Alright, we're doing this. And probably, at some point in the future, I'll look back and find out how this post aged...
So I am a volunteer participating in a study on N95 mask decontamination. It's still pretty early, but I'm hoping that they get useful data from this. It would add just a bit to the body of scientific knowledge when it comes to these things. While the occupational usage and efficacy of protective gear is generally well-studied, there's really not a lot of good scientific information on other attempted applications, such as the long-term use of masks as a prophylactic by the general public. Not a lot of information, but there sure is a lot of enthusiasm. And this crap has really gotten out of control.
Most masks that people are wearing don't do much, if anything at all, to prevent the spread of respiratory infections when worn by healthy people. That's about as succinct a summary as I can get from the available science at this time. Social distancing, on the other hand, is effective. There's very strong evidence to back up both of those statements, but I'm not going to delve into sources here because this is just my personal blog that mostly only I read anyway. You wanna debate? This ain't the place. Whatever. The papers will still be archived in the future anyway. And I don't even have particular ones in mind. The scientific literature on this subject has been pretty consistent.
Notice that I'm not saying, "masks don't work." On the contrary: there are masks manufactured by companies to meet certain certifications. They do meet those certifications (and often exceed them). They do what they were meant to do. And unlike certain public figures who are also respected medical professionals, I'm not about to dissemble on this topic and skirt the issue by noting that there are different types of masks and so the issue is ever so complicated, or whatever. It's not that hard:
- You've got your full-face respirators. Vital for some jobs. Easy to get a good fit/seal, so the air you're breathing came through the intake, and viruses aren't making it in that way through pretty much any kind of filter cartridge. Your exhalation isn't filtered and aerosolized viral particles could totally be coming out through there. So this sort of mask would indeed protect your from SARS-CoV-2 for sure, if used properly. Wouldn't stop you from spreading it, if you had it.
- You've got your half-face respirators with filter cartridges. Not quite as strong of a seal, and your eyes are exposed, so that's one route a virus could getcha. But these do seal well enough to ordinarily filter out particles much smaller than respiratory droplets, so you'd be at least mostly protected. And again, this wouldn't stop you from spreading a virus.
- You've got your certified "dust masks" or whatever you want to call them. Everything from P100 to N95, just pick one. None of them seal nearly as well as a full-face mask, but other than exposed eyes, that doesn't matter too much for our purposes. If the fit is good, then almost all of the air you're breathing is passing through that filter. Some of what you're exhaling might be seeping out the sides, but most of it shouldn't be. Respiratory aerosols with viral particles would be caught in that filter. They're not passing through. So, assuming you're using a well-fitted mask properly, you'd get a measure of protection (not perfect) and you'd be unlikely to contaminate your surroundings if you were infected.
- You've got your multi-layer operating room style masks. These don't seal at all, so when your big old lungs expand and suck in half a liter of sweet, sweet air, it'll go right around that mask without being filtered. That's why your eyeglasses are fogging up, dumbass: you're not protected at all. Now, these masks do serve to catch some of your exhalation and slow it down, especially blocking large droplets of saliva. This does help keep infected people from getting their biohazardous slobber on surfaces, contaminating those surfaces and turning them into what medical-type-people call (and I wish I was making this stupid word up) "fomites."
- You've got single-layer, non-certified stuff that people made for some reason, as well as homemade masks. These are crap and don't protect anyone.
We could break it down further and there are some weird hybrids, but basically, those are the main categories. And nothing I've said about any of them should be controversial. Prior to this year, none of it would have been. Oh, and there's another important thing: if you're sick with a lung infection, you definitely shouldn't be wearing any of the masks covered under those first three bullet points. That could be dangerous for you.
If you're healthy, but working around infected people, the primary type of protection that you should be using is not gear worn on your face, but environmental controls, such as partitions. Personal protective equipment could be used to complement those environmental controls, but doesn't replace them. Equipment would include not just a mask, probably an N95 in this case, but also safety glasses, gloves, and some kind of body covering such as a gown, sleeve covers, or even a full suit. Viruses like SARS-CoV-2 don't go through your skin, and the reason for all that PPE on non-face bodyparts is to deal with fomites. The PPE is used for an interval, then procedurally doffed and discarded, so any potential viral contamination is left behind with it.
But if you're not working around sick people, if your workplace doesn't have environmental controls in place, if you're not trained with PPE chosen to fit the tasks you're performing, or if you aren't following proper hygiene practices for using your PPE, it's not merely unhelpful, but counterproductive. The experts know this and have known it all along. Ordinary, dumb mouthbreathing citizens aren't as keen on such matters, and the stupid "mask everywhere" fad caught on with them way before organizations like the CDC reluctantly obfuscated their previously clear, sensible positions on the matter and started hedging like they were building a damn maze. It's pathetic.
As a creature of myth and legend, an essential worker, I've been commuting to my workplace every weekday this whole time (other than Memorial Day). So I've seen some stuff. I've seen people on the streets...
- ...wearing disposable nitrile gloves.
- ...wearing masks on their foreheads.
- ...wearing masks with their noses exposed.
- ...wearing full-face air-purifying respirators.
- ...wearing masks made of whatever crap they had at home.
- ...wearing masks upside-down.
- ...wearing masks backwards.
- ...wearing masks while driving alone in their own cars.
- ...ignoring social distancing because they're all wearing masks.
Your masks might as well be charm bracelets at this point, for all the good they do you. One argument I've encountered is that even if masks aren't very effective, they might help a little bit and it's worth the cost if it means saving lives. Guess what: the same goes for charm bracelets. Now stop being an idiot. Not only are people too stupid to follow most public health recommendations properly, but you're introducing unecessary cognitive load if you have them focusing on useless PPE. Keep the energy on hand-washing and social distancing. Those things work, and they're not being practiced enough.
Oh, and I'm aware of the notion that masks for the general population are good because they prevent asymptomatic (or presymptomatic) carriers from spreading their infection. Time will probably tell, but this looks sketchy to me. We already know from other viruses that the particles being shed by asymptomatic carriers probably have a very low transmission rate. Just because they're being picked up on an assay doesn't mean they're viable. Also, people who don't have symptoms presumably aren't coughing or sneezing, so they're not ejecting those big infectious droplets that a mask would catch anyway. If they are shedding infectious particles, it's in aerosolized respiratory droplets, and those, as I've mentioned, go right past a flimsy little cloth mask anyway, pushed through by a current exhalation, courtesy of your infected lungs. So don't expect much help on the count.
"But the CDC said..." Nope. Stop. What they did was hedging. Doesn't count.
"You're just a dumb nobody and the experts know more than you do." Sure. They got any scientific research to back up these novel claims?
Some of the same people I've seen tirelessly engage antivaxx lunatics and come prepared with a mountain of sources showing how safe vaccines are have now come full-circle: shaming people for not wearing masks, without having science to back up their claims that the masks even help. And that's just sad.
In a hundred years, people will look back at this epidemic and there'll be some quip about how wearing masks became popular, but the masks were primitive and did not stop the virus. Or perhaps I'm wrong this time. Guess we'll have to wait and see.
