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some say "wearing a mask outside health care facilities offers little, if any, protection from infection".

lenny2

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Jan 18, 2012
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We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.

new england journal of medicine

That's merely an unsupported opinion with no scientific research to support it, so quite useless, unlike all the scientific evidence that i posted:

Besides it being obviously common sense, there's tons of evidence that mask wearing reduces infections and deaths by C-19. For example:

"Face Masks Against COVID-19: An Evidence Review

Jeremy Howarda,c,1 , Austin Huangb , Zhiyuan Lik , Zeynep Tufekcim, Zdimal Vladimire , Helene-Mari van der Westhuizenf,g , Arne von Delfto,g , Amy Pricen , Lex Fridmand , Lei-Han Tangi,j , Viola Tangl , Gregory L. Watsonh , Christina E. Baxs , Reshama Shaikhq , Frederik Questierr , Danny Hernandezp , Larry F. Chun , Christina M. Ramirezh , and Anne W. Rimoint

a fast.ai, 101 Howard St, San Francisco, CA 94105, US; bWarren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI 02903; cData Institute, University of San Francisco, 101 Howard St, San Francisco, CA 94105, US; dDepartment of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139; e Institute of Chemical Process Fundamentals, Czech Academy of Sciences, Rozvojová 135, CZ-165 02 Praha 6, Czech Republic; fDepartment of Primary Health Care Sciences, Woodstock Road, University of Oxford, OX2 6GG, United Kingdom; gTB Proof, Cape Town, South Africa; hDepartment of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095; iDepartment of Physics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China; jComplex Systems Division, Beijing Computational Science Research Center, Haidian, Beijing 100193, China; kCenter for Quantitative Biology, Peking University, Haidian, Beijing 100871, China; lDepartment of Information Systems, Business Statistics and Operations Management, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China; mUniversity of North Carolina at Chapel Hill; nSchool of Medicine Anesthesia Informatics and Media (AIM) Lab, Stanford University, 300 Pasteur Drive, Grant S268C, Stanford, CA 94305; oSchool of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, 7925, South Africa; pOpenAI, 3180 18th St, San Francisco, CA 94110; qData Umbrella, 345 West 145th St, New York, NY 10031; rVrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; sUniversity of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104; tDepartment of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095

This manuscript was compiled on April 10, 2020...

The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly...

The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both
laboratory and clinical contexts...

"3. Filtering Capability of Masks

...Multiple studies show the filtration effects of cloth masks relative to surgical masks. Particle sizes for speech are on the order of 1 µm (20) while typical definitions of droplet size are 5 µm-10 µm (5). Generally available household materials had between a 49% and 86% filtration rate for 0.02 µm exhaled particles whereas surgical masks filtered 89% of those particles (21). In a laboratory setting, household materials had 3% to 60% filtration rate for particles in the relevant size range, finding them comparable to some surgical masks (22). In another laboratory setup, a tea cloth mask was found to filter 60% ofparticles between 0.02 µm to 1 µm, where surgical masks filtered 75% (23). Dato et al (2006) (24), note that "quality commercial masks are not always accessible." They designed and tested a mask made from heavyweight T-shirts, finding that it "offered substantial protection from the challenge aerosol and showed good fit with minimal leakage".Although cloth and surgical masks are primarily targeted towards droplet particles, some evidence suggests they may have a partial effect in reducing viral aerosol shedding (25).

When considering the relevance of these studies of ingress, it’s important to note that they are likely to substantially underestimate effectiveness of masks for
source control. When someone is breathing, speaking, or coughing, only a tiny amount of what is coming out of their mouths is already in aerosol form. Nearly all of what is being emitted is droplets. Many of these droplets will then evaporate and turn into aerosolized particles that are 3 to 5-fold smaller. The point of wearing a mask as source control is largely to stop this process from occurring, since big droplets dehydrate to smaller aerosol particles that can float for longer in air (26).

Anfinrud et al (6) used laser light-scattering to sensitively detect droplet emission while speaking. Their analysis showed that virtually no droplets were "expelled" with a homemade mask consisting of a washcloth attached with two rubber bands around the head, while significant levels were expelled without a mask. The authors stated that "wearing any kind of cloth mouth cover in public by every person, as well as strict adherence to distancing and handwashing, could significantly decrease the transmission rate and thereby contain the pandemic until a vaccine becomes available."

An important focus of analysis for public mask wearing is droplet source control. This refers to the effectiveness of blocking droplets from an infectious person, particularly during speech, when droplets are expelled at a lower pressure and are not small enough to squeeze through the weave of a cotton mask. Many recommended cloth mask designs also include a layer of paper towel or coffee filter, which could increase filter effectiveness for PPE, but does not appear to be necessary for blocking droplet emission (6, 27, 28).

In summary, there is laboratory-based evidence that household masks have some filtration capacity in the relevant droplet size range, as well some efficacy in
blocking droplets and particles from the wearer (26). That is, these masks help people keep their droplets to themselves.

4. Mask Efficacy Studies

Although no randomized controlled trials (RCT) on the use of masks as source control for SARS-CoV-2 has been published, a number of studies have attempted to indirectly estimate the efficacy of masks. Overall, an evidence review (29) finds "moderate certainty evidence shows that the use of handwashing plus masks probably reduces the spread of respiratory viruses."

The most relevant paper (30), with important implications for public mask wearing during the COVID-19 outbreak, is one that compares the efficacy of surgical masks for source control for seasonal coronavirus, influenza, and rhinovirus. With ten participants, the masks were effective at blocking coronavirus droplets of all sizes for every subject. However, masks were far less effective at blocking rhinovirus droplets of any size, or of blocking small influenza droplets. The results suggest that masks may have a significant role in source control for the current coronavirus outbreak. The study did not use COVID-19 patients, and it is not yet known whether seasonal coronavirus behaves the same as SARS-CoV-2; however, they are of the same genus, so similar behavior is likely.

Another relevant (but under-powered, with n=4) study (31) found that a cotton mask blocked 96% (reported as 1.5 log units or about a 36-fold decrease) of viral load on average, at eight inches away from a cough from a patient infected with COVID-19. If this is replicated in larger studies it would be an important result, because it has been shown (32) that "every 10-fold increase in viral load results in 26% more patient deaths" from "acute infections caused by highly pathogenic viruses".

A comparison of homemade and surgical masks for bacterial and viral aerosols (21) observed that "the median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask." Research focused on aerosol exposure has found all types of masks are at least somewhat effective at protecting the wearer. Van der Sande et al (33) found that "all types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity", and concluded that "any type of general mask use is likely to decrease viral exposure and infection risk on a population level, despite imperfect fit and imperfect adherence". Overall however, analysis of particle filtration is likely to underestimate the effectiveness of masks, since the fraction of particles that are emitted as aerosol (vs. droplet) is quite small (26). Analysis of seasonal coronavirus compared to rhinovirus (30) suggests that filtration of COVID-19 may be much more effective, especially for source control.

The importance of using masks for health care workers has been observed (34) in three Chinese hospitals where, in each hospital, medical staff wearing masks (mainly in quarantine areas) had no COVID-19 infections, despite being around COVID-19 patients far more often, whilst other medical staff had 10 or more infections in each of the three hospitals.

Masks seem to be effective for source control in the controlled setting of an airplane. One case report (35) describes a man who flew from China to Toronto and then tested positive for COVID-19. He was wearing a mask during the flight. The 25 people closest to him on plane/flight attendants were tested and all were negative. Nobody has been reported from that flight as getting COVID-19. Another case study involving a masked influenza patient on an airplane (36) found that
"wearing a face mask was associated with a decreased risk for influenza acquisition during this long-duration flight".

Guideline development for health worker personal protective equipment have focused on whether surgical masks or N95 respirators should be recommended. Most of the research in this area focuses on influenza. At this point, it is not known to what extent findings from influenza studies apply to COVID-19 filtration. Wilkes et al (37) found that "filtration performance of pleated hydrophobic membrane filters was demonstrated to be markedly greater than that of electrostatic filters." However, even substantial differences in materials and construction do not seem to impact the transmission of droplet-borne viruses in practice, such as a metaanalysis of N95 respirators compared to surgical masks (38) that found "the use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratoryconfirmed influenza." Johnson et al (39) showed that "surgical and N95 masks were equally effective in preventing the spread of PCR-detectable influenza". Radonovich et al (40) found in an outpatient setting that "use of N95 respirators, compared with medical masks... resulted in no significant difference in the rates of laboratory-confirmed influenza."

One of the most frequently mentioned papers evaluating the benefits and harms of cloth masks have been by MacIntyre et al (41). Findings have been
misinterpreted, and therefore justify detailed discussion here. The authors "caution against the use of cloth masks" for healthcare professionals compared
to the use of surgical masks and regular procedures, based on an analysis of transmission in hospitals in Hanoi. We emphasize the setting of the study - health workers using masks to protect themselves against infection. The study compared a "surgical mask" group which received 2 new masks per day, to a "cloth mask" group that received 5 masks for the entire 4week period and were required to wear the masks all day, to a "control group" which used masks in compliance with existing hospital protocols, which the authors describe as a "very high level of mask use". It is important to note that the authors did not have a "no mask" control group because it was deemed "unethical to ask participants to not wear a mask." The study does not inform policy pertaining to public mask wearing as compared to the absence of masks in a community setting, since there is not a "no mask" group. The results of the study show that the group with a regular supply of new surgical masks each day had significantly lower infection of rhinovirus than the group that wore a limited supply of cloth masks. This paper lends support to the use of clean, surgical masks by medical staff in hospital settings to avoid rhinovirus infection by the wearer, and is consistent with other studies that show cloth masks provide poor filtration for rhinovirus (30). Its implementation does not inform the effect of using cloth masks versus not using masks in a community setting for source control of SARS-CoV-2, which is of the same genus as seasonal coronavirus, which has been found to be effectively filtered by cloth masks in a source control setting (30).

A. Studies of Impact on Community Transmission.

When evaluating the available evidence for the impact of masks on community transmission, it is critical to clarify the setting of the research study (health care facility or community), the respiratory illness being evaluated and what reference standard was used (no mask or surgical mask). There are no RCTs that have been done to evaluate the impact of masks on community transmission during a coronavirus pandemic. While there is some evidence from influenza outbreaks, the current global pandemic poses a unique challenge. A review (42) of 67 studies including randomized controlled trials and observational studies found that simple and lowcost interventions would be useful for reducing transmission of epidemic respiratory viruses. The review recommended that "the following effective interventions should be implemented, preferably in a combined fashion, to reduce transmission of viral respiratory disease: 1. frequent handwashing with or without adjunct antiseptics; 2. barrier measures such as gloves, gowns, and masks with filtration apparatus; and 3. suspicion diagnosis with the isolation of likely cases". However, it cautioned that routine longterm implementation of some measures assessed might be difficult without the threat of an epidemic."

http://files.fast.ai/papers/masks_lit_review.pdf
 

canada-man

Well-known member
Jun 16, 2007
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Toronto, Ontario
canadianmale.wordpress.com
That's merely an unsupported opinion with no scientific research to support it, so quite useless, unlike all the scientific evidence that i posted:

Besides it being obviously common sense, there's tons of evidence that mask wearing reduces infections and deaths by C-19. For example:

"Face Masks Against COVID-19: An Evidence Review

Jeremy Howarda,c,1 , Austin Huangb , Zhiyuan Lik , Zeynep Tufekcim, Zdimal Vladimire , Helene-Mari van der Westhuizenf,g , Arne von Delfto,g , Amy Pricen , Lex Fridmand , Lei-Han Tangi,j , Viola Tangl , Gregory L. Watsonh , Christina E. Baxs , Reshama Shaikhq , Frederik Questierr , Danny Hernandezp , Larry F. Chun , Christina M. Ramirezh , and Anne W. Rimoint

a fast.ai, 101 Howard St, San Francisco, CA 94105, US; bWarren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI 02903; cData Institute, University of San Francisco, 101 Howard St, San Francisco, CA 94105, US; dDepartment of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139; e Institute of Chemical Process Fundamentals, Czech Academy of Sciences, Rozvojová 135, CZ-165 02 Praha 6, Czech Republic; fDepartment of Primary Health Care Sciences, Woodstock Road, University of Oxford, OX2 6GG, United Kingdom; gTB Proof, Cape Town, South Africa; hDepartment of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095; iDepartment of Physics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China; jComplex Systems Division, Beijing Computational Science Research Center, Haidian, Beijing 100193, China; kCenter for Quantitative Biology, Peking University, Haidian, Beijing 100871, China; lDepartment of Information Systems, Business Statistics and Operations Management, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China; mUniversity of North Carolina at Chapel Hill; nSchool of Medicine Anesthesia Informatics and Media (AIM) Lab, Stanford University, 300 Pasteur Drive, Grant S268C, Stanford, CA 94305; oSchool of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, 7925, South Africa; pOpenAI, 3180 18th St, San Francisco, CA 94110; qData Umbrella, 345 West 145th St, New York, NY 10031; rVrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; sUniversity of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104; tDepartment of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095

This manuscript was compiled on April 10, 2020...

The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly...

The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both
laboratory and clinical contexts...

"3. Filtering Capability of Masks

...Multiple studies show the filtration effects of cloth masks relative to surgical masks. Particle sizes for speech are on the order of 1 µm (20) while typical definitions of droplet size are 5 µm-10 µm (5). Generally available household materials had between a 49% and 86% filtration rate for 0.02 µm exhaled particles whereas surgical masks filtered 89% of those particles (21). In a laboratory setting, household materials had 3% to 60% filtration rate for particles in the relevant size range, finding them comparable to some surgical masks (22). In another laboratory setup, a tea cloth mask was found to filter 60% ofparticles between 0.02 µm to 1 µm, where surgical masks filtered 75% (23). Dato et al (2006) (24), note that "quality commercial masks are not always accessible." They designed and tested a mask made from heavyweight T-shirts, finding that it "offered substantial protection from the challenge aerosol and showed good fit with minimal leakage".Although cloth and surgical masks are primarily targeted towards droplet particles, some evidence suggests they may have a partial effect in reducing viral aerosol shedding (25).

When considering the relevance of these studies of ingress, it’s important to note that they are likely to substantially underestimate effectiveness of masks for
source control. When someone is breathing, speaking, or coughing, only a tiny amount of what is coming out of their mouths is already in aerosol form. Nearly all of what is being emitted is droplets. Many of these droplets will then evaporate and turn into aerosolized particles that are 3 to 5-fold smaller. The point of wearing a mask as source control is largely to stop this process from occurring, since big droplets dehydrate to smaller aerosol particles that can float for longer in air (26).

Anfinrud et al (6) used laser light-scattering to sensitively detect droplet emission while speaking. Their analysis showed that virtually no droplets were "expelled" with a homemade mask consisting of a washcloth attached with two rubber bands around the head, while significant levels were expelled without a mask. The authors stated that "wearing any kind of cloth mouth cover in public by every person, as well as strict adherence to distancing and handwashing, could significantly decrease the transmission rate and thereby contain the pandemic until a vaccine becomes available."

An important focus of analysis for public mask wearing is droplet source control. This refers to the effectiveness of blocking droplets from an infectious person, particularly during speech, when droplets are expelled at a lower pressure and are not small enough to squeeze through the weave of a cotton mask. Many recommended cloth mask designs also include a layer of paper towel or coffee filter, which could increase filter effectiveness for PPE, but does not appear to be necessary for blocking droplet emission (6, 27, 28).

In summary, there is laboratory-based evidence that household masks have some filtration capacity in the relevant droplet size range, as well some efficacy in
blocking droplets and particles from the wearer (26). That is, these masks help people keep their droplets to themselves.

4. Mask Efficacy Studies

Although no randomized controlled trials (RCT) on the use of masks as source control for SARS-CoV-2 has been published, a number of studies have attempted to indirectly estimate the efficacy of masks. Overall, an evidence review (29) finds "moderate certainty evidence shows that the use of handwashing plus masks probably reduces the spread of respiratory viruses."

The most relevant paper (30), with important implications for public mask wearing during the COVID-19 outbreak, is one that compares the efficacy of surgical masks for source control for seasonal coronavirus, influenza, and rhinovirus. With ten participants, the masks were effective at blocking coronavirus droplets of all sizes for every subject. However, masks were far less effective at blocking rhinovirus droplets of any size, or of blocking small influenza droplets. The results suggest that masks may have a significant role in source control for the current coronavirus outbreak. The study did not use COVID-19 patients, and it is not yet known whether seasonal coronavirus behaves the same as SARS-CoV-2; however, they are of the same genus, so similar behavior is likely.

Another relevant (but under-powered, with n=4) study (31) found that a cotton mask blocked 96% (reported as 1.5 log units or about a 36-fold decrease) of viral load on average, at eight inches away from a cough from a patient infected with COVID-19. If this is replicated in larger studies it would be an important result, because it has been shown (32) that "every 10-fold increase in viral load results in 26% more patient deaths" from "acute infections caused by highly pathogenic viruses".

A comparison of homemade and surgical masks for bacterial and viral aerosols (21) observed that "the median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask." Research focused on aerosol exposure has found all types of masks are at least somewhat effective at protecting the wearer. Van der Sande et al (33) found that "all types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity", and concluded that "any type of general mask use is likely to decrease viral exposure and infection risk on a population level, despite imperfect fit and imperfect adherence". Overall however, analysis of particle filtration is likely to underestimate the effectiveness of masks, since the fraction of particles that are emitted as aerosol (vs. droplet) is quite small (26). Analysis of seasonal coronavirus compared to rhinovirus (30) suggests that filtration of COVID-19 may be much more effective, especially for source control.

The importance of using masks for health care workers has been observed (34) in three Chinese hospitals where, in each hospital, medical staff wearing masks (mainly in quarantine areas) had no COVID-19 infections, despite being around COVID-19 patients far more often, whilst other medical staff had 10 or more infections in each of the three hospitals.

Masks seem to be effective for source control in the controlled setting of an airplane. One case report (35) describes a man who flew from China to Toronto and then tested positive for COVID-19. He was wearing a mask during the flight. The 25 people closest to him on plane/flight attendants were tested and all were negative. Nobody has been reported from that flight as getting COVID-19. Another case study involving a masked influenza patient on an airplane (36) found that
"wearing a face mask was associated with a decreased risk for influenza acquisition during this long-duration flight".

Guideline development for health worker personal protective equipment have focused on whether surgical masks or N95 respirators should be recommended. Most of the research in this area focuses on influenza. At this point, it is not known to what extent findings from influenza studies apply to COVID-19 filtration. Wilkes et al (37) found that "filtration performance of pleated hydrophobic membrane filters was demonstrated to be markedly greater than that of electrostatic filters." However, even substantial differences in materials and construction do not seem to impact the transmission of droplet-borne viruses in practice, such as a metaanalysis of N95 respirators compared to surgical masks (38) that found "the use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratoryconfirmed influenza." Johnson et al (39) showed that "surgical and N95 masks were equally effective in preventing the spread of PCR-detectable influenza". Radonovich et al (40) found in an outpatient setting that "use of N95 respirators, compared with medical masks... resulted in no significant difference in the rates of laboratory-confirmed influenza."

One of the most frequently mentioned papers evaluating the benefits and harms of cloth masks have been by MacIntyre et al (41). Findings have been
misinterpreted, and therefore justify detailed discussion here. The authors "caution against the use of cloth masks" for healthcare professionals compared
to the use of surgical masks and regular procedures, based on an analysis of transmission in hospitals in Hanoi. We emphasize the setting of the study - health workers using masks to protect themselves against infection. The study compared a "surgical mask" group which received 2 new masks per day, to a "cloth mask" group that received 5 masks for the entire 4week period and were required to wear the masks all day, to a "control group" which used masks in compliance with existing hospital protocols, which the authors describe as a "very high level of mask use". It is important to note that the authors did not have a "no mask" control group because it was deemed "unethical to ask participants to not wear a mask." The study does not inform policy pertaining to public mask wearing as compared to the absence of masks in a community setting, since there is not a "no mask" group. The results of the study show that the group with a regular supply of new surgical masks each day had significantly lower infection of rhinovirus than the group that wore a limited supply of cloth masks. This paper lends support to the use of clean, surgical masks by medical staff in hospital settings to avoid rhinovirus infection by the wearer, and is consistent with other studies that show cloth masks provide poor filtration for rhinovirus (30). Its implementation does not inform the effect of using cloth masks versus not using masks in a community setting for source control of SARS-CoV-2, which is of the same genus as seasonal coronavirus, which has been found to be effectively filtered by cloth masks in a source control setting (30).

A. Studies of Impact on Community Transmission.

When evaluating the available evidence for the impact of masks on community transmission, it is critical to clarify the setting of the research study (health care facility or community), the respiratory illness being evaluated and what reference standard was used (no mask or surgical mask). There are no RCTs that have been done to evaluate the impact of masks on community transmission during a coronavirus pandemic. While there is some evidence from influenza outbreaks, the current global pandemic poses a unique challenge. A review (42) of 67 studies including randomized controlled trials and observational studies found that simple and lowcost interventions would be useful for reducing transmission of epidemic respiratory viruses. The review recommended that "the following effective interventions should be implemented, preferably in a combined fashion, to reduce transmission of viral respiratory disease: 1. frequent handwashing with or without adjunct antiseptics; 2. barrier measures such as gloves, gowns, and masks with filtration apparatus; and 3. suspicion diagnosis with the isolation of likely cases". However, it cautioned that routine longterm implementation of some measures assessed might be difficult without the threat of an epidemic."

http://files.fast.ai/papers/masks_lit_review.pdf

are you saying the new england journal of medicine is not scientific?
 

lenny2

Well-known member
Jan 18, 2012
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730
113
are you saying the new england journal of medicine is not scientific?
" Most of the critical points that this piece makes its argument on do not have sources"

---


"Yes, this is not science. These are opinions from a small hierarchical group of people in Boston."

---

"We know that wearing a mask outside health care facilities offers little, if any, protection from infection."
Do we really know that? References are lacking..

---

" Thank you for the usual constipated academic medicine quibbling."

---

" Disappointed that this article is being taken out of context. It is about hospital workers. It has nothing whatsoever to do with "my mask protects you, your mask protects me" as a public health initiative. NEJM should issue a clarification. This excerpt is dangerous."


---


" Actually this statement is in the study. “More compelling is the possibility that wearing a mask may reduce the likelihood of transmission from asymptomatic and minimally symptomatic health care workers with Covid-19 to other providers and patients.”

--

" The masks are not 100% but they do prohibit the travel of sneezes and coughs which spreads this virus. It’s science and it works."


--

It's not only science. It's obviously common sense.
 

lenny2

Well-known member
Jan 18, 2012
3,572
730
113
are you saying the new england journal of medicine is not scientific?
Evidently it wasn't meant to imply what you think, as the authors are actually supportive of mask wearing:

"We understand that some people are citing our Perspective article (published on April 1 at NEJM.org)1 as support for discrediting widespread masking. In truth, the intent of our article was to push for more masking, not less. It is apparent that many people with SARS-CoV-2 infection are asymptomatic or presymptomatic yet highly contagious and that these people account for a substantial fraction of all transmissions.2,3 Universal masking helps to prevent such people from spreading virus-laden secretions, whether they recognize that they are infected or not.4"

"We did state in the article that “wearing a mask outside health care facilities offers little, if any, protection from infection,” but as the rest of the paragraph makes clear, we intended this statement to apply to passing encounters in public spaces, not sustained interactions within closed environments. A growing body of research shows that the risk of SARS-CoV-2 transmission is strongly correlated with the duration and intensity of contact: the risk of transmission among household members can be as high as 40%, whereas the risk of transmission from less intense and less sustained encounters is below 5%.5-7 This finding is also borne out by recent research associating mask wearing with less transmission of SARS-CoV-2, particularly in closed settings.8 We therefore strongly support the calls of public health agencies for all people to wear masks when circumstances compel them to be within 6 ft of others for sustained periods."


So not only is all the scientific evidence i posted in opposition to your view, but so also are the opinions of the authors of the piece you posted from the NEJM in your OP.
 
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GameBoy27

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Evidently it wasn't meant to imply what you think, as the authors are actually supportive of mask wearing:

"We understand that some people are citing our Perspective article (published on April 1 at NEJM.org)1 as support for discrediting widespread masking. In truth, the intent of our article was to push for more masking, not less. It is apparent that many people with SARS-CoV-2 infection are asymptomatic or presymptomatic yet highly contagious and that these people account for a substantial fraction of all transmissions.2,3 Universal masking helps to prevent such people from spreading virus-laden secretions, whether they recognize that they are infected or not.4"

"We did state in the article that “wearing a mask outside health care facilities offers little, if any, protection from infection,” but as the rest of the paragraph makes clear, we intended this statement to apply to passing encounters in public spaces, not sustained interactions within closed environments. A growing body of research shows that the risk of SARS-CoV-2 transmission is strongly correlated with the duration and intensity of contact: the risk of transmission among household members can be as high as 40%, whereas the risk of transmission from less intense and less sustained encounters is below 5%.5-7 This finding is also borne out by recent research associating mask wearing with less transmission of SARS-CoV-2, particularly in closed settings.8 We therefore strongly support the calls of public health agencies for all people to wear masks when circumstances compel them to be within 6 ft of others for sustained periods."


So not only is all the scientific evidence i posted in opposition to your view, but so also are the opinions of the authors of the piece you posted from the NEJM in your OP.
I don't know how any rationally minded individual with half a brain could read that and still think wearing a mask or face covering could be anything but beneficial in reducing transmission of this virus.

Queue canada-man and TeeJay in 3... 2... 1...
 
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lenny2

Well-known member
Jan 18, 2012
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113
I don't know how any rationally minded individual with half a brain could read that and still think wearing a mask or face covering could be anything but beneficial in reducing transmission of this virus.

Queue canada-man and TeeJay in 3... 2... 1...
Unfortunately many people don't think very rationally, don't research things or know how to do so, or couldn't understand the research if they did.

Some also have hidden agendas behind their words or actions in opposition to mask wearing.
 

canada-man

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Jun 16, 2007
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Toronto, Ontario
canadianmale.wordpress.com
ONA Wins Second Decision on “Unreasonable and Illogical” Vaccinate or Mask Influenza Policies



The Ontario Nurses’ Association (ONA) has won a second decision on the controversial vaccinate or mask (VOM) policy, striking down the policy in effect at St. Michael’s Hospital and several other hospitals that form the Toronto Academic Health Science Network (TAHSN). These policies force nurses and other health-care workers to wear an unfitted surgical mask for the entirety of their shift if they choose not to receive the influenza vaccine.


After reviewing extensive expert evidence submitted by both ONA and St. Michael’s Hospital, which was the lead case for the TAHSN group, Arbitrator William Kaplan, in his September 6 decision, found that St. Michael’s VOM policy is “illogical and makes no sense” and “is the exact opposite of being reasonable.” In reaching this conclusion, Arbitrator Kaplan rejected the hospital’s evidence. A copy of the full decision is available here.


The TAHSN group involved in the arbitration also includes Sinai Health System, Sunnybrook Health Sciences Centre, North York General Hospital, the Centre for Addiction and Mental Health, Michael Garron Hospital and Baycrest Health Sciences. Other TAHSN hospitals did not have VOM policies in place.


This is the second such win for ONA. In 2015, Arbitrator James Hayes struck down the same type of policy in an arbitration that included other Ontario hospitals across the province, with Sault Area Hospital as the lead case. Hayes found there was “scant evidence” that forcing nurses to use masks reduced the transmission of influenza to patients. Despite this clear ruling, the majority of TAHSN hospitals refused to follow the Hayes award and maintained their respective VOM policies. As a result, ONA was forced to litigate this matter again at St. Michael’s Hospital.


“The priority of nurses across Ontario is first and foremost the safety of our patients, but these hospital policies do not protect patients,” said ONA President Vicki McKenna, RN. “ONA has already successfully argued against VOM policies, proving they are fundamentally flawed, and we are deeply disappointed that taxpayers’ money has been wasted on having to do so all over again. Our collective agreement already protects our patients if the Medical Officer of Health determines there is an influenza outbreak by ensuring that comprehensive measures are put in place to reduce the risk of transmission to patients.”


ONA’s well-regarded expert witnesses, including Toronto infection control expert Dr. Michael Gardam, Quebec epidemiologist Dr. Gaston De Serres, and Dr. Lisa Brosseau, an American expert on masks, testified that there was insufficient evidence to support the St. Michael’s policy and no evidence that forcing healthy nurses to wear masks during the influenza season did anything to prevent transmission of influenza in hospitals. They further testified that nurses who have no symptoms are unlikely to be a real source of transmission and that it was not logical to force healthy unvaccinated nurses to mask. Arbitrator Kaplan accepted this expert evidence. In contrast, he noted the only fair words to describe the hospital’s evidence in support of masking are “insufficient, inadequate and completely unpersuasive.”


He also agreed with ONA that there was little evidence of any positive impact on patient care outcomes as a result of the VOM policy. Both prior to and after introducing the policy, hospitals continued to experience outbreaks of influenza. He concluded the evidence supported that masks “do not prevent the transmission of the influenza virus.”

 

canada-man

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masks don't work


Professor Denis Rancourt Ph.D, is the lead analyst on this topic at the Ontario Civil Liberties Association. His report, “Masks Don’t Work”, is an extensive analysis of the medical and scientific literature on masking . He writes;


“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.”

 

lenny2

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Jan 18, 2012
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masks don't work


Professor Denis Rancourt Ph.D, is the lead analyst on this topic at the Ontario Civil Liberties Association. His report, “Masks Don’t Work”, is an extensive analysis of the medical and scientific literature on masking . He writes;

“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.”


Masks work.

"What you need to know: Forest, the Republican running for governor against Democrat Cooper, held a Fourth of July campaign event with Republican U.S. House candidate Madison Cawthorn in Henderson County, where he criticized Cooper’s approach to handling the COVID-19 pandemic. In a conversation with the Hendersonville Times-News after his speech, Forest claimed past studies had shown masks are ineffective at containing the spread of viruses.


“There have been multiple comprehensive studies at the deepest level held to scientific standards in controlled environments that have all said for decades, masks do not work with viruses,” he said, according to the Times-News. “That’s why we’ve never used a mask for a coronavirus before, ever.”

But Gavin Yamey, a professor of global health and public policy at Duke University, said the lieutenant governor was “factually incorrect.”

“There is evidence that masks reduce viral transmission,” he said, pointing to an analysis of 10 studies published last month. The analysis found that “face mask use could result in a large reduction in risk of infection, a reduction of as much as 85%,” Yamey said.

...health experts say that over time the research has grown to show that wearing a mask can curb the spread of the virus.

“The evidence gets stronger by the day, as more and more studies show that masks are a critical tool in preventing transmission of the novel coronavirus,” Yamey said. “Research has shown that face masks block the spread of respiratory droplets that can carry the coronavirus. Countries where masks were widely used soon after their COVID-19 outbreak started were more likely to keep their death rates low and to have a shorter outbreak.”

The research on the topic continues to evolve, revealing new details on how to prevent the spread of the virus. A study from researchers at UNC-Chapel Hill found the virus could be transmitted more easily through nasal passages, and that masks which covered the nose were particularly effective at preventing the spread of the virus, the N&O reported last month.

In the emailed statement, Dunn pointed to two different studies in supporting Forest’s comments.

In the first, a May study from the New England Journal of Medicine, researchers stated, “We know that wearing a mask outside health care facilities offers little, if any, protection from infection.” But just two weeks later, the Journal issued a follow up statement acknowledging that some had cited its article to discredit the widespread use of masks, and clarifying that “the intent of our article was to push for more masking, not less.”

The researchers added they “strongly support the calls of public health agencies for all people to wear masks when circumstances compel them to be within 6 ft of others for sustained periods.”

In the second, a 2015 study from the National Institutes of Health which looked at influenza and other viral outbreaks, researchers concluded masks and other protective gear may not be effective or necessary outside of clinical areas.


Frank Scholle, a virologist at N.C. State University, said it’s important to distinguish between the kinds of protection a mask can offer.

“Yes, there are conflicting reports on whether masks are protective, but by and large they focus on healthy people trying to prevent getting infected,” he said. “With COVID-19 we are trying to get people to use masks so they don’t spread the virus to other folks if they are asymptomatic or presymptomatic.”

Still, he added that “there is a difference between an absence of evidence and an evidence of absence.”

In other words, a mask may also protect its wearer, but the research isn’t quite there yet to make a more definitive statement in either direction.

He added that this “is not influenza,” as is the focus of one of the cited studies, and that “different viruses need to be handled differently.”

Scholle said with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two previous coronaviruses, infected individuals were not contagious until they became sick. That reduced the need for masks as those with symptoms could stay home. But a person could have COVID-19 and not realize they are infected until after spreading it to others."

 
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canada-man

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By wearing a mask, the exhaled viruses will not be able to escape and will concentrate in the nasal passages, enter the olfactory nerves and travel into the brain.
Russell Blaylock, MD


Dr. Russell Blaylock warns that not only do face masks fail to protect the healthy from getting sick, but they also create serious health risks to the wearer. The bottom line is that if you are not sick, you should not wear a face mask.


As businesses reopen, many are requiring shoppers and employees to wear a face mask. Costco, for instance, will not allow shoppers into the store without wearing a face mask. Many employers are requiring all employees to wear a face mask while at work. In some jurisdictions, all citizens must wear a face mask if they are outside of their own home. ⁃ TN Editor
With the advent of the so-called COVID-19 pandemic, we have seen a number of medical practices that have little or no scientific support as regards reducing the spread of this infection. One of these measures is the wearing of facial masks, either a surgical-type mask, bandana or N95 respirator mask. When this pandemic began and we knew little about the virus itself or its epidemiologic behavior, it was assumed that it would behave, in terms of spread among communities, like other respiratory viruses. Little has presented itself after intense study of this virus and its behavior to change this perception.


This is somewhat of an unusual virus in that for the vast majority of people infected by the virus, one experiences either no illness (asymptomatic) or very little sickness. Only a very small number of people are at risk of a potentially serious outcome from the infection—mainly those with underlying serious medical conditions in conjunction with advanced age and frailty, those with immune compromising conditions and nursing home patients near the end of their lives. There is growing evidence that the treatment protocol issued to treating doctors by the Center for Disease Control and Prevention (CDC), mainly intubation and use of a ventilator (respirator), may have contributed significantly to the high death rate in these select individuals.


By wearing a mask, the exhaled viruses will not be able to escape and will concentrate in the nasal passages, enter the olfactory nerves and travel into the brain.
Russell Blaylock, MD
As for the scientific support for the use of face mask, a recent careful examination of the literature, in which 17 of the best studies were analyzed, concluded that, “ None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”1 Keep in mind, no studies have been done to demonstrate that either a cloth mask or the N95 mask has any effect on transmission of the COVID-19 virus. Any recommendations, therefore, have to be based on studies of influenza virus transmission. And, as you have seen, there is no conclusive evidence of their efficiency in controlling flu virus transmission.


It is also instructive to know that until recently, the CDC did not recommend wearing a face mask or covering of any kind, unless a person was known to be infected, that is, until recently. Non-infected people need not wear a mask. When a person has TB we have them wear a mask, not the entire community of non-infected. The recommendations by the CDC and the WHO are not based on any studies of this virus and have never been used to contain any other virus pandemic or epidemic in history.


Now that we have established that there is no scientific evidence necessitating the wearing of a face mask for prevention, are there dangers to wearing a face mask, especially for long periods? Several studies have indeed found significant problems with wearing such a mask. This can vary from headaches, to increased airway resistance, carbon dioxide accumulation, to hypoxia, all the way to serious life-threatening complications.


There is a difference between the N95 respirator mask and the surgical mask (cloth or paper mask) in terms of side effects. The N95 mask, which filters out 95% of particles with a median diameter >0.3 µm2 , because it impairs respiratory exchange (breathing) to a greater degree than a soft mask, and is more often associated with headaches. In one such study, researchers surveyed 212 healthcare workers (47 males and 165 females) asking about presence of headaches with N95 mask use, duration of the headaches, type of headaches and if the person had preexisting headaches.2


They found that about a third of the workers developed headaches with use of the mask, most had preexisting headaches that were worsened by the mask wearing, and 60% required pain medications for relief. As to the cause of the headaches, while straps and pressure from the mask could be causative, the bulk of the evidence points toward hypoxia and/or hypercapnia as the cause. That is, a reduction in blood oxygenation (hypoxia) or an elevation in blood C02 (hypercapnia). It is known that the N95 mask, if worn for hours, can reduce blood oxygenation as much as 20%, which can lead to a loss of consciousness, as happened to the hapless fellow driving around alone in his car wearing an N95 mask, causing him to pass out, and to crash his car and sustain injuries. I am sure that we have several cases of elderly individuals or any person with poor lung function passing out, hitting their head. This, of course, can lead to death.


A more recent study involving 159 healthcare workers aged 21 to 35 years of age found that 81% developed headaches from wearing a face mask.3 Some had pre-existing headaches that were precipitated by the masks. All felt like the headaches affected their work performance.


Unfortunately, no one is telling the frail elderly and those with lung diseases, such as COPD, emphysema or pulmonary fibrosis, of these dangers when wearing a facial mask of any kind—which can cause a severe worsening of lung function. This also includes lung cancer patients and people having had lung surgery, especially with partial resection or even the removal of a whole lung.

While most agree that the N95 mask can cause significant hypoxia and hypercapnia, another study of surgical masks found significant reductions in blood oxygen as well. In this study, researchers examined the blood oxygen levels in 53 surgeons using an oximeter. They measured blood oxygenation before surgery as well as at the end of surgeries.4 The researchers found that the mask reduced the blood oxygen levels (pa02) significantly. The longer the duration of wearing the mask, the greater the fall in blood oxygen levels.


The importance of these findings is that a drop in oxygen levels (hypoxia) is associated with an impairment in immunity. Studies have shown that hypoxia can inhibit the type of main immune cells used to fight viral infections called the CD4+ T-lymphocyte. This occurs because the hypoxia increases the level of a compound called hypoxia inducible factor-1 (HIF-1), which inhibits T-lymphocytes and stimulates a powerful immune inhibitor cell called the Tregs. . This sets the stage for contracting any infection, including COVID-19 and making the consequences of that infection much graver. In essence, your mask may very well put you at an increased risk of infections and if so, having a much worse outcome.5,6,7


People with cancer, especially if the cancer has spread, will be at a further risk from prolonged hypoxia as the cancer grows best in a microenvironment that is low in oxygen. Low oxygen also promotes inflammation which can promote the growth, invasion and spread of cancers.8,9 Repeated episodes of hypoxia has been proposed as a significant factor in atherosclerosis and hence increases all cardiovascular (heart attacks) and cerebrovascular (strokes) diseases.10


There is another danger to wearing these masks on a daily basis, especially if worn for several hours. When a person is infected with a respiratory virus, they will expel some of the virus with each breath. If they are wearing a mask, especially an N95 mask or other tightly fitting mask, they will be constantly rebreathing the viruses, raising the concentration of the virus in the lungs and the nasal passages. We know that people who have the worst reactions to the coronavirus have the highest concentrations of the virus early on. And this leads to the deadly cytokine storm in a selected number.


It gets even more frightening. Newer evidence suggests that in some cases the virus can enter the brain.11,12 In most instances it enters the brain by way of the olfactory nerves (smell nerves), which connect directly with the area of the brain dealing with recent memory and memory consolidation. By wearing a mask, the exhaled viruses will not be able to escape and will concentrate in the nasal passages, enter the olfactory nerves and travel into the brain.13


It is evident from this review that there is insufficient evidence that wearing a mask of any kind can have a significant impact in preventing the spread of this virus. The fact that this virus is a relatively benign infection for the vast majority of the population and that most of the at-risk group also survive, from an infectious disease and epidemiological standpoint, by letting the virus spread through the healthier population we will reach a herd immunity level rather quickly that will end this pandemic quickly and prevent a return next winter. During this time, we need to protect the at-risk population by avoiding close contact, boosting their immunity with compounds that boost cellular immunity and in general, care for them.


One should not attack and insult those who have chosen not to wear a mask, as these studies suggest that is the wise choice to make.


References


  1. bin-Reza F et al. The use of mask and respirators to prevent transmission of influenza: A systematic review of the scientific evidence. Resp Viruses 2012;6(4):257-67.
  2. Zhu JH et al. Effects of long-duration wearing of N95 respirator and surgical facemask: a pilot study. J Lung Pulm Resp Res 2014:4:97-100.
  3. Ong JJY et al. Headaches associated with personal protective equipment- A cross-sectional study among frontline healthcare workers during COVID-19. Headache 2020;60(5):864-877.
  4. Bader A et al. Preliminary report on surgical mask induced deoxygenation during major surgery. Neurocirugia 2008;19:12-126.
  5. Shehade H et al. Cutting edge: Hypoxia-Inducible Factor-1 negatively regulates Th1 function. J Immunol 2015;195:1372-1376.
  6. Westendorf AM et al. Hypoxia enhances immunosuppression by inhibiting CD4+ effector T cell function and promoting Treg activity. Cell Physiol Biochem 2017;41:1271-84.
  7. Sceneay J et al. Hypoxia-driven immunosuppression contributes to the pre-metastatic niche. Oncoimmunology 2013;2:1 e22355.
  8. Blaylock RL. Immunoexcitatory mechanisms in glioma proliferation, invasion and occasional metastasis. Surg Neurol Inter 2013;4:15.
  9. Aggarwal BB. Nucler factor-kappaB: The enemy within. Cancer Cell 2004;6:203-208.
  10. Savransky V et al. Chronic intermittent hypoxia induces atherosclerosis. Am J Resp Crit Care Med 2007;175:1290-1297.
  11. Baig AM et al. Evidence of the COVID-19 virus targeting the CNS: Tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci 2020;11:7:995-998.
  12. Wu Y et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behavior, and Immunity, In press.
  13. Perlman S et al. Spread of a neurotropic murine coronavirus into the CNS via the trigeminal and olfactory nerves. Virology 1989;170:556-560.



 

canada-man

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Data lacking to recommend broad mask use

We do not recommend requiring the general public who do not have symptoms of COVID-19-like illness to routinely wear cloth or surgical masks because:


  • There is no scientific evidence they are effective in reducing the risk of SARS-CoV-2 transmission
  • Their use may result in those wearing the masks to relax other distancing efforts because they have a sense of protection
  • We need to preserve the supply of surgical masks for at-risk healthcare workers.

Sweeping mask recommendations—as many have proposed—will not reduce SARS-CoV-2 transmission, as evidenced by the widespread practice of wearing such masks in the Hubai province before and during its mass COVID-19 transmission experience earlier this year. Our review of relevant studies indicates that cloth masks will be ineffective at preventing SARS-CoV-2 transmission, whether worn as source control or as PPE.


Surgical masks likely have some utility as source control (meaning the wearer limits virus dispersal to another person) from a symptomatic patient in a healthcare setting to stop the spread of large cough particles and limit the lateral dispersion of cough particles. They may also have very limited utility as source control or PPE in households.
 

TeeJay

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Yeah we all saw how effective wearing masks was in China
It totally nipped that Covid virus thing in the bud and noone got sick


If MILLIONS of Asians wear a mask EVERY DAY then how do you explain the entire pandemic?
 

squeezer

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Jan 8, 2010
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Yeah we all saw how effective wearing masks was in China
It totally nipped that Covid virus thing in the bud and noone got sick


If MILLIONS of Asians wear a mask EVERY DAY then how do you explain the entire pandemic?
I'm going to bite my tongue and not say what I really want to say so instead I'll just post some facts

CHINA CURRENTLY INFECTED CASES 326
USA CURRENTLY INFECTED CASES (I'm not even going to post it because it's ridiculous for you to even mention China's track record on flattening the curve)

1.4 Billion (China Population)
328 Million (Trumpfart land)

Sorry Teejay, you're right masks do jack shit.
 

lenny2

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Jan 18, 2012
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Data lacking to recommend broad mask use

We do not recommend requiring the general public who do not have symptoms of COVID-19-like illness to routinely wear cloth or surgical masks because:


  • There is no scientific evidence they are effective in reducing the risk of SARS-CoV-2 transmission
  • Their use may result in those wearing the masks to relax other distancing efforts because they have a sense of protection
  • We need to preserve the supply of surgical masks for at-risk healthcare workers.

Sweeping mask recommendations—as many have proposed—will not reduce SARS-CoV-2 transmission, as evidenced by the widespread practice of wearing such masks in the Hubai province before and during its mass COVID-19 transmission experience earlier this year. Our review of relevant studies indicates that cloth masks will be ineffective at preventing SARS-CoV-2 transmission, whether worn as source control or as PPE.


Surgical masks likely have some utility as source control (meaning the wearer limits virus dispersal to another person) from a symptomatic patient in a healthcare setting to stop the spread of large cough particles and limit the lateral dispersion of cough particles. They may also have very limited utility as source control or PPE in households.

That article is dated April 2/20. However the June 30 update of it states:

"Commentary update: The School of Public Health strongly encourages people follow the guidelines set forth from local, state, and federal public health agencies and supports people wearing cloth face coverings, as required.

We would encourage the funding of research evaluating the impact of face coverings to reduce the transmission of COVID-19. There is no peer-reviewed scientific study to date which demonstrates cloth face coverings reduce transmission of infectious disease as demonstrated in this commentary. Papers that have come out in the last several months primarily claim to show filtration efficiency of cloth materials. In general, these studies do not use a standardized approach for filter testing and/or do not take into account a variety of sized particles or breathing rates of humans. It is likely larger particles generated from coughs and sneezes may be captured in the cloth material while the smaller particles that also may contain disease will simply go straight through or around the cloth material. Additionally, there is no standardization of how the cloth face coverings are produced which is needed to demonstrate a reliable reduction of disease transmission."


Compare:

"Face Masks Against COVID-19: An Evidence Review


Jeremy Howarda,c,1 , Austin Huangb , Zhiyuan Lik , Zeynep Tufekcim, Zdimal Vladimire , Helene-Mari van der Westhuizenf,g , Arne von Delfto,g , Amy Pricen , Lex Fridmand , Lei-Han Tangi,j , Viola Tangl , Gregory L. Watsonh , Christina E. Baxs , Reshama Shaikhq , Frederik Questierr , Danny Hernandezp , Larry F. Chun , Christina M. Ramirezh , and Anne W. Rimoint


a fast.ai, 101 Howard St, San Francisco, CA 94105, US; bWarren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI 02903; cData Institute, University of San Francisco, 101 Howard St, San Francisco, CA 94105, US; dDepartment of Electrical Engineering & Computer Science, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139; e Institute of Chemical Process Fundamentals, Czech Academy of Sciences, Rozvojová 135, CZ-165 02 Praha 6, Czech Republic; fDepartment of Primary Health Care Sciences, Woodstock Road, University of Oxford, OX2 6GG, United Kingdom; gTB Proof, Cape Town, South Africa; hDepartment of Biostatistics, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095; iDepartment of Physics, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China; jComplex Systems Division, Beijing Computational Science Research Center, Haidian, Beijing 100193, China; kCenter for Quantitative Biology, Peking University, Haidian, Beijing 100871, China; lDepartment of Information Systems, Business Statistics and Operations Management, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China; mUniversity of North Carolina at Chapel Hill; nSchool of Medicine Anesthesia Informatics and Media (AIM) Lab, Stanford University, 300 Pasteur Drive, Grant S268C, Stanford, CA 94305; oSchool of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, 7925, South Africa; pOpenAI, 3180 18th St, San Francisco, CA 94110; qData Umbrella, 345 West 145th St, New York, NY 10031; rVrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; sUniversity of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104; tDepartment of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E Young Drive, Los Angeles, CA 90095


This manuscript was compiled on April 10, 2020...


The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly...


The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both
laboratory and clinical contexts...


"3. Filtering Capability of Masks


...Multiple studies show the filtration effects of cloth masks relative to surgical masks. Particle sizes for speech are on the order of 1 µm (20) while typical definitions of droplet size are 5 µm-10 µm (5). Generally available household materials had between a 49% and 86% filtration rate for 0.02 µm exhaled particles whereas surgical masks filtered 89% of those particles (21). In a laboratory setting, household materials had 3% to 60% filtration rate for particles in the relevant size range, finding them comparable to some surgical masks (22). In another laboratory setup, a tea cloth mask was found to filter 60% ofparticles between 0.02 µm to 1 µm, where surgical masks filtered 75% (23). Dato et al (2006) (24), note that "quality commercial masks are not always accessible." They designed and tested a mask made from heavyweight T-shirts, finding that it "offered substantial protection from the challenge aerosol and showed good fit with minimal leakage".Although cloth and surgical masks are primarily targeted towards droplet particles, some evidence suggests they may have a partial effect in reducing viral aerosol shedding (25).


When considering the relevance of these studies of ingress, it’s important to note that they are likely to substantially underestimate effectiveness of masks for
source control. When someone is breathing, speaking, or coughing, only a tiny amount of what is coming out of their mouths is already in aerosol form. Nearly all of what is being emitted is droplets. Many of these droplets will then evaporate and turn into aerosolized particles that are 3 to 5-fold smaller. The point of wearing a mask as source control is largely to stop this process from occurring, since big droplets dehydrate to smaller aerosol particles that can float for longer in air (26).


Anfinrud et al (6) used laser light-scattering to sensitively detect droplet emission while speaking. Their analysis showed that virtually no droplets were "expelled" with a homemade mask consisting of a washcloth attached with two rubber bands around the head, while significant levels were expelled without a mask. The authors stated that "wearing any kind of cloth mouth cover in public by every person, as well as strict adherence to distancing and handwashing, could significantly decrease the transmission rate and thereby contain the pandemic until a vaccine becomes available."


An important focus of analysis for public mask wearing is droplet source control. This refers to the effectiveness of blocking droplets from an infectious person, particularly during speech, when droplets are expelled at a lower pressure and are not small enough to squeeze through the weave of a cotton mask. Many recommended cloth mask designs also include a layer of paper towel or coffee filter, which could increase filter effectiveness for PPE, but does not appear to be necessary for blocking droplet emission (6, 27, 28).


In summary, there is laboratory-based evidence that household masks have some filtration capacity in the relevant droplet size range, as well some efficacy in
blocking droplets and particles from the wearer (26). That is, these masks help people keep their droplets to themselves.


4. Mask Efficacy Studies


Although no randomized controlled trials (RCT) on the use of masks as source control for SARS-CoV-2 has been published, a number of studies have attempted to indirectly estimate the efficacy of masks. Overall, an evidence review (29) finds "moderate certainty evidence shows that the use of handwashing plus masks probably reduces the spread of respiratory viruses."


The most relevant paper (30), with important implications for public mask wearing during the COVID-19 outbreak, is one that compares the efficacy of surgical masks for source control for seasonal coronavirus, influenza, and rhinovirus. With ten participants, the masks were effective at blocking coronavirus droplets of all sizes for every subject. However, masks were far less effective at blocking rhinovirus droplets of any size, or of blocking small influenza droplets. The results suggest that masks may have a significant role in source control for the current coronavirus outbreak. The study did not use COVID-19 patients, and it is not yet known whether seasonal coronavirus behaves the same as SARS-CoV-2; however, they are of the same genus, so similar behavior is likely.


Another relevant (but under-powered, with n=4) study (31) found that a cotton mask blocked 96% (reported as 1.5 log units or about a 36-fold decrease) of viral load on average, at eight inches away from a cough from a patient infected with COVID-19. If this is replicated in larger studies it would be an important result, because it has been shown (32) that "every 10-fold increase in viral load results in 26% more patient deaths" from "acute infections caused by highly pathogenic viruses".


A comparison of homemade and surgical masks for bacterial and viral aerosols (21) observed that "the median-fit factor of the homemade masks was one-half that of the surgical masks. Both masks significantly reduced the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask." Research focused on aerosol exposure has found all types of masks are at least somewhat effective at protecting the wearer. Van der Sande et al (33) found that "all types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity", and concluded that "any type of general mask use is likely to decrease viral exposure and infection risk on a population level, despite imperfect fit and imperfect adherence". Overall however, analysis of particle filtration is likely to underestimate the effectiveness of masks, since the fraction of particles that are emitted as aerosol (vs. droplet) is quite small (26). Analysis of seasonal coronavirus compared to rhinovirus (30) suggests that filtration of COVID-19 may be much more effective, especially for source control.


The importance of using masks for health care workers has been observed (34) in three Chinese hospitals where, in each hospital, medical staff wearing masks (mainly in quarantine areas) had no COVID-19 infections, despite being around COVID-19 patients far more often, whilst other medical staff had 10 or more infections in each of the three hospitals.


Masks seem to be effective for source control in the controlled setting of an airplane. One case report (35) describes a man who flew from China to Toronto and then tested positive for COVID-19. He was wearing a mask during the flight. The 25 people closest to him on plane/flight attendants were tested and all were negative. Nobody has been reported from that flight as getting COVID-19. Another case study involving a masked influenza patient on an airplane (36) found that
"wearing a face mask was associated with a decreased risk for influenza acquisition during this long-duration flight".


Guideline development for health worker personal protective equipment have focused on whether surgical masks or N95 respirators should be recommended. Most of the research in this area focuses on influenza. At this point, it is not known to what extent findings from influenza studies apply to COVID-19 filtration. Wilkes et al (37) found that "filtration performance of pleated hydrophobic membrane filters was demonstrated to be markedly greater than that of electrostatic filters." However, even substantial differences in materials and construction do not seem to impact the transmission of droplet-borne viruses in practice, such as a metaanalysis of N95 respirators compared to surgical masks (38) that found "the use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratoryconfirmed influenza." Johnson et al (39) showed that "surgical and N95 masks were equally effective in preventing the spread of PCR-detectable influenza". Radonovich et al (40) found in an outpatient setting that "use of N95 respirators, compared with medical masks... resulted in no significant difference in the rates of laboratory-confirmed influenza."


One of the most frequently mentioned papers evaluating the benefits and harms of cloth masks have been by MacIntyre et al (41). Findings have been
misinterpreted, and therefore justify detailed discussion here. The authors "caution against the use of cloth masks" for healthcare professionals compared
to the use of surgical masks and regular procedures, based on an analysis of transmission in hospitals in Hanoi. We emphasize the setting of the study - health workers using masks to protect themselves against infection. The study compared a "surgical mask" group which received 2 new masks per day, to a "cloth mask" group that received 5 masks for the entire 4week period and were required to wear the masks all day, to a "control group" which used masks in compliance with existing hospital protocols, which the authors describe as a "very high level of mask use". It is important to note that the authors did not have a "no mask" control group because it was deemed "unethical to ask participants to not wear a mask." The study does not inform policy pertaining to public mask wearing as compared to the absence of masks in a community setting, since there is not a "no mask" group. The results of the study show that the group with a regular supply of new surgical masks each day had significantly lower infection of rhinovirus than the group that wore a limited supply of cloth masks. This paper lends support to the use of clean, surgical masks by medical staff in hospital settings to avoid rhinovirus infection by the wearer, and is consistent with other studies that show cloth masks provide poor filtration for rhinovirus (30). Its implementation does not inform the effect of using cloth masks versus not using masks in a community setting for source control of SARS-CoV-2, which is of the same genus as seasonal coronavirus, which has been found to be effectively filtered by cloth masks in a source control setting (30).


A. Studies of Impact on Community Transmission.


When evaluating the available evidence for the impact of masks on community transmission, it is critical to clarify the setting of the research study (health care facility or community), the respiratory illness being evaluated and what reference standard was used (no mask or surgical mask). There are no RCTs that have been done to evaluate the impact of masks on community transmission during a coronavirus pandemic. While there is some evidence from influenza outbreaks, the current global pandemic poses a unique challenge. A review (42) of 67 studies including randomized controlled trials and observational studies found that simple and lowcost interventions would be useful for reducing transmission of epidemic respiratory viruses. The review recommended that "the following effective interventions should be implemented, preferably in a combined fashion, to reduce transmission of viral respiratory disease: 1. frequent handwashing with or without adjunct antiseptics; 2. barrier measures such as gloves, gowns, and masks with filtration apparatus; and 3. suspicion diagnosis with the isolation of likely cases". However, it cautioned that routine longterm implementation of some measures assessed might be difficult without the threat of an epidemic."


 
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lenny2

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Jan 18, 2012
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Yeah we all saw how effective wearing masks was in China
It totally nipped that Covid virus thing in the bud and noone got sick


If MILLIONS of Asians wear a mask EVERY DAY then how do you explain the entire pandemic?
That's like saying..."look how useless condoms are...if they were of any use why haven't STIs been eliminated in cases where condoms were used?"
 
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canada-man

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Jun 16, 2007
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“This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally.”


Healthy people wearing masks. These days you see them everywhere. But according to Patricia Neuenschwander, M.S.N., R.N., C.P.N.P.-P.C., an emergency room nurse with over two decades of experience, the science doesn’t support healthy people wearing masks. When Neuenschwander found out that her grandchild’s Montessori preschool was going to require even toddlers to wear masks, she did a deep dive into the research to better educate herself and her grandchild’s school about mask-wearing.




Could We Please Have at Least ONE Aspect of COVID-19 Public Health Policy Founded on SCIENCE? By James Lyons Weiler Ph.D


Citing a number of studies with an overall conclusion that, “Science does not support the use of masks in public spaces to reduce transmission of viruses the size of SARS-CoV-2. Pores in N95 masks are 95 microns in size, the virus is far smaller than that. Could We Please Have at Least ONE Aspect of COVID-19 Public Health Policy Founded on SCIENCE?”


“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 use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory-confirmed influenza.”





Covid-19 Face Masks by Roman Bystrianyk
“Historically, in any type of epidemic, only the infected would wear a mask, not all those who are not sick. This type of unscientific recommendations has never been used to contain any other virus pandemic or epidemic in history. So why are face masks being mandated for this virus where most people experience no or very mild symptoms?”




New Study Questions Effectiveness Against SARS CoV-2 by Medical News Today
“Research published at the beginning of April casts serious doubts about the effectiveness of both surgical and cloth masks in preventing the spread of infectious SARS-CoV-2 particles.”



The Science of The Impact of Wearing Masks By James Lyons Weiler Ph.D
“Public health policy should be founded on science. We’ve already seen how study after study show that masks do not reduce transmission in public spaces. Now it appears that a study from 2015 found that wearing cloth masks increases respiratory infections.”



To citizens wearing medical masks; You’re whacko conspiracy theorists By Jon Rappoport
“Mask wearers of the world, take them off—you have nothing to lose but your insanity… Journal of the American Medical Association, April 17, 2020, “Masks and Coronavirus Disease”. “Unless you are sick, a health care worker, or caring for someone who has COVID-19, medical masks (including surgical face masks and N95s) are not recommended.” Jon also reports on masks being recycled and disinfected with toxic chemicals with this quote from the Washington State Nurses Association: “Nurses are reporting that respirators and face masks at WSNA represented Providence facilities are being collected for reprocessing using ethylene oxide to decontaminate. The EPA has concluded that ethylene oxide is carcinogenic to humans and that exposure to ethylene oxide increases the risk of lymphoid cancer and, for females, breast cancer. Reprocessing masks using toxic chemicals is not a solution”
 
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