Diarmuid Breatnach

(Reading time: 10 mins)

To wear a face-mask or not?  This article seeks to clarify some of the issues of conflicting advice around the advisability or otherwise of people who are not healthcare frontline staff wearing face-masks.

          There has been some discussion around this on social media and in my sphere some of it particularly tense and even illogical. I have observed at a number of times throughout my life that the reaction of some people to a stressful situation is to create more stress around it – as human behaviour one assumes it must have a function, though I find it difficult to see what it might be. However, the question, with possible repercussions to general safety from the Coronavirus-19 is a serious one.

It is worth remarking that some bad advice and information about the Coronavirus-19 has circulated on social media and even been given by Governments. I myself have seen advice on drinking hot drinks as an effective remedy and I am aware that the President of an East European country claimed that drinking vodka killed the virus or prevented one contracting it. Why anyone should wish to put out unscientific advice about such a serious matter is beyond me but it has happened a number of times from different sources.

FACT AND ARGUMENT

          There is general agreement that the primary method of contamination by the virus, especially in the case of no physical contact with an infected person, is by droplets from a person who has the virus passing it on to us. The method of passing these droplets might be sneezing, coughing, spitting (for example unintentionally, during speech). The virus then lingers on our face until we convey it to our mouths by touch from the infected area, or by inhalation etc, from whence it proceeds to infect our lungs.

That being so, it is completely counter-intuitive and appears to contradict logic to say that masks would be of no preventive use whatsoever. However, intuition is sometime wrong and many times what has been promoted as “common sense” has turned out to be merely an expression of prejudice or ignorance – or belief in an individual or institution. So maybe a face-mask provides no protection, right? Well no, because frontline health practitioners are wearing them and in fact there is some agitation about their not being available in sufficient numbers for their use.

A SCIENTIFIC ARGUMENT AGAINST EFFICACY OF FACE-MASKS?

          OK, so what is being said by the main group of face-mask-usefulness deniers, from my observation, is that the particular face masks used by those health professionals, with a filter, is a good defence against contracting the virus from direct contact with infected droplets to the face. But only those. OK, that might be so, in which case we’d expect to be given a rational scientific reason. However, no-one arguing with me has supplied such an explanation nor have I seen scientific argument justifying it. In fact, I have seen, quite apart from my “common sense”, scientific evidence that seems to show that other types of face-mask do indeed help to prevent direct droplet infection.

So why are some authorities arguing against it? A conspiracy theorist might suggest those who rule us don’t want the expense of supplying us with those masks but, considering the effect this pandemic is having on our economy, I would be inclined to dismiss that explanation. What I tend to believe instead is that the authorities fear that wearing such masks will give us a false sense of security, leading to incautious behaviour and a greater chance of contracting and spreading the virus.

If that were so, why don’t they give us the best advice all around about face-masks but still strongly advise us about the other precautions, such as wearing gloves, washing hands with soap, keeping a distance of six feet etc? I would assume they don’t do that because they don’t trust us, they think most of us are stupid. The behaviour of some during this pandemic would indeed seem to prove their point which in some ways might not be surprising; if you deprive people of responsibility for most things that regulate their lives, it’s somewhat contradictory to then expect them to act responsibly. But in fact, most people have been acting responsibly – and caringly. And neither the Government, the HSE or the capitalist concerns are in a great position to be lecturing us on our lack of responsibility – but I leave that for another day’s discussion.

I am not a scientist and I have not done a huge amount of research but I think I have done enough to convince me that wearing of most kinds of face-mask in public does indeed provide some protection against direct contaminated droplet contact. And in fact, even many of those who say it would not give the wearer any protection do admit that it would give other people some protection from an infected person. And since one can be carrying the virus for some days without exhibiting signs of it, surely everyone should be wearing a face-mask in public? EVERYONE!

When I was employed managing teams working with homeless people and/ or substance misusers, our health safety advice was to assume that anyone we worked with was HIV positive. Because you can never know for sure.

The advice being put out from the HSE is that in the case of this virus no face-masks except the special ones work. However, the World Health Organisation began in the early days by saying it would help but lately says only that it would only help to prevent its spread. Well, well …. only help to prevent its spread? ONLY?

COUNTRIES ENCOURAGING OR ENFORCING GENERAL FACE-MASK WEARING

A number of Asian countries insist that the level of transmission in their countries is much lower than in some European countries and they ascribe that to the universal wearing of face-masks. Czech Republic says the same. I have not seen statistics to confirm those claim but nor have I seen a statistical refutation. The US Centre for Disease Control recommends everyone wear face-masks.

I have seen reported an experiment which seems to prove that the droplets do not pass through a cotton-and-paper barrier (see the accompanying video for the experiment and also practical demonstration on how to construct such a reusable face-mask from a T-shirt). I have also read an article in the well-respected medical journal The Lancet, discussing the scientific merits of the arguments for and against.

I think the evidence tends to support the case that wearing most kinds of face-mask does help protect the wearer but the fact that they help in preventing the spread to others should be enough on its own to encourage us all to wear them.

There are some social issues with wearing the masks that have emerged in some parts of the world and I list the ones I have come across:

• STIGMA: People may shun someone wearing a mask as they consider the wearers to be infected. So what, if they have an effective role? And isn’t countering this a job for the responsible authorities, community organisations etc?

• EXCLUSION: Some facilities may refuse to permit entry to people not wearing face-masks, as is apparently the case in Hong Kong. But the exclusion has a fairly simple solution.

• EXPENSE & RACKETEERING: Yes, we saw some examples of that here in Ireland with some suppliers of latex etc. gloves and hand sanitiser gel. If we learn how to make effective ones we can overcome this problem but, in any case, the benefits of wearing the mask outweigh the negative aspects involved in supply.

WHO SHOULD WEAR THE MOST EFFECTIVE FACE-MASKS?

          Some people have put forward the argument that no-one but the front-line health professionals should wear the most effective models and I have even seen posters on the internet telling people not to wear one unless they are infected. Their reasoning is that there are not enough of these available to supply those who need them most. Well that seems to make sense except that their condemnation is often directed at the occasional non-healthworker person wearing such a mask rather than at the Government and HSE which have not laid in sufficient stocks.

Is it an issue that many people are wearing the special face-masks and that is the reason health-workers are not being supplied with them? Certainly there has been no evidence of this in Ireland.

Some concede that certain high-risk groups are entitled to wear the special face-masks also, which is very gracious of them.

On a personal note, my special mask was given to me as a gift, I did not seek it nor was I aware of its special nature when I received it. In addition, on a number of counts I do belong to a high-risk group; readers are free to believe or disbelieve me but I do not intend to explain that or to justify it.

On this and other general questions I would encourage people to concentrate on the overall issue and to be a part of the solution rather than add to the problem.

Feel free to comment on the scientific and practical points made in this article but please do not respond with purely personal opinions or those substantiated by restricted sources (e.g “HSE professionals have told me”) and without dealing with sources and points listed here.

End.

REFERENCES:

World Health Organisation (somewhat equivocal): https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

European Centre for Disease Control (also somewhat equivocal): https://www.ecdc.europa.eu/sites/default/files/documents/COVID-19-use-face-masks-community.pdf

Article containing video with scientific test report and instructions on making an effective mask: https://www.theguardian.com/us-news/2020/apr/06/how-to-make-no-sew-face-mask-coronavirus?fbclid=IwAR06lGIjK_BT-IDrU0E9ztTvudsFVf1B48e-2XSKEK5n1IZzA0kKxT0MmdM

Guardian article: https://www.theguardian.com/world/2020/apr/11/can-a-face-mask-protect-me-from-coronavirus-covid-19-myths-busted

Lancet article: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30134-X/fulltext