Am making this a “sticky post” at the top for a few days. Below is a list of counties that made face masks mandatory as far back as early to mid-April. All of these counties, as of July, are seeing an out of control spread of Covid-19. It appears that mandatory face masks have not resulted in solving the problem. Several of these counties are now re-closing businesses. Why are face masks not working? (See below for a lengthy list.)
The media is spinning a controversy over face masks as a left versus right issue because the media is incapable of seeing other perspectives. In their spin, the left wears face masks and the right objects. And that is the end of the story. And they could not be more wrong.
Not everyone can wear a face mask, and if they can, it may depend on the type of face mask.
Recently published evidence for use of face masks was tortured by the media in to saying that “new study proves face masks work” when that was not the conclusion of the study – at all. I summarize the full study here and reproduce my summary conclusions here:
- N95 respirators are valuable in reducing the spread of Covid-19
- A 12-16 layer cotton mask appears to also be valuable.
- No one is wearing 12-16 layer cotton masks. See if you can breath through 6-8 t-shirts placed in front of your face. Other studies found it is difficult to breathe using more than about 4 layers in a homemade face mask.
- There is no current evidence to support the use of randomly designed, random materials, assembled by persons of unknown skill, home made face masks.
- There is no evidence what so ever that wearing homemade face masks in outdoor setting has any impact what so ever on reducing the spread of Covid-19.
- The study documents risks of wearing face masks (most studies did not have people wearing face masks full time, which is now required for many workers.)
The Occupational Safety and Hazard Administration (OHSA) has guidelines for evaluating an employees ability to use an N95 respirator type mask. These problems are already well known.
Employers are to take the following into consideration:
C. Medical Factors and Conditions
The medical evaluation is designed to identify general medical conditions that place employees who use respirators at risk of serious medical consequences. Medical conditions known to compromise an employee’s ability to tolerate respirator-, job-, and workplace-related physiological stress include: cardiovascular and respiratory diseases (e.g., a history of high blood pressure, angina, heart attack, cardiac arrhythmias, stroke, asthma, chronic bronchitis, emphysema); reduced pulmonary function caused by other factors (e.g., smoking or prior exposure to respiratory hazards); neurological or musculoskeletal disorders (e.g., ringing in the ears, epilepsy, lower back pain); impaired sensory function (e.g., perforated ear drums, reduced or absent ability to smell); and psychological disorders (e.g., claustrophobia and severe anxiety).
As you can see, there are numerous medical and behavioral health conditions that make it difficult, if not dangerous, for many to cover their faces and airway. But from the media’s perspective, it comes down to left versus right politics … thus, if you have a medical or behavioral health condition that precludes mask wearing, the media insists you must be on the right. And if you are wearing a mask, you are obviously on the left.
The media’s spin translates to the world of social media insta-experts. Social media idiots publicly shame everyone who is not wearing a face mask, accusing them of everything from having the wrong politics to wanting to murder people.
I have suffered six traumatic brain injuries and experience “ringing in the ears” as well as generalized anxiety. I also have high blood pressure and exercise induced asthma since I was a teen. That’s 4 of the items on the OSHA list. Not until 2018 was the TBI connection recognized and I received treatment (over the years I experienced about a dozen and half effects of TBI).
Because of these personal challenges, I have been practicing – or training – to wear different types of masks while at home.
At this time, I can only wear an N95 respirator for about 15 minutes while sitting (have not tried it while being active, walking about or working). Around 15 minutes I start to feel slightly breathless and begin to experience mild panic and have to take it off. I tried a home made face mask with multiple layers of cloth and had similar problems. For now, the only “mask” I can wear for longer periods (like shopping) is a bandanna.
Of course, social media idiots are now publicly shaming the use of bandannas as ineffective. You cannot do anything right. I now suffer anxiety about wearing my bandanna while at Lowe’s or the grocery store and fears I will be called out.
I cannot visit Instagram or Facebook without being flooded with “mask shaming” posts by social media insta-experts who lack understanding and empathy. This adds to my anxiety. I’ve ended up “hiding”, “muting” or unfollowing many people due to their animosity towards those who may not be able to comply. There is zero empathy from the social media insta-experts.
I continue to practice using different masks at home with the intent of over coming these difficulties and finding a mask that works.
Anxiety is Real
Psychology Today has an article on “mask anxiety” (it is a real thing and should not be so quickly dismissed by politicians, pundits and media morons). See How to Combat Mask Anxiety | Psychology Today Canada
If you look at online forums focused on anxiety, you will find hundreds of posts from people who are experiencing severe anxiety, even panic attacks, due to the mask issue. The disappearance of faces and the loss of face contact can itself be a cause of anxiety and other issues. Even though OSHA recognizes a set of medical conditions , the media quotes “expert” doctors contradicting OSHA and saying there are no medical conditions to preclude wearing a mask (but see what people with COPD are saying about that). Doctors who say there are no medical conditions to preclude wearing a face mask are dumb asses who never met a deaf person. Idiots.
The point here is that there are real reasons some cannot easily wear a face mask. Do not publicly shame people – you have no idea why they may not be wearing a face mask or not wearing a politically correct face mask. Public shaming has led to persons with bona fide health conditions being denied access to stores.
The Anxiety of Mask Violence
A recent paper in The Lancet found home made masks should ideally have 12-16 layers of cotton cloth. However, another study found that at 4 layers and above, most people find breathing difficult.
Considering the emotional toll – and actual violence – as too many have been assaulted, knifed, even shot for wearing or not wearing a mask or the right kind of mask – as of July 4th, there is not yet scientific evidence from controlled trials that home made or improvised face masks reduce the spread of Covid-19 in the general community.
Surprising Lack of Data
While reducing the spread of Covid-19 among the general public by wearing a mask seems intuitive, there is not yet trial data to confirm this. And there are scenarios involving close in, indoor, extended time contacts where droplet spread seems likely.
But instead of trial data, we have computer models and correlations that project face masks will reduce the spread when worn in public settings. But these are not data – and correlations often fail simply by finding a single counter example.
California is an example of a state where most of the populated counties implemented mandatory face mask policies in April. But by July, new cases of Covid-19 are surging throughout the state in spite of of their face mask policy.
- California’s Sutter and Yuba Counties issue face masks mandatory orders effective April 10th.
- San Francisco City and County makes face masks mandatory as of April 17th.
- Los Angeles has had a face mask mandate in effect since April 18th. As of the 4th of July, the county has reverted to a semi-lock down state as cases explode (beaches, bike lanes, bars and restaurants are again closed). As of July 12th, the spread of Covid-19 is out of control in Los Angeles. As of July 13th, Los Angeles announces that schools will not re-open in the fall. How did the face mask requirement work out?
- Marin County issued a mandatory face mask order on April 17. On July 3, Marin County, California was added to a “Watch list” of counties where Covid-19 is getting worse. How did the face mask requirement work out?
- Mendocino and Humboldt Counties makes face masks mandatory on April 24th. Yolo County adds a face mask requirement effective April 27th. Monterrey County mandates face masks as of April 30th.
- Santa Cruz County announces on April 29th it will soon have a mandatory face mask policy.
- Santa Clara County issues a mandatory face coverings order on May 20th requiring face masks even in outdoor settings. In July, Santa Clara County was added to a watch list where cases are getting worse. How did the face mask requirement work out?
- California – click here for an animated graphic showing how Covid-19 is worsening in California, including in counties that made not wearing a face mask a criminal offense in April and May.
- Washington State’s largest county made face masks mandatory on May 18th. Whatcom County on May 22. San Juan County also about that time. The State made masks mandatory for all workers, statewide, on June 8th. and for everyone in Yakima County on June 20th. Washington State enacted a mandatory face mask, state wide, on June 26th. And then on July 6th, Washington State reported its highest ever number of positive test results. How did the face mask requirement work out?
Update: July 11-King County, WA has seen new daily cases triple in the last 4 weeks. Face masks were made mandatory on May 18th.
- July 12 – 7 of 9 SF Bay area counties in California are back on “watch lists” and Sonoma County is back to closing businesses. Most have had mandatory face mask requirements since mid April.
- Denmark has comparatively mild prevalence of the disease in Europe, had a short lock down (4 weeks) before re-opening in April, and a one meter (3 feet) social distancing rule (not the two meters (6 feet) used in the U.S. and the U.K). Denmark does not require the wearing of face masks and few people voluntarily wear face masks.
- Argentina was heralded for its very strict lock down (even banning outdoor exercise), closing some stores on March 20th, and was viewed as a success in stopping Covid-19 in South America. Face masks were made mandatory in public settings. Argentina is now reversing its re-opening strategy and requiring thousands of businesses to close again. How did the face mask requirement work out?
- Meanwhile, Germany has had a mask requirement since April 27th and has few cases. The media cherry picks Germany as proving that masks work.
- And then there is Peru – Peru was the first country in South America to go to “lock down”, starting on March 16th and including the closing of their border. Police and the military strictly enforced the lock down orders, prohibiting all but very local travel. This lock down remained in effect until June 30, when it was lifted because of the economic damage. As of early July, Peru has the 2nd largest number of cases in South America, the 10th highest in the world – and face masks have been mandatory since the beginning (the government even provided face masks to everyone). Did they work?
- And recent research suggests virus transmission by aerosols, not just droplets. Most home made masks do a very poor job of blocking aerosol transmission, based on prior research. If true, we all need N95 respirators, not cloth that frequently leaks like a sieve and around the edges. And this implies most masks worn by the public have limited effectiveness at stopping aerosol transmission.
- How much protection does a mask add relative to social distance for a momentary instant in time contact in a grocery store? Contact tracers only seek out those who had close contact for 15 minutes or more suggesting they are not too concerned about momentary close contacts ...
- Update July 11 – looking over the above and looking at the newest numbers it appears no one has a consistent and coherent explanation as to why cases are rising in many areas of the country. It seems all of the measures thrown at it – social distancing, “enhanced sanitization”, face masks, are having little effect.
Some suggest face masks are a magic bullet solution, seeing only a single variable problem – but reducing the spread of Covid-19 is a multi-variable problem. Face masks may play a large role, a small role, or no role – we literally do not know. From the above list, it is not clear that face mask usage has had much impact.
The reality may be that real world usage renders masks ineffective: random mask designs using random materials, worn without covering the nose, or removed when talking to others, or worn around the neck, or using N95 respirators with unfiltered outflow valves, not washing masks frequently and physically mishandling them, and neglecting social distancing when wearing a mask, or handling masks with contaminated hands. All of these real world problems may make mask usage far less effective then staying focused on distancing and sanitization.
We need scientific controlled trials or similar to determine once and for all if face masks work in the real world, in conjunction with how they are actually used and made, and how well they work: a lot, a little, or not at all.
Meanwhile, just visit Facebook or Nextdoor.com to see the barrage of mask shaming that continues every day from the social media insta-experts.
On June 18th the Oregonian newspaper noted:
“…there are no randomly controlled studies yet to answer that question [do masks work?] with great scientific certainty.” https://www.oregonlive.com/coronavirus/2020/06/gov-kate-brown-announces-plans-for-mask-requirements-next-steps-in-reopening-watch-live.html
On June 2, LiveScience noted
The bottom line, experts say, is that masks might help keep people with COVID-19 from unknowingly passing along the virus. But the evidence for the efficacy of surgical or homemade masks is limited, and masks aren’t the most important protection against the coronavirus.https://www.livescience.com/are-face-masks-effective-reducing-coronavirus-spread.html