56 (1114 cases among 5.6387m people)

Hong Kong: 113.06 (846 cases among 7.4825m people)

 

About 43% reduction in cases per million.

[geo12the]

For some reason the mask issue is confounding for many people, perhaps because many see things in all or nothing terms. This is my comment on my social media to all the  "Masks don't work" posts:

 

It's a physical barrier and as such can prevent some virus particles from reaching your mouth. Yes I know aerosolized virus particles are small enough to pass through, BUT not all of them will. Some will be blocked by the physical barrier. It's not 100% but added up with other preventative steps it's smart. At the end of the day it's about cumulative steps to reduce the risk of being infected: Maintain distance from people, have an awareness and paranoia of possible sources of contamination (those of us trained in sterile technique have a leg up on this), spray hands with sanitizer, wash hands etc. Combined with those steps, wearing a mask is, in my opinion, a good idea.

[Hip]

The coronavirus death toll is about 100 times higher in countries which do not use masks for the general populace:

 

Countries where the populace are not generally wearing masks:

• UK Coronavirus Worldometers — Deaths: 4,934
• France Coronavirus Worldometers  — Deaths: 7,560
• Germany Coronavirus Worldometers  — Deaths: 1,479
• Italy Coronavirus Worldometers  — Deaths: 15,362

Countries where the populace nearly all wear masks:

• Taiwan Coronavirus Worldometers — Deaths: 5
• Hong Kong Coronavirus Worldometers — Deaths: 4
• Japan Coronavirus Worldometers — Deaths: 77
• South Korea Coronavirus Worldometers — Deaths: 183

If it is masks that have dramatically reduced the spread and the death toll of coronavirus, then those experts who were behind the WHO's advice on face masks are responsible for the death of ten of thousands so far — and still counting. The global death toll is going to be in the hundreds of thousands in a few days, and then in the millions in about two weeks time.

 

[ymc]

As of April 9th, cases per million are

 

Singapore: 338.73 (1910 cases among 5.6387m people)

Hong Kong: 130.17 (974 cases among 7.4825m people)

 

HK now has 61.58% fewer cases per million than Singapore.

 

By the way, Singapore's government also announced a switch to a mask encouraging policy. Let's see if that can put their situation under control.

 

[Danail Bulgaria]

My opinion brief ad clear:

 

https://www.longecit...lements-needed/

 

 

[gamesguru]

Regrettably tea cloth and basic surgical masks only provide a protection factor of about ~1.15^[1].  This means they allow through about 1/1.15 = 0.87% of contaminated air.

 

The same study above shows that they have an outward protection factor closer to 2-4.  So they are more effective at preventing infected people spreading, reducing it about 70%.

 

Obviously the best strategy then is where everyone where's a mask as a precaution that they might be a spreader.  From two individuals, the protection factors multiply.. so 1.15 * 3 = 3.5, or only about 28% of contaminated air gets through if both sides are masked.

 

The higher quality N95/KF94 masks have much higher protective factor, ~100 both ways.  The ones with a release valve don't affect this much either way.

 

So if everyone uses masks perfectly, we can expect the Rt value to drop from 3 to below 1.  But it doesn't prevent infection by fomites and not everyone uses them, but even on their own masks are expected to be very helpful in fighting the spread.

[Florin]

Most people are still not serious about masks, because if they were, they'd start making masks out of HEPA filters. Apparently, economic suicide is way better than wearing more effective masks.

[pamojja]

For anyone interested, a local company has worked almost for 10 years for a better inovative mask. And now started online sales: https://www.virustaticshield.com/

 

Though not cheap, it supposetly works for 550 hours.

[gamesguru]

Sincerely doubt a homemade mask could offer a protection factor more than 3-5.  It's just not easy to get a good fit around the nose.

 

The real value from everyone wearing a mask comes from the outward protective factor.  They are better at catching sneeze droplets than filtering in fresh air.

 

Of course that's pretty useless when the old guy on a scooter has a horrible cough, and isn't wearing a mask!

[Hip]

Most people are still not serious about masks, because if they were, they'd start making masks out of HEPA filters. Apparently, economic suicide is way better than wearing more effective masks.

 

Yes, the world does seem rather crazy when it comes to competent pandemic control. 

 

We know that N95 mask are pretty effective at blocking viral particles, and so if everyone wore one of these, we could carry on with normal life, until such time as the vaccines become available.

 

It should not be beyond humanity's capabilities to provide such masks to all the population. If we specifically chose to focus on this objective, and massively ramp up mask production, it could be done. Taiwan has already provided masks for its entire population by massively ramping up production (which it did in the early days, being a smart nation). No lockdown in Taiwan, and only 6 coronavirus deaths.

 

You could probably make a single N95 mask last say 10 days or more by disinfecting it every day, so that cuts the amount of masks we need to make by a factor of 10. Some research at Stanford found that placing a mask in hot steam for 10 minutes is effective at  disinfecting a mask, and without damaging the functioning of the mask.

 

Many people already have a vegetable steamer in their kitchen, so presumably you could use that to disinfect your mask. Stanford also found that 30 minutes in the oven at 70°C works to disinfect masks (though for some reason the state this should not be your own home oven, which I don't understand, as if the oven is hot enough to disinfect the mask, it should also disinfect itself).

Edited by Hip, 29 April 2020 - 06:15 PM.

[Florin]

Sincerely doubt a homemade mask could offer a protection factor more than 3-5.  It's just not easy to get a good fit around the nose.

 

The real value from everyone wearing a mask comes from the outward protective factor.  They are better at catching sneeze droplets than filtering in fresh air.

 

Of course that's pretty useless when the old guy on a scooter has a horrible cough, and isn't wearing a mask!

 

Can we leave the clown show for the CDC and the WHO? Those clowns apparently don't have access to the Intertubes, but you apparently do.

 

DIY: Use Paper Cup to Make High Performance N95-like Respirator

 

A Doctor Explains How to Make the Safest Face Mask

 

How to Make the Best Face Mask, No Sewing (Don't use Cotton or Vac Bags!)

[Florin]

Wearing a face shield is also a good idea.

 

https://jamanetwork....article/2765525

[Florin]

If you live in the United States and your State doesn't have mandatory mask wearing, you can ask your State's Governor to mandate mask wearing by texting Masks4All to 50409.

 

What U.S. States Require Masks In Public?

https://masks4all.co...tory-mask-laws/

 

Over 100 Prominent Health Experts Call For Cloth Mask Requirements

https://masks4all.co...k-requirements/

 

Background:

 

Masks Help Stop the Spread of Coronavirus – The Science Is Simple

https://www.snopes.c...ence-is-simple/

 

On May 14, I and 100 of the world’s top academics released an open letter to all U.S. governors asking that “officials require cloth masks to be worn in all public places, such as stores, transportation systems, and public buildings.”

 

Currently, the U.S. Centers for Disease Control and Prevention recommends that everyone wears a mask – as do the governments covering 90% of the world’s population – but, so far, only 12 states in the U.S. require it. In the majority of the remaining states, the CDC recommendation has not been enough: Most people do not currently wear masks. However, things are changing fast. Every week more and more jurisdictions require mask use in public. As I write this, there are now 94 countries that have made this move.

Edited by Florin, 17 May 2020 - 08:49 PM.

[Florin]

The public has access to millions of reusable N95 respirators and could be used in close quarters to provide better protection than cloth masks. Their filters can last for months and new filters are easy to make.

 

Edited by Florin, 05 June 2020 - 09:30 PM.

[Daniel Cooper]

What a load of farce, it's most likely in the 0.5-0.75% range at least.  This thing kills old people and overwhelms city hospitals like nobody's business.

 

I'm in favor of masks, I just doubt their implementation alone is enough.

 

It comes near overwhelming hospitals in very large cities.  The hospital near me and in the vast majority of the country (the part that is normally called "fly over country") not only were not overwhelmed, they actually saw their loading go down because of the canceling of elective surgeries doing the most intense portion of the lock down.

 

I live in a county of 400k people.  We've had 5 deaths.  That's 12.5 deaths/million population.  NY state is at 1,596 deaths/million population.

 

Question: Does it make sense to use the same level of masking/distancing/lock down in these two areas?

[gamesguru]

Tough call to make, i might want to enforce the same level of masks but open more businesses up.

 

Recognize that has political complications too, as the Federal Pandemic Unemployment will still equally dis-incentivize labor in rural areas and perhaps rightfully so.  But ideally states, and the whole country, lifts and imposes restrictions in unison.  By sending everyone back, the good parts of the executive order (unemployment, rent suspension) could go away unexpectedly too.

[Daniel Cooper]

I think you could have clearly done with less lock down in an area like mine, and NY (particularly NYC) could have done more. For instance, as long as NYC let the subways continue to run, I don't think they were serious at all about this.  The subways had to be a major vector for covid.  And yet they ran throughout the entire ordeal.

 

An area with a lower population density is inherently more socially distanced.  NYC would have to work hard to achieve the same amount of social distancing as is the default in my area because of their very high population density.  I'd bet you that if we did nothing in my area we'd never hit the deaths per capita you saw in NYC with the maximum effort they applied.

 

 

[Florin]

But if nothing's done in lower density areas, higher density ones could eventually be reinfected once they relax their anti-transmission controls.

Edited by Florin, 17 June 2020 - 11:19 PM.

[Daniel Cooper]

But if nothing's done in lower density areas, higher density ones could eventually be reinfected once they lift their anti-transmission controls.

 

That would be a concern if the higher density areas were in any danger of getting their infections down to zero.  I don't see that happening any time soon.

 

This thing isn't going away.  We've sort of moved the goalposts here.  The original rational for the lock down was to spread the cases out over time, not to prevent people from getting infected altogether.  In fact, it was only to lower the death toll due to excess deaths as a result of the health care system being overwhelmed.  It's actually done that reasonably well.  It was never assumed that it would lower the death toll by preventing a large segment of the population from becoming infected.  The only way that happens is if there is a decently effective vaccine somewhere on the near horizon.  Fauci is now talking about next summer.  If that slips another year, it probably isn't going to matter a great deal since most people will have been infected by then.

[Florin]

Yeah, that makes sense. The only places where it might not make sense would be in countries like China where they've supposedly almost-but-not-quite wiped out the virus.

 

I don't see any goalposts moving here, however. The rationale for the lockdowns was to prevent the collapse of the healthcare system and to prevent millions of deaths caused mostly and directly by the virus itself. That's what China seemed to have accomplished, and the rest of the world simply attempted to follow its example. The problem is that the lockdowns didn't work quite as well outside of China in every case, and the fear is that this will merely delay rather than prevent the collapse and the deaths. Now, the hope seems to be to use other techniques to further delay transmission in order to avoid future lockdowns and buy time for a vaccine to be developed.

Edited by Florin, 18 June 2020 - 12:44 AM.

[Daniel Cooper]

Yeah, that makes sense. The only places where it might not make sense would be in countries like China where they've supposedly almost-but-not-quite wiped out the virus.

 

I don't see any goalposts moving here, however. The rationale for the lockdowns was to prevent the collapse of the healthcare system and to prevent millions of deaths caused mostly and directly by the virus itself. That's what China seemed to have accomplished, and the rest of the world simply attempted to follow its example. The problem is that the lockdowns didn't work quite as well outside of China in every case, and the fear is that this will merely delay rather than prevent the collapse and the deaths. Now, the hope seems to be to use other techniques to further delay transmission in order to avoid future lockdowns and buy time for a vaccine to be developed.

 

We don't know what China has accomplished.  I have a small and oblique data point.

 

I have a friend that does supply chain management for a large tech company that sources both components and finished assemblies from China.  He's telling me that lead times out of China are now 3x of normal.  Now, according to China, they got covid under control in about 6 weeks.  That was several months ago.  And, there is a global recession at the moment so their exports are down significantly from their normal numbers.  By all rights, their lead times should be near normal if not better.

 

And yet, lead times are very stretched out and the feedback he's getting is that they don't know when they will be returning to normal.  He's not buying "all is well in China". 

 

Now, perhaps he's wrong.  Maybe there are valid reasons for the ongoing supply chain disruptions.  But I wouldn't take anything the Chinese government says as gospel at the moment.

[Florin]

Right, and that's why I used words like "supposedly" and "seemed." In the panic of March (or was it the March of panic?), the seeming seemed good enough.

 

Leaving China aside, lockdowns really have worked at eliminating and even altogether avoiding excess deaths in several countries like France and Norway. But in both cases, the virus is almost-but-not-quite wiped out. Should masks stop being mandated in areas of France that are not as dense as Paris? Seems kinda risky.

 

https://www.euromomo...graphs-and-maps
https://ourworldinda...country=NOR~FRA

Edited by Florin, 18 June 2020 - 02:59 AM.

[Mind]

 

But what if the mortality rate was much higher like 50% or 99%? That's not inconceivable for future pandemics caused by lab accidents or bioterrorists. So, we better stock up on elastomerics and start getting used to wearing them sooner rather than later.

 

Then there are much bigger problems than infectious disease. Wearing a mask is just like putting a band-aid on a severed femoral artery.

[Florin]

But what if the mortality rate was much higher like 50% or 99%? That's not inconceivable for future pandemics caused by lab accidents or bioterrorists. So, we better stock up on elastomerics and start getting used to wearing them sooner rather than later.
 

Then there are much bigger problems than infectious disease. Wearing a mask is just like putting a band-aid on a severed femoral artery.

 

What's your solution?

[Daniel Cooper]

What's your solution?

 

Not Mind, but for me some broad based anti-viral like DRACO would be my solution.

 

How many masks would you have to stockpile as a precaution?  There's 330 million people in this country.  So, if we're talking about elastomeric masks we need at least 330 million masks then how many of the replaceable filter units?  1 billion?  That's only 3 per person.

 

And the thing is, you don't know that the next deadly virus will be spread through a respiratory route.  Ebola isn't.  Marburg isn't.  Zika is spread by mosquitoes.  

 

Military generals are often accused of preparing for the last war.  We can't assume that the next viral pandemic will be like the last.  We need the equivalent of a broad based antibiotic - except for viruses.  DRACO isn't the only route to achieve that, but it's a route.

 

A 99% lethal *and* highly contagious virus is the stuff of apocalyptic movies.  Fortunately, there is normally an inverse relationship between lethality and contagiousness.  Ebola is highly lethal, but it really isn't that contagious.  If highly lethal and highly contagious went together, we probably wouldn't be having this conversation right now.

[Florin]

Not Mind, but for me some broad based anti-viral like DRACO would be my solution.

DRACO might never see the light of day. Even if DRACO was available today, it wouldn't be effective against all types of viruses. And bioterrorists might find ways of defeating antivirals like DRACO. So, everyone would still need a mask.
 
Masks can be 100% effective against any airborne virus no matter what. Today.
 

How many masks would you have to stockpile as a precaution?  There's 330 million people in this country.  So, if we're talking about elastomeric masks we need at least 330 million masks then how many of the replaceable filter units?  1 billion?  That's only 3 per person.

I don't see any big problem with this. Unless the filters become soiled, they basically last forever. 660 million filters, two per mask per person.
 
And what about the logistics of DRACO? How many doses per person? What if a person gets reinfected? How will DRACO be stored? How easily can DRACO be manufactured? From a logistics standpoint, masks seem far more practical.
 

And the thing is, you don't know that the next deadly virus will be spread through a respiratory route.  Ebola isn't.  Marburg isn't.  Zika is spread by mosquitoes.

The most efficient way for pandemics to take off is through airborne transmission via the mouth, nose, and more rarely eyes. None of those examples can cause pandemics. Zika spreads slowly and only where mosquitoes survive.
 

Military generals are often accused of preparing for the last war.  We can't assume that the next viral pandemic will be like the last.  We need the equivalent of a broad based antibiotic - except for viruses.  DRACO isn't the only route to achieve that, but it's a route.

It's safe to assume that any pandemic will be caused by transmission via the mouth, nose, and more rarely eyes. There's no guarantee that DRACO or any other broad spectrum antiviral could offer anywhere near 100% protection. Only masks can provide such a guarantee.
 

A 99% lethal *and* highly contagious virus is the stuff of apocalyptic movies.  Fortunately, there is normally an inverse relationship between lethality and contagiousness.  Ebola is highly lethal, but it really isn't that contagious.  If highly lethal and highly contagious went together, we probably wouldn't be having this conversation right now.

 
Do you really want to play Russian roulette? What if some bioterrorist released different kinds of viruses each with a lethality of 10%? They'd just need a few to get to 99% or even to 100% lethality. Civilization could be destroyed even if 50% of humanity somehow managed to survive the pandemics. And then most of those survivors would be wiped out by famine and disease.

 

The only thing that has any guarantee of avoiding apocalyptic pandemics today and for the foreseeable future is elastomeric masks.

Edited by Florin, 18 June 2020 - 09:57 PM.

[pamojja]

double post

Edited by pamojja, 08 July 2020 - 09:09 PM.

[pamojja]

The counter arguments, prepublished :
 
https://vixra.org/abs/2006.0044
 

1

Masks Don’t Work

A review of science relevant to COVID-19 social policy
 

Denis G. Rancourt, PhD

Researcher, Ontario Civil Liberties Association (ocla.ca)

Prior publishing-attempt history of this article:
https://archive.org/details/covid-censorship-at-research-gate-2/

April 2020
 

Summary / Abstract

Masks and respirators do not work.

There have been extensive randomized controlled trial (RCT) studies, and meta-analysis reviews
of RCT studies, which all show that masks and respirators do not work to prevent respiratory
influenza-like illnesses, or respiratory illnesses believed to be transmitted by droplets and
aerosol particles.

Furthermore, the relevant known physics and biology, which I review, are such that masks and
respirators should not work. It would be a paradox if masks and respirators worked, given what
we know about viral respiratory diseases: The main transmission path is long-residence-time
aerosol particles (< 2.5 μm), which are too fine to be blocked, and the minimum-infective-dose
is smaller than one aerosol particle.

The present paper about masks illustrates the degree to which governments, the mainstream
media, and institutional propagandists can decide to operate in a science vacuum, or select only
incomplete science that serves their interests.  Such recklessness is also certainly the case with
the current global lockdown of over 1 billion people, an unprecedented experiment in medical
and political history.


2

Review of the Medical Literature

Here are key anchor points to the extensive scientific literature that establishes that wearing
surgical masks and respirators (e.g., “N95”) does not reduce the risk of contracting a verified
illness:

Jacobs, J. L. et al. (2009) “Use of surgical face masks to reduce the incidence of the
common cold among health care workers in Japan: A randomized controlled trial”,
American Journal of Infection Control, Volume 37, Issue 5, 417 - 419.
https://www.ncbi.nlm.nih.gov/pubmed/19216002
 
N95-masked health-care workers (HCW) were significantly more likely to
experience headaches. Face mask use in HCW was not demonstrated to provide
benefit in terms of cold symptoms or getting colds. 

Cowling, B. et al. (2010) “Face masks to prevent transmission of influenza virus: A
systematic review”, Epidemiology and Infection, 138(4), 449-456.
doi:10.1017/S0950268809991658
https://www.cambridge.org/core/journals/epidemiology-and-infection/article/face-
masks-to-prevent-transmission-of-influenza-virus-a-systematic-
review/64D368496EBDE0AFCC6639CCC9D8BC05
 
None of the studies reviewed showed a benefit from wearing a mask, in either
HCW or community members in households (H). See summary Tables 1 and 2
therein.
 
bin-Reza et al. (2012) “The use of masks and respirators to prevent transmission of
influenza: a systematic review of the scientific evidence”, Influenza and Other
Respiratory Viruses 6(4), 257–267.
https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1750-2659.2011.00307.x
“There were 17 eligible studies. … None of the studies established a conclusive
relationship between mask ⁄ respirator use and protection against influenza
infection.”
 
Smith, J.D. et al. (2016) “Effectiveness of N95 respirators versus surgical masks in
protecting health care workers from acute respiratory infection: a systematic review and
meta-analysis”, CMAJ Mar 2016, cmaj.150835; DOI: 10.1503/cmaj.150835
https://www.cmaj.ca/content/188/8/567
“We identified 6 clinical studies ... In  the  meta-analysis of the clinical studies,
we found no significant  difference  between  N95  respirators  and surgical
masks in associated risk of (a) laboratory-confirmed  respiratory  infection, (b)
influenza-like illness,  or  ©  reported  work-place absenteeism.”
 

3
 

Offeddu, V. et al. (2017) “Effectiveness of Masks and Respirators Against Respiratory
Infections in Healthcare Workers: A Systematic Review and Meta-Analysis”, Clinical
Infectious Diseases, Volume 65, Issue 11, 1 December 2017, Pages 1934–1942,
https://doi.org/10.1093/cid/cix681
https://academic.oup.com/cid/article/65/11/1934/4068747
“Self-reported assessment of clinical outcomes was prone to bias. Evidence of a
protective effect of masks or respirators against verified respiratory infection
(VRI) was not statistically significant”; as per Fig. 2c therein:

Radonovich, L.J. et al. (2019) “N95 Respirators vs Medical Masks for Preventing
Influenza Among Health Care Personnel: A Randomized Clinical Trial”, JAMA. 2019;
322(9): 824–833. doi:10.1001/jama.2019.11645
https://jamanetwork.com/journals/jama/fullarticle/2749214
“Among 2862 randomized participants, 2371 completed the study and
accounted for 5180 HCW-seasons. … Among outpatient health care personnel,
N95 respirators vs medical masks as worn by participants in this trial resulted in
no significant difference in the incidence of laboratory-confirmed influenza.”

Long, Y. et al. (2020) “Effectiveness of N95 respirators versus surgical masks against
influenza: A systematic review and meta-analysis”, J Evid Based Med. 2020; 1- 9.
https://doi.org/10.1111/jebm.12381
https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12381
“A total of six RCTs involving 9 171 participants were included. There were no
statistically significant differences in preventing laboratory-confirmed influenza,
laboratory-confirmed respiratory viral infections, laboratory-confirmed
respiratory infection and influenza-like illness  using N95 respirators and surgical
masks. Meta-analysis indicated a protective effect of N95 respirators against
laboratory-confirmed bacterial colonization (RR = 0.58, 95% CI 0.43-0.78). The
 
4
 
use of N95 respirators compared with surgical masks is not associated with a
lower risk of laboratory-confirmed influenza.”
 

Conclusion Regarding that Masks Do Not Work


No RCT study with verified outcome shows a benefit for HCW or community members in
households to wearing a mask or respirator. There is no such study. There are no exceptions.
 
Likewise, no study exists that shows a benefit from a broad policy to wear masks in public
(more on this below).
 
Furthermore, if there were any benefit to wearing a mask, because of the blocking power
against droplets and aerosol particles, then there should be more benefit from wearing a
respirator (N95) compared to a surgical mask, yet several large meta-analyses, and all the RCT,
prove that there is no such relative benefit.
 
Masks and respirators do not work.
 



Precautionary Principle Turned on Its Head with Masks

In light of the medical research, therefore, it is difficult to understand why public-health
authorities are not consistently adamant about this established scientific result, since the
distributed psychological, economic and environmental harm from a broad recommendation to
wear masks is significant, not to mention the unknown potential harm from concentration and
distribution of pathogens on and from used masks. In this case, public authorities would be
turning the precautionary principle on its head (see below).
 


Physics and Biology of Viral Respiratory Disease and of Why Masks Do Not Work

In order to understand why masks cannot possibly work, we must review established
knowledge about viral respiratory diseases, the mechanism of seasonal variation of excess
deaths from pneumonia and influenza, the aerosol mechanism of infectious disease
transmission, the physics and chemistry of aerosols, and the mechanism of the so-called
minimum-infective-dose.

In addition to pandemics that can occur anytime, in the temperate latitudes there is an extra
burden of respiratory-disease mortality that is seasonal, and that is caused by viruses. For
 

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example, see the review of influenza by Paules and Subbarao (2017).  This has been known for a
long time, and the seasonal pattern is exceedingly regular.

For example, see Figure 1 of Viboud (2010), which has “Weekly time series of the ratio of
deaths from pneumonia and influenza to all deaths, based on the 122 cities surveillance in the
US (blue line). The red line represents the expected baseline ratio in the absence of influenza
activity,” here:

The seasonality of the phenomenon was largely not understood until a decade ago. Until
recently, it was debated whether the pattern arose primarily because of seasonal change in
virulence of the pathogens, or because of seasonal change in susceptibility of the host (such as
from dry air causing tissue irritation, or diminished daylight causing vitamin deficiency or
hormonal stress). For example, see Dowell (2001).

In a landmark study, Shaman et al. (2010) showed that the seasonal pattern of extra
respiratory-disease mortality can be explained quantitatively on the sole basis of absolute
humidity, and its direct controlling impact on transmission of airborne pathogens.

Lowen et al. (2007) demonstrated the phenomenon of humidity-dependent airborne-virus
virulence in actual disease transmission between guinea pigs, and discussed potential
underlying mechanisms for the measured controlling effect of humidity.

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The underlying mechanism is that the pathogen-laden aerosol particles or droplets are
neutralized within a half-life that monotonically and significantly decreases with increasing
ambient humidity. This is based on the seminal work of Harper (1961). Harper experimentally
showed that viral-pathogen-carrying droplets were inactivated within shorter and shorter
times, as ambient humidity was increased.

Harper argued that the viruses themselves were made inoperative by the humidity (“viable
decay”), however, he admitted that the effect could be from humidity-enhanced physical
removal or sedimentation of the droplets (“physical loss”): “Aerosol viabilities reported in this
paper are based on the ratio of virus titre to radioactive count in suspension and cloud samples,
and can be criticized on the ground that test and tracer materials were not physically identical.”

The latter (“physical loss”) seems more plausible to me, since humidity would have a universal
physical effect of causing particle / droplet growth and sedimentation, and all tested viral
pathogens have essentially the same humidity-driven “decay”. Furthermore, it is difficult to
understand how a virion (of all virus types) in a droplet would be molecularly or structurally
attacked or damaged by an increase in ambient humidity. A “virion” is the complete, infective
form of a virus outside a host cell, with a core of RNA or DNA and a capsid. The actual
mechanism of such humidity-driven intra-droplet “viable decay” of a virion has not been
explained or studied.

In any case, the explanation and model of Shaman et al. (2010) is not dependant on the
particular mechanism of the humidity-driven decay of virions in aerosol / droplets. Shaman’s
quantitatively demonstrated model of seasonal regional viral epidemiology is valid for either
mechanism (or combination of mechanisms), whether “viable decay” or “physical loss”. 
 
The breakthrough achieved by Shaman et al. is not merely some academic point. Rather, it has
profound health-policy implications, which have been entirely ignored or overlooked in the
current coronavirus pandemic.
 
In particular, Shaman’s work necessarily implies that, rather than being a fixed number
(dependent solely on the spatial-temporal structure of social interactions in a completely
susceptible population, and on the viral strain), the epidemic’s basic reproduction number (R0)
is highly or predominantly dependent on ambient absolute humidity.

For a definition of R0, see HealthKnowlege-UK (2020): R0 is “the average number of secondary
infections produced by a typical case of an infection in a population where everyone is
susceptible.” The average R0 for influenza is said to be 1.28 (1.19–1.37); see the comprehensive
review by Biggerstaff et al. (2014).
 
In fact, Shaman et al. showed that R0 must be understood to seasonally vary between humid-
summer values of just larger than “1” and dry-winter values typically as large as “4” (for
example, see their Table 2). In other words, the seasonal infectious viral respiratory diseases
that plague temperate latitudes every year go from being intrinsically mildly contagious to


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virulently contagious, due simply to the bio-physical mode of transmission controlled by
atmospheric humidity, irrespective of any other consideration.

Therefore, all the epidemiological mathematical modelling of the benefits of mediating policies
(such as social distancing), which assumes humidity-independent R0 values, has a large
likelihood of being of little value, on this basis alone. For studies about modelling and regarding
mediation effects on the effective reproduction number, see Coburn (2009) and Tracht (2010).
 
To put it simply, the “second wave” of an epidemic is not a consequence of human sin
regarding mask wearing and hand shaking. Rather, the “second wave” is an inescapable
consequence of an air-dryness-driven many-fold increase in disease contagiousness, in a
population that has not yet attained immunity.

If my view of the mechanism is correct (i.e., “physical loss”), then Shaman’s work further
necessarily implies that the dryness-driven high transmissibility (large R0) arises from small
aerosol particles fluidly suspended in the air; as opposed to large droplets that are quickly
gravitationally removed from the air.

Such small aerosol particles fluidly suspended in air, of biological origin, are of every variety and
are everywhere, including down to virion-sizes (Despres, 2012). It is not entirely unlikely that
viruses can thereby be physically transported over inter-continental distances (e.g., Hammond,
1989).

More to the point, indoor airborne virus concentrations have been shown to exist (in day-care
facilities, health centres, and onboard airplanes) primarily as aerosol particles of diameters
smaller than 2.5 μm, such as in the work of Yang et al. (2011):

“Half of the 16 samples were positive, and their total virus
concentrations ranged from 5800 to 37 000 genome copies m⁻³. On
average, 64 per cent of the viral genome copies were associated with
fine particles smaller than 2.5 µm, which can remain suspended for
hours. Modelling of virus concentrations indoors suggested a source
strength of 1.6 ± 1.2 × 10⁵ genome copies m⁻³ air h⁻¹ and a deposition
flux onto surfaces of 13 ± 7 genome copies m⁻² h⁻¹ by Brownian motion.
Over 1 hour, the inhalation dose was estimated to be 30 ± 18 median
tissue culture infectious dose (TCID₅₀), adequate to induce infection.
These results provide quantitative support for the idea that the aerosol
route could be an important mode of influenza transmission.” 

Such small particles (< 2.5 μm) are part of air fluidity, are not subject to gravitational
sedimentation, and would not be stopped by long-range inertial impact. This means that the
slightest (even momentary) facial misfit of a mask or respirator renders the design filtration
norm of the mask or respirator entirely irrelevant.  In any case, the filtration material itself of
 

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N95 (average pore size ~0.3−0.5 μm) does not block virion penetration, not to mention surgical
masks. For example, see Balazy et al. (2006).
 
Mask stoppage efficiency and host inhalation are only half of the equation, however, because
the minimal infective dose (MID) must also be considered. For example, if a large number of
pathogen-laden particles must be delivered to the lung within a certain time for the illness to
take hold, then partial blocking by any mask or cloth can be enough to make a significant
difference.
 
On the other hand, if the MID is amply surpassed by the virions carried in a single aerosol
particle able to evade mask-capture, then the mask is of no practical utility, which is the case.
 
Yezli and Otter (2011), in their review of the MID, point out relevant features:
 
• most respiratory viruses are as infective in humans as in tissue culture having optimal
laboratory susceptibility
 
• it is believed that a single virion can be enough to induce illness in the host

• the 50%-probability MID (“TCID₅₀”) has variably been found to be in the range 100−1000
virions
 
• there are typically 10³−10⁷ virions per aerolized influenza droplet with diameter 1 μm −
10 μm
 
• the 50%-probability MID easily fits into a single (one) aerolized droplet
 


For further background:
 
• A classic description of dose-response assessment is provided by Haas (1993). 
 
• Zwart et al. (2009) provided the first laboratory proof, in a virus-insect system, that the
action of a single virion can be sufficient to cause disease. 
 
• Baccam et al. (2006) calculated from empirical data that, with influenza A in humans,
“we estimate that after a delay of ~6 h, infected cells begin producing influenza virus
and continue to do so for ~5 h. The average lifetime of infected cells is ~11 h, and the
half-life of free infectious virus is ~3 h. We calculated the [in-body] basic reproductive
number, R₀, which indicated that a single infected cell could produce ~22 new
productive infections.”
 
• Brooke et al. (2013) showed that, contrary to prior modeling assumptions, although not
all influenza-A-infected cells in the human body produce infectious progeny (virions),
nonetheless, 90% of infected cell are significantly impacted, rather than simply surviving
unharmed.
 

All of this to say that: if anything gets through (and it always does, irrespective of the mask),
then you are going to be infected. Masks cannot possibly work. It is not surprising, therefore,
that no bias-free study has ever found a benefit from wearing a mask or respirator in this
application.
 

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Therefore, the studies that show partial stopping power of masks, or that show that masks can
capture many large droplets produced by a sneezing or coughing mask-wearer, in light of the
above-described features of the problem, are irrelevant. For example, such studies as these:
Leung (2020), Davies (2013), Lai (2012), and Sande (2008).
 


Why There Can Never Be an Empirical Test of a Nation-Wide Mask-Wearing
Policy


As mentioned above, no study exists that shows a benefit from a broad policy to wear masks in
public. There is good reason for this. It would be impossible to obtain unambiguous and bias-
free results:

• Any benefit from mask-wearing would have to be a small effect, since undetected in
controlled experiments, which would be swamped by the larger effects, notably the
large effect from changing atmospheric humidity.

• Mask compliance and mask adjustment habits would be unknown.

• Mask-wearing is associated (correlated) with several other health behaviours; see Wada
(2012).

• The results would not be transferable, because of differing cultural habits.

• Compliance is achieved by fear, and individuals can habituate to fear-based propaganda,
and can have disparate basic responses.
 
• Monitoring and compliance measurement are near-impossible, and subject to large
errors.
 
• Self-reporting (such as in surveys) is notoriously biased, because individuals have the
self-interested belief that their efforts are useful.
 
• Progression of the epidemic is not verified with reliable tests on large population
samples, and generally relies on non-representative hospital visits or admissions.
 
• Several different pathogens (viruses and strains of viruses) causing respiratory illness
generally act together, in the same population and/or in individuals, and are not
resolved, while having different epidemiological characteristics.
 


Unknown Aspects of Mask Wearing

 
Many potential harms may arise from broad public policies to wear masks, and the following
unanswered questions arise:
 
• Do used and loaded masks become sources of enhanced transmission, for the wearer
and others? 
 

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• Do masks become collectors and retainers of pathogens that the mask wearer would
otherwise avoid when breathing without a mask? 
 
• Are large droplets captured by a mask atomized or aerolized into breathable
components? Can virions escape an evaporating droplet stuck to a mask fiber?
 
• What are the dangers of bacterial growth on a used and loaded mask? 
 
• How do pathogen-laden droplets interact with environmental dust and aerosols
captured on the mask? 
 
• What are long-term health effects on HCW, such as headaches, arising from impeded
breathing? 
 
• Are there negative social consequences to a masked society? 
 
• Are there negative psychological consequences to wearing a mask, as a fear-based
behavioural modification?
 
• What are the environmental consequences of mask manufacturing and disposal? 
 
• Do the masks shed fibres or substances that are harmful when inhaled?
 


Conclusion

By making mask-wearing recommendations and policies for the general public, or by expressly
condoning the practice, governments have both ignored the scientific evidence and done the
opposite of following the precautionary principle.

In an absence of knowledge, governments should not make policies that have a hypothetical
potential to cause harm. The government has an onus barrier before it instigates a broad social-
engineering intervention, or allows corporations to exploit fear-based sentiments.
 
Furthermore, individuals should know that there is no known benefit arising from wearing a
mask in a viral respiratory illness epidemic, and that scientific studies have shown that any
benefit must be residually small, compared to other and determinative factors.
 
Otherwise, what is the point of publicly funded science?

The present paper about masks illustrates the degree to which governments, the mainstream
media, and institutional propagandists can decide to operate in a science vacuum, or select only
incomplete science that serves their interests.  Such recklessness is also certainly the case with
the current global lockdown of over 1 billion people, an unprecedented experiment in medical
and political history.

Edited by pamojja, 08 July 2020 - 09:14 PM.