Sunday, November 1, 2020

Masking the Truth about COVID Transmission

by Brian T. Lynch


Without question, the Coronavirus is spread when we breathe. Each breath expels a spray of tiny moisture particles, some in the form of droplets that are visible in the right lighting situation. If you ever sat near a stage during a play you might have seen them coming from the actors as they performed. Gravity pulls them quickly out of the air. Their length of travel depends on their size and speed, but most of them settle out over about three feet.

Aerosols are very small moisture particles that we also expel. They are invisible to the naked eye. You can see only see them (and see how they move) when you breathe out in very cold air - when you can literally "see your breath."

To keep us from panicking early on in February, the Trump administration told everyone that the Coronavirus wasn't transmitted in aerosols, but only in the larger breath droplets. This was a lie. We know now that it was a lie because we heard President Trump admit it in his tape-recorded interview with Carl Bernstein.

But the aerosol deceit early on served another purpose. It allowed the CDC to recommend cloth masks. The CDC knew that these cheap and readily available alternatives to higher quality surgical masks were not as effective, but medical-grade masks were in short supply. The most effective masks had to be spared for healthcare workers so they wouldn't succumb to the virus and thus crash the whole healthcare system.

Most cloth masks do stop most of the larger droplets we exhale, but they do not stop aerosols. In some cases, it has been discovered that they may even increase aerosols by breaking up particles into smaller sizes. That wouldn't be a problem if the virus isn't transmitted by aerosols, but it is. These tiny vapors hang in the air for hours and build up in well-occupied rooms that don't have proper ventilation. There is no good reason for us to be wearing cloth masks that are 40% to 60% effective when we could all be wearing surgical masks or highly effective N95 masks that are 75% to 95% effective? We are many months into this pandemic and there shouldn't be any excuse for shortages of good quality masks for public use.

Having no national policy that focuses on sparing us from the spread of the virus is terrible, but worse yet is a policy that drains our national treasury on false promises of a cure.

The N95 cone mask, pictured here, fits comfortably over your face and nose. It filters our micron-size particles and has a double elastic strap with an adjustable nose piece and anti-fog foam to increase comfort and prevent leakage. It seals in and keeps out all particles and most aerosols. It comes in a regular size and a small size for smaller faces (think children). It costs 63¢ retail and much less if our national government were to purchase them in bulk. A mask like this worn properly by 90% of our people could reduce transmission rates by more than 75%. It would in essence have the same effect as natural herd immunity.

On the other hand, Eli Lilly’s experimental anti-viral drug proved completely ineffective in a level 3 clinical trial for patients hospitalized with COVID-19. Two days later the Trump administration struck a deal to buy up to 950,000 doses of this useless drug at a cost of $1,247 per dose. The doses would be given free of charge to people with mild symptoms, who do not require hospitalization, in the hope that it might help them recover more quickly. That deal equals a total cost potential of $1.18 billion dollars in sales once the FDA issues an emergency use authorization.

The money spent on this proven ineffective therapeutic is enough to purchase 1.87 billion N95 cone masks at the full retail price of 63¢ each. The President has the power to invoke the Defense Production Act to purchase more than double or triple that number for the price. This is another glaring example of why national leadership matters.

With holiday celebrations moving indoors and the largest surge in infection so far on the horizon, social distancing and masks wearing are more urgently needed than ever. So, what does the science say about masks? 
Several new scientific studies have examined the effectiveness of wearing masks. Face mask-wearing is the strongest predictor for the number of deaths per million. It affects 70% of the death rates from the deadly disease. Almost 80% of the COVID-19 deaths reported in early June could be linked to the reluctance of people wear a face mask in mid-March. Yet a YouGov survey of people from more than 20 countries revealed that only 21% of people 'in Britain said they wear masks while over 90% in some Asian countries wear them. Japanese researchers also found that people with more body fat are less likely to wear face masks because they feel more uncomfortable. "An obese adult inhales an average of 50% more air per day than non-obese adults," they said.

Although they are not close fitting, blue, disposable surgical masks are fluid resistant and provide some protection against larger respiratory droplets from coughs and sneezes. Primarily, they prevent the wearer from spreading infectious droplets to others. They are best used in settings where aerosol buildup isn’t an issue, such as outdoors.

A July study found that Cloth face masks offer essentially zero protection against the COVID-19 virus. Kazunari Onishi at St. Luke’s International University in Tokyo found that cloth masks had a 100-percent leakage rate in terms of airborne particles penetrating the fabric and through the gap between masks and faces. When worn properly, good quality blue surgical masks, the rectangular pleated ones, had a 52% leakage rate while some low-quality procedural masks had an 81% leakage rate. When casually worn, (Below the nose or on the tip of the nose for example) both procedural masks had a 100% leakage rate, meaning they were no better than not wearing them at all.

To be clear, the only reason the CDC recommended cloth masks is because surgical masks and N95 masks were in such short supply. It was more critical that healthcare professionals have them, otherwise high infection rates among them would incapacitate our hospitals. We are well paid 230 days into this national crisis. We should have an adequate supply of N95 masks by now, but we don’t. Therefore, we should still only buy them in modest quantities (no hoarding!), and reuse them safely. N95 masks can be put in a rice cooker to sanitize them. There are good videos on YouTube to show you how to re-sanitize these masks. 
Whatever else we do over the next few months, properly wearing good quality masks should be part of it.

Stay safe, everyone, and have a happy holiday season.







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