Although, it seems probable that masks and isolation during COVID played a major role.
"Following widespread adoption of community mitigation measures to reduce transmission of SARS-CoV-2, the virus that causes COVID-19, the percentage of U.S. respiratory specimens submitted for influenza testing that tested positive decreased from >20% to 2.3% and has remained at historically low interseasonal levels (0.2% versus 1–2%). Data from Southern Hemisphere countries also indicate little influenza activity."
"In the United States, influenza virus circulation declined sharply within 2 weeks of the COVID-19 emergency declaration and widespread implementation of community mitigation measures, including school closures, social distancing, and mask wearing." (This is from the CDC Report:
Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020. Weekly / September 18, 2020 / 69(37);1305–1309)
It's frustrating we don't know the magnitude of the effect of each of those interventions though. And that both of those interventions seem to have been wildly effective for Influenza, but not for Covid.
I have a question for Dr Marine - what are your thoughts and additionally do you know of any recent research papers on the efficacy of masking to prevent spread if you yourself are sick with ILI? Without having looked too deeply into this question myself (optimistically yet, but realistically probably not with uni kicking off again soon) I seem to remember there being some consensus that surgical masks were practical in the operating room to prevent source infection from the doctors and nurses to the patient. Is this still the case?
If I can recount a personal anecdote on this very question - on a recent international flight I was seated next to a stranger who was very clearly unwell with ILI (I tried to tell myself maybe she just had hayfever), had a surgical mask tucked into a pocket on her handbag and did not once wear it. Within 48hrs I myself became unwell with what seemed to be similar symptoms to my seat neighbour. On my way home a few days later, I was still in the midst of this lovely head cold, and wore a P2 mask on the flight to try and not pass on my germs to any other poor sucker seated near me. Is there any point to doing this?
There may have been more recent work, but I think the consensus is that there is no statistical difference in wound infection. The trials are limited though.
A properly-fitted N95 mask can be protective for the person harboring the virus as well as those nearby. In a hospital setting, when we are fitted and tested, proof of adequate fit is confirmed when a noxious odor is sprayed into a sac covering one's head; lack of sensing the odor is confirmation of a successful fit. Unfortunately, many masks are simply not too helpful due to suboptimal seal or sometimes the error of wearing a vented dust mask which filters incoming dust but vents the virus right out from the wearer's mouth and nose. The criticism of masks is wellfounded and due to a lack of effective material and seal.
It's like trying to stop the transmission of HIV with condoms when three quarters of the population has been given condoms that they don't know are full of holes.
And they haven't been taught they have to unroll them when they put them on.
We told people to use flawed and leaky cloth and surgical masks without making it clear they leak (condom holes)
Then when we asked them to upgrade to respirators we gave little to no instruction on fit testing or donning and doffing (unrolling condom).
I think we can take it as read that we'll fitted PPE, designed and tested for it's job, and used properly does what it says it does.
(Edit: I've just realized I've been replying to *you* all over this thread. Nothing personal, and thank you for not seeming to take it that way. This topic really "triggers" me. Once I break the seal I can't shut up about it. I'm now going to push thoughts of this back down into a tight little ball in my stomach and seal it up until the next time it escapes 😄)
That's interesting...thank-you. However, I'm still wondering what factor led to the flattening of the flu curve during the COVID pandemic. (Was it the masks and isolation?)
I don't think we know. Sadly we refused to "do the work".
The flu is particularly interesting epidemiologically though, since novel seasonal strains routinely appear in East and South-East Asia first and make their way Westward to Europe and North-America from there.
So, early and strong social-distancing locally in countries in that area, as well as complete travel bans to Europe and the Americas from them may have delayed flu transmission for a season even if European and American efforts regarding masks and social-distancing happened to be completely worthless.
There's some suggestion that's the case, since famously "lax" Sweden, with little to no mask and social-distancing requirements also had no seasonal flu in '20-'21 either (only 29 cases).
In a lot of ways I think we came out of the pandemic knowing less than when we went in.
Masking is purely about catering to the vocal minority, hospital admin public relations, and mask pandering.
Surgical type masks are pointless with respiratory aerosoles. N95 or equivalent are marginally less useless depending on IF used appropriately.
Here is the rubber meets the road comment:
If surgical masks are efficacious enough to prevent infection by aerosolized pathogens that mandates can be assigned, then why do BSL4 labs researching aerosolized pathogens use ALOT more PPE than a simple surgical mask or even N95?
Its all kabuki theater.
No N95 or surgical mask manufacturer can market that their PPE is protective nor can the manufacturers testify under oath that the masks are effective... neither can any hospital admin.
Its akin to the "unavoidably unsafe" legal.speak with respect to vaccines. Masks are unavoidably ineffective.
However, I would not put N95 in that category. Of course, those are not what the mandates require. And I agree with the stipulation of “properly fitted and worn”.
Interesting they did not specifically say fitted N95 or KN95 masks only. Apparently by not denoting the type of mask people can go back to making their own masks or using the paper ones with ear strips. Have not seen a person who wears it correctly in a long time. Even correctly why isn't anyone saying if you're not getting fitted with a K95, just forget it. Cite the science.
Having traveled to Japan and Taiwan many times over the past 20 years, masking does not seem to be a problem for those cultures. Perhaps we could learn something from them?
Yeah, I'm for complete personal freedom...I hate to stop for red lights and stop signs and I'm real smart...I can judge for myself...why should anyone who doesn't realize how careful I am dare tell me to stop when I know I'm a better judge of the situation; and there's no scientific study indicating that smart people like me should obey the law.
good thing Trump won otherwise you would be headed to the gulag never to be seen again even with the change its still difficult to speak truth to the unknowing powers at be most people don't have a clue why they are called surgical mask Doc
I'll admit that I have walked in the street with an N95 on. Getting out of crowded public transit and going into a shop. Or when I a go in and out of several shops. I prefer to avoid manipulating my mask...
Have you read the material regarding how they are essentially useless?
REPUTABLE healthcare providers tried to provide helpful information but were
shoved aside while Fauci called it symbolic as he sat elbow to elbow with others
in bleachers of some ball field. . .maskless
The part about having done nothing to contain Spanish Flu is even more
demonstrative of what it all means. . .masks, distancing and lockdowns that destroyed lives not only economically but many took their lives due to despair of having lost
everything.
However, in the case of lone individuals who wear them . . .
I am speaking of not another human being within blocks when I have seen them on the street walking or riding a bike (just passing traffic). . .Do they think it will swoop down on them like some sort of raptor and attack them?
In 2020 during a research regarding the jab (opted for an alternative protocol) I found the information
I would never have worn a mask or distanced had it not been for facing a horde of drones who not only eagerly complied but shrieked loudly at anyone who refused.
When little girl governor Katie told us to stay home U went out everyday, something I ordinarily don't do even now
The key was opting for RATIONAL preventive measures in the protocol I used, by same experts who pushed, and still do, the jab and the rest which did nothing to contain Spanish Flu
The newsletters from reputable were full of information
about what the issues were in pushing masks, distancing and lockdowns
I adopted in '20 an alternative protocol outlined by my naturopath
While 3 friends died and several have been infected more than once, one hospitalized, I have yet to have a sniffle in almost 5 years and last month turned 83
The common denominator for the friends?
All fully jabbed
I can tell you what wearing masks did for me
I had elevate carbon dioxide which was documented in blood work over a 2 year period
When we lived in Asia, father was military, it was common to see masks for colds etc.
Years ago when I had pneumonia my naturopath advised a N95 if I needed to go out not only to protect others but also to protect myself from picking up something else
which were pointed to by the CDC as resources for people concerned about the recent L.A. wildfires.
Written in 2021, deep in COVID, they include such gems as:
* "Cloth (wet or dry), paper masks or tissues will NOT filter out wildfire smoke"
* "Respirators are NOT designed to fit children"
* "Facial hair prevents proper fit and effectiveness"
* " Wearing a respirator can make it harder to breathe. If you have heart or lung problems, ask your doctor before using a respirator."
Given that the dangerous particle size in wildfire smoke is < 2.5um and aerosolized virus particles are below that size, it's hard for me to understand how the CDC and the EPA didn't apply and publish the same caveats to masking for biological protection. Especially since a virus replicates, therefore presumably needs a smaller "dose" to cause harm.
Anyway, had to get those articles off my chest. I hate this topic.
Another example of why we should eliminate all "public health" agencies. Calling for controlled studies of seasonal respiratory disorders is unrealistic. They require accurate data. The tests for causative agents in URIs are too inaccurate to be used for scientific studies. The incidence of the disorders is basically a guess as most people do not seek medical attention for minor illnesses they have dealt with throughout their lives. Hospitalizations and emergency room visits are likely proportional to the amount of scare talk the media provides. Death certificates' listed cause of death have always been notoriously unreliable. Government subsidies to hospitals that learn to "code" correctly have multiplied this unreliability tremendously. But the real joker in the deck is that all the "public health" rules and regulations focus on limiting communicability---something that has never been proven scientifically despite a number of attempts in the past. People have been able to deal with these seasonal illnesses quite well through the years by employing their own common sense measures. Getting rid of the public health bureaucracies would be a good first step in order to return to sanity.
A possible cohort study of states that did and states that didn't mask, comparing the base rates of infection, rates of transmission, should be possible. Hospital admissions were covid screened, supposedly, exclude non-respiratory admissions (ie the motorcyclist who was admitted to trauma after a crash who tested positive before admission) who were positive. The key would be finding institutions who screened prior to admission (negatives) and prior to discharge (positive conversions), and compare those rates between the states with different policies.
I suspect that data won't be available or reliable, though, since it appears we cured the common cold as most of them became covid cases.
(See Naquin, A. et al, Morbidity and Mortality Weekly Report Surv.Summ. 2024 Oct 31; 73(6):1-18).
But it looks like the cold and flu are bouncing back, so maybe we can get a prospective study in comparing states like MD to other states with similar climates, and population densities that don't do this.
They would have to start by measuring the problem of nosocomial transmission of respiratory viruses in acute healthcare settings. Not clear to me that they even know what problem they are trying to solve. They should probably start with cluster randomized trials in nursing homes/chronic care facilities.
Tracy, a point made earlier was the fact that the annual seasonal flu spike, which killed many people each year including children, did not occur during the COVID isolation...most likely due to the isolation and masking (despite poor quality masking). So, those lives were saved.
Precisely correct. But you have to convince the state officials that they're not particularly astute. That's why I made a comment in 2020 at an interdisciplinary conference discussion the COVID response at the hospital that we'd cured the common cold. We didn't of course, but the cold/flu admit dx were all Covid, which may or may not have had any relationship to reimbursement rates. But, Maryland has given us the opportunity to prove them wrong again and fund a research resident for a year.
A public health intervention *always* takes place in a context anyway. A population wide intervention can't be divorced from the population's adherence.
The valid study *is* one in which in real life most people don't wear masks properly. At this time and place. In this context.
I would add to your questioning....at what point does the mask transition from help to harm, and under what circumstances. See, the problem here is that everyone is treating masks as if they are an Engineering Control ( Hierarchy Of Controls) You just put it on and it turns on and runs all day till you take it off. They are PPE, not Engineering....and with PPE there is a massive human behavior component that must exist, before the material an design can even do its job ( think of a spoon...its designed to carry soup into your mouth...but all that design isn't going to do diddly if you put the spoon in the bowl upside down and in your mouth upside down.)...remember how when you go to work at the hospital you have to don and doff all of your PPE a certain procedural way?...yeah thats what all that busienss is about...its the behaviour mechanism of the PPE functionality. its about Contamination. THAT is the key....in addition, everyone ...both for and against masks all have one thing in common...they all are hell bent sure that the masks are the thing producing the data...yet NONE of them have ever qualified that assumption.....well we have science on this (Exposure Science) which tells us the order of strength of any possible harm mitigation...and PPE is dead last against literally everything else you can even think of....opening windows, the wind blowing....literally everything else in a given study playfield is doing more toward prevention than masks....so the big question you and everyone else all STILL haven't answered is to qualify where your data is coming from. and Finally, you have to think of masks as if they were a band aid. ...band aids have filtration and absorption mechanics in their design ( the padding)...and all of this mask talk is exactly like people arguing whether to keep using the same bandaid on all your cuts because it still has absorption ability....but we all know THAT is stupid?...and why?...because of contamination. ....now apply that understanding to masks. If you want to do an RCT on masks....forget the stupid filtration crap...especially if your not going to ever acknowledge all of the other things happening around the masks....just test the masks surfaces, and the argument will be over....people will understand...oh, ok...masks are like bandaids...or dishtowels that were just used to wipe up raw chicken...or poop stained diapers....etc. Your welcome.
I was sad to hear so little from industrial hygienists during this debate. Either for *or* against masking. It's a profession uniquely qualified to weigh in.
In the same vein as your question about the positive harms of masking, I've often wondered, given the age-mortality gradient of COVID, what damage was done if we convinced elderly people they could resume normal life as long as they wore an, at best, partially effective mask.
Having worked during the recent pandemic as an APRN, I agree that masking is difficult and creates challenges to many- however, I wore a mask throughout as a courtesy to my patients and their families, as well as my own family members at risk. Do we always know if we are walking into a room with someone with a co-morbidity such as suppressed immunity, or perhaps they had a family member at home with this and were at greater risk from potential airborne infection? Washing hands before, during and after patient contact, and being mindful of staff practices as well I am sure reduced the potential for spread of infection. Patient's are not always honest when asked about recent or concurrent URI symptoms. When a patient is politely advised of the reasons to wear a mask, they usually submit. There is no reason to politicize this catastrophic infection or any other and sometimes, well constructed studies to prove something are just too slow and too difficult to conduct in real time.... I support the use of masks and honestly, if I were undergoing a surgical procedure, I would expect my surgeon and technicians to have the courtesy to protect me from their runny noses, their sneezes and their coughs....somehow this just makes sense.
Surgical masks are less meant to protect the patient from the surgeon but to protect the surgeon and others from splash contamination, which is very common in a surgical theater.
Julie, I think there's actually very little evidence that mask wearing does much in surgery - definitely not for anyone else but the surgeon, and I'm not sure that we have any hard evidence that it makes much difference if they're wearing one either! So if that's the crux of your point, it's a very weak one. We mask in surgery because it's a convention, not because we have any convincing peer reviewed evidence that it actually does anything. Sucked in by biological plausibility yet again...
You are certainly entitled to an opinion on the use of masks in a health care setting. Let us not confuse opinion with fact here. Perhaps you would like to comment further and be specific about what you believe to be a "lie" as it relates to the importance of masks in reducing the transmission of certain infectious diseases. I can certainly cite recent studies and reviews about the effectiveness of respirators/surgical masks. Let me know if you would like to see the data. Civil exchange is welcome.
Just one brief question: Do you realize that surgery, where an incision is made creating a potential transmission route that *does not exist in nature*, is a very different case from a simple office visit? That’s why surgical teams have worn masks for decades, maybe even centuries, even at times when masking in other contexts was unheard-of. (Ditto for dentistry and other procedures requiring you to work inside the patient’s open mouth). It disturbs me that a degreed health professional can lose sight of such elementary distinctions.
A simple office visit is a rare event these days. And yes, working in the outpatient setting is very different than a surgical suite and oncology unit or ICU. If you are given a choice of walking into an exam room to see a patient who has respiratory symptoms, mild or severe, acute or chronic, would you yourself choose to err on the side of caution and wear a mask in that setting? Or would you roll the dice and hope the patient does not have TB or RSV? And your next patient is a mom with her baby who was recently discharged from the NICU due to prematurity....Think about that. The variables on any given day in any given setting are vast. That is my distinction for you to ponder.
Julie, it seems you see this as a simple, dramatic moral question: “Do we care enough to protect our patients and ourselves from harm?”
This would make sense if it were supported by the facts. You assume that if Patient #1 has a respiratory virus and you don’t mask, you WILL catch it – and transmit it to the baby (seroconversion within 15 minutes I guess!). If you do mask, you WILL NOT catch it and will keep everyone safe.
If wearing a disposable N95 were really that kind of magic talisman, I think we would have known it long, long before 2020. But it’s not, and to believe this requires something much closer to religious faith than scientific confidence.
The closest we have to solid evidence, I think, is that Cochrane Review meta-analysis from 2022 – which failed to find a significant benefit. That matches my own “anecdotal” experience. Particularly since the dawn of the Omicron Era three years ago, which forced me to face facts: the Covid virus was definitely aerosolized (not droplets), and masking was clearly pretty feeble to prevent its spread. Luckily, it had also become much less lethal.
So what can we say? As you put it, “the variables on any given day in any given setting are vast.” Are you sitting across a desk from me; briefly putting a stethoscope to my back; leaning in for a long hard look at my tonsils; or opening up my abdominal cavity with a scalpel? Am I sniffing slightly every five minutes, or sneezing and coughing uncontrollably? How old or young, how healthy or fragile are each of us? And what is circulating in the community: Tuberculosis, or RSV? There’s a difference, you know.
It may be that wearing an N95 makes transmission of “a respiratory virus” at least 8% less likely. Maybe even 12%. Depending on the circumstances. So, if I am bending low over a newborn, premature baby, perhaps it makes sense to invoke every protection possible: masks, latex gloves, alcohol wipes, maybe even grandma’s rosary.
But if I am sitting in my PCP’s office trying my best to hear and speak clearly, breathe freely and produce an accurate blood-pressure reading so he can figure out what's ailing me? In that case I think it makes sense to let my PCP use his clinical judgment (and let us do some shared decision-making) rather than impose a mandate on either of us.
Stupid never dies until the head is cut off and a stake driven through it’s heart. Even then, some fool always wants to pull the stake out, because “ now, we know how to do it right!”
Although, it seems probable that masks and isolation during COVID played a major role.
"Following widespread adoption of community mitigation measures to reduce transmission of SARS-CoV-2, the virus that causes COVID-19, the percentage of U.S. respiratory specimens submitted for influenza testing that tested positive decreased from >20% to 2.3% and has remained at historically low interseasonal levels (0.2% versus 1–2%). Data from Southern Hemisphere countries also indicate little influenza activity."
"In the United States, influenza virus circulation declined sharply within 2 weeks of the COVID-19 emergency declaration and widespread implementation of community mitigation measures, including school closures, social distancing, and mask wearing." (This is from the CDC Report:
Decreased Influenza Activity During the COVID-19 Pandemic — United States, Australia, Chile, and South Africa, 2020. Weekly / September 18, 2020 / 69(37);1305–1309)
It's frustrating we don't know the magnitude of the effect of each of those interventions though. And that both of those interventions seem to have been wildly effective for Influenza, but not for Covid.
I have a question for Dr Marine - what are your thoughts and additionally do you know of any recent research papers on the efficacy of masking to prevent spread if you yourself are sick with ILI? Without having looked too deeply into this question myself (optimistically yet, but realistically probably not with uni kicking off again soon) I seem to remember there being some consensus that surgical masks were practical in the operating room to prevent source infection from the doctors and nurses to the patient. Is this still the case?
If I can recount a personal anecdote on this very question - on a recent international flight I was seated next to a stranger who was very clearly unwell with ILI (I tried to tell myself maybe she just had hayfever), had a surgical mask tucked into a pocket on her handbag and did not once wear it. Within 48hrs I myself became unwell with what seemed to be similar symptoms to my seat neighbour. On my way home a few days later, I was still in the midst of this lovely head cold, and wore a P2 mask on the flight to try and not pass on my germs to any other poor sucker seated near me. Is there any point to doing this?
There may have been more recent work, but I think the consensus is that there is no statistical difference in wound infection. The trials are limited though.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002929.pub3/full
Very happy to be enlightened if there's newer work that counters this.
A properly-fitted N95 mask can be protective for the person harboring the virus as well as those nearby. In a hospital setting, when we are fitted and tested, proof of adequate fit is confirmed when a noxious odor is sprayed into a sac covering one's head; lack of sensing the odor is confirmation of a successful fit. Unfortunately, many masks are simply not too helpful due to suboptimal seal or sometimes the error of wearing a vented dust mask which filters incoming dust but vents the virus right out from the wearer's mouth and nose. The criticism of masks is wellfounded and due to a lack of effective material and seal.
Sadly, yes.
It's like trying to stop the transmission of HIV with condoms when three quarters of the population has been given condoms that they don't know are full of holes.
And they haven't been taught they have to unroll them when they put them on.
Yes...but I'm not sure if the analogy fits.
Dunno. I think it's pretty apt.
We told people to use flawed and leaky cloth and surgical masks without making it clear they leak (condom holes)
Then when we asked them to upgrade to respirators we gave little to no instruction on fit testing or donning and doffing (unrolling condom).
I think we can take it as read that we'll fitted PPE, designed and tested for it's job, and used properly does what it says it does.
(Edit: I've just realized I've been replying to *you* all over this thread. Nothing personal, and thank you for not seeming to take it that way. This topic really "triggers" me. Once I break the seal I can't shut up about it. I'm now going to push thoughts of this back down into a tight little ball in my stomach and seal it up until the next time it escapes 😄)
Not at all; I hear you and your opinion matters.
Why was the flu incidence curve flat during the COVID epidemic?
Extraordinarily, Norovirus also reached essentially zero during 2020. Yet it's transmitted primarily through fecal-oral. Food (ha!) for thought.
That's interesting...thank-you. However, I'm still wondering what factor led to the flattening of the flu curve during the COVID pandemic. (Was it the masks and isolation?)
I don't think we know. Sadly we refused to "do the work".
The flu is particularly interesting epidemiologically though, since novel seasonal strains routinely appear in East and South-East Asia first and make their way Westward to Europe and North-America from there.
So, early and strong social-distancing locally in countries in that area, as well as complete travel bans to Europe and the Americas from them may have delayed flu transmission for a season even if European and American efforts regarding masks and social-distancing happened to be completely worthless.
There's some suggestion that's the case, since famously "lax" Sweden, with little to no mask and social-distancing requirements also had no seasonal flu in '20-'21 either (only 29 cases).
In a lot of ways I think we came out of the pandemic knowing less than when we went in.
Joseph.
Masking is purely about catering to the vocal minority, hospital admin public relations, and mask pandering.
Surgical type masks are pointless with respiratory aerosoles. N95 or equivalent are marginally less useless depending on IF used appropriately.
Here is the rubber meets the road comment:
If surgical masks are efficacious enough to prevent infection by aerosolized pathogens that mandates can be assigned, then why do BSL4 labs researching aerosolized pathogens use ALOT more PPE than a simple surgical mask or even N95?
Its all kabuki theater.
No N95 or surgical mask manufacturer can market that their PPE is protective nor can the manufacturers testify under oath that the masks are effective... neither can any hospital admin.
Its akin to the "unavoidably unsafe" legal.speak with respect to vaccines. Masks are unavoidably ineffective.
I agree surgical masks are just for show.
However, I would not put N95 in that category. Of course, those are not what the mandates require. And I agree with the stipulation of “properly fitted and worn”.
Interesting they did not specifically say fitted N95 or KN95 masks only. Apparently by not denoting the type of mask people can go back to making their own masks or using the paper ones with ear strips. Have not seen a person who wears it correctly in a long time. Even correctly why isn't anyone saying if you're not getting fitted with a K95, just forget it. Cite the science.
Thank you so much. Good read.
Having traveled to Japan and Taiwan many times over the past 20 years, masking does not seem to be a problem for those cultures. Perhaps we could learn something from them?
The issue is involuntary masking. If anyone feels more comfortable, wearing a mask, that is OK with me.
Yeah, I'm for complete personal freedom...I hate to stop for red lights and stop signs and I'm real smart...I can judge for myself...why should anyone who doesn't realize how careful I am dare tell me to stop when I know I'm a better judge of the situation; and there's no scientific study indicating that smart people like me should obey the law.
I think it would be instructive to ask them, pre-covid, why and when they wore masks. I think that's how you learn.
good thing Trump won otherwise you would be headed to the gulag never to be seen again even with the change its still difficult to speak truth to the unknowing powers at be most people don't have a clue why they are called surgical mask Doc
locally some are wearing them in cars ALONE,
on bicycles ALONE,
walking ALONE
The lunacy never ends but given it is Orygun which excels in LUNACY, hardly a shock
I was in line at a store in the fall and sneezed (bad allergies to trees etc. in spring and fall)
People immediately backed away
I said "Calm down, it is only an allergy"
(the checker rolled her eyes)
It was even worse during COVID. . . e.g. when a couple ripped off their
masks as they began to get in their car (was parked next to them so heard and saw the
lunacy up close) the shriek:
"Have you no concern for society?"
Masks, lockdowns and distancing did NOTHING to contain Spanish Flu but
they dragged it all out assuring it would save lives
I'll admit that I have walked in the street with an N95 on. Getting out of crowded public transit and going into a shop. Or when I a go in and out of several shops. I prefer to avoid manipulating my mask...
In my view, people should be allowed to wear on their faces whatever they find comfortable, It is forced masking that is problematic.
Have you read the material regarding how they are essentially useless?
REPUTABLE healthcare providers tried to provide helpful information but were
shoved aside while Fauci called it symbolic as he sat elbow to elbow with others
in bleachers of some ball field. . .maskless
The part about having done nothing to contain Spanish Flu is even more
demonstrative of what it all means. . .masks, distancing and lockdowns that destroyed lives not only economically but many took their lives due to despair of having lost
everything.
However, in the case of lone individuals who wear them . . .
I am speaking of not another human being within blocks when I have seen them on the street walking or riding a bike (just passing traffic). . .Do they think it will swoop down on them like some sort of raptor and attack them?
The alone in a car is even more insane IMO
Rosalee, please provide links to the material...
use for COVID, but Spanish Flu was also a virus:
https://le.utah.gov/publicweb/BRISCJK/PublicWeb/43178/43178.html
https://www.cidrap.umn.edu/covid-19/commentary-masks-all-covid-19-not-based-sound-data
https://www.city-journal.org/article/approximately-zero
Tried to edit the date from my earlier reply.
Should obviously read '20, not '29
So you have no way to research it yourself?
In 2020 during a research regarding the jab (opted for an alternative protocol) I found the information
I would never have worn a mask or distanced had it not been for facing a horde of drones who not only eagerly complied but shrieked loudly at anyone who refused.
When little girl governor Katie told us to stay home U went out everyday, something I ordinarily don't do even now
The key was opting for RATIONAL preventive measures in the protocol I used, by same experts who pushed, and still do, the jab and the rest which did nothing to contain Spanish Flu
What links?
The masks?
Even Fauci admitted they were primarily symbolic
The newsletters from reputable were full of information
about what the issues were in pushing masks, distancing and lockdowns
I adopted in '20 an alternative protocol outlined by my naturopath
While 3 friends died and several have been infected more than once, one hospitalized, I have yet to have a sniffle in almost 5 years and last month turned 83
The common denominator for the friends?
All fully jabbed
I can tell you what wearing masks did for me
I had elevate carbon dioxide which was documented in blood work over a 2 year period
yes, about the masks. You say "Have you read the material regarding how they are essentially useless?"
So I am asking you about links to that material.
Properly wearing an N95 mask is, of course, going to prevent the spread of respiratory diseases.
When we lived in Asia, father was military, it was common to see masks for colds etc.
Years ago when I had pneumonia my naturopath advised a N95 if I needed to go out not only to protect others but also to protect myself from picking up something else
Pursuant to Doran Peck's comment regarding hierarchy of controls, but not really to Dr. Marine's post, I just have to vent about these documents:
https://www.airnow.gov/sites/default/files/2021-12/protect-your-lungs-from-wildfire-smoke-or-ash.pdf
and
https://www.airnow.gov/sites/default/files/2020-02/the-right-respirator-and%20proper-fit-508.pdf
which were pointed to by the CDC as resources for people concerned about the recent L.A. wildfires.
Written in 2021, deep in COVID, they include such gems as:
* "Cloth (wet or dry), paper masks or tissues will NOT filter out wildfire smoke"
* "Respirators are NOT designed to fit children"
* "Facial hair prevents proper fit and effectiveness"
* " Wearing a respirator can make it harder to breathe. If you have heart or lung problems, ask your doctor before using a respirator."
Given that the dangerous particle size in wildfire smoke is < 2.5um and aerosolized virus particles are below that size, it's hard for me to understand how the CDC and the EPA didn't apply and publish the same caveats to masking for biological protection. Especially since a virus replicates, therefore presumably needs a smaller "dose" to cause harm.
Anyway, had to get those articles off my chest. I hate this topic.
Good points - thanks for sharing this.
Fight Fight Fight
The way to end the stupid face diaper mandates is to DISOBEY THEM
Another example of why we should eliminate all "public health" agencies. Calling for controlled studies of seasonal respiratory disorders is unrealistic. They require accurate data. The tests for causative agents in URIs are too inaccurate to be used for scientific studies. The incidence of the disorders is basically a guess as most people do not seek medical attention for minor illnesses they have dealt with throughout their lives. Hospitalizations and emergency room visits are likely proportional to the amount of scare talk the media provides. Death certificates' listed cause of death have always been notoriously unreliable. Government subsidies to hospitals that learn to "code" correctly have multiplied this unreliability tremendously. But the real joker in the deck is that all the "public health" rules and regulations focus on limiting communicability---something that has never been proven scientifically despite a number of attempts in the past. People have been able to deal with these seasonal illnesses quite well through the years by employing their own common sense measures. Getting rid of the public health bureaucracies would be a good first step in order to return to sanity.
I understand the frustration. They do perform some necessary functions, but need radical overhaul. Hopefully soon.
A possible cohort study of states that did and states that didn't mask, comparing the base rates of infection, rates of transmission, should be possible. Hospital admissions were covid screened, supposedly, exclude non-respiratory admissions (ie the motorcyclist who was admitted to trauma after a crash who tested positive before admission) who were positive. The key would be finding institutions who screened prior to admission (negatives) and prior to discharge (positive conversions), and compare those rates between the states with different policies.
I suspect that data won't be available or reliable, though, since it appears we cured the common cold as most of them became covid cases.
(See Naquin, A. et al, Morbidity and Mortality Weekly Report Surv.Summ. 2024 Oct 31; 73(6):1-18).
https://pubmed.ncbi.nlm.nih.gov/39471107/#&gid=article-figures&pid=figure-2-uid-1)
But it looks like the cold and flu are bouncing back, so maybe we can get a prospective study in comparing states like MD to other states with similar climates, and population densities that don't do this.
They would have to start by measuring the problem of nosocomial transmission of respiratory viruses in acute healthcare settings. Not clear to me that they even know what problem they are trying to solve. They should probably start with cluster randomized trials in nursing homes/chronic care facilities.
What is "masking"????????????
You can NOT do any truly valid study, because 90% of face diaper wearers don't wear their diaper right anyway, and they don't wear it at home.
Tons of studies, forever, have failed to demonstrate any value.
People crying for MORE studies sound like people wishing proof of gods.
Tracy, a point made earlier was the fact that the annual seasonal flu spike, which killed many people each year including children, did not occur during the COVID isolation...most likely due to the isolation and masking (despite poor quality masking). So, those lives were saved.
Precisely correct. But you have to convince the state officials that they're not particularly astute. That's why I made a comment in 2020 at an interdisciplinary conference discussion the COVID response at the hospital that we'd cured the common cold. We didn't of course, but the cold/flu admit dx were all Covid, which may or may not have had any relationship to reimbursement rates. But, Maryland has given us the opportunity to prove them wrong again and fund a research resident for a year.
A public health intervention *always* takes place in a context anyway. A population wide intervention can't be divorced from the population's adherence.
The valid study *is* one in which in real life most people don't wear masks properly. At this time and place. In this context.
I would add to your questioning....at what point does the mask transition from help to harm, and under what circumstances. See, the problem here is that everyone is treating masks as if they are an Engineering Control ( Hierarchy Of Controls) You just put it on and it turns on and runs all day till you take it off. They are PPE, not Engineering....and with PPE there is a massive human behavior component that must exist, before the material an design can even do its job ( think of a spoon...its designed to carry soup into your mouth...but all that design isn't going to do diddly if you put the spoon in the bowl upside down and in your mouth upside down.)...remember how when you go to work at the hospital you have to don and doff all of your PPE a certain procedural way?...yeah thats what all that busienss is about...its the behaviour mechanism of the PPE functionality. its about Contamination. THAT is the key....in addition, everyone ...both for and against masks all have one thing in common...they all are hell bent sure that the masks are the thing producing the data...yet NONE of them have ever qualified that assumption.....well we have science on this (Exposure Science) which tells us the order of strength of any possible harm mitigation...and PPE is dead last against literally everything else you can even think of....opening windows, the wind blowing....literally everything else in a given study playfield is doing more toward prevention than masks....so the big question you and everyone else all STILL haven't answered is to qualify where your data is coming from. and Finally, you have to think of masks as if they were a band aid. ...band aids have filtration and absorption mechanics in their design ( the padding)...and all of this mask talk is exactly like people arguing whether to keep using the same bandaid on all your cuts because it still has absorption ability....but we all know THAT is stupid?...and why?...because of contamination. ....now apply that understanding to masks. If you want to do an RCT on masks....forget the stupid filtration crap...especially if your not going to ever acknowledge all of the other things happening around the masks....just test the masks surfaces, and the argument will be over....people will understand...oh, ok...masks are like bandaids...or dishtowels that were just used to wipe up raw chicken...or poop stained diapers....etc. Your welcome.
You don't need any legal "harm", you only need failure to be of any use. Medical mandates are ALL wrong.
I was sad to hear so little from industrial hygienists during this debate. Either for *or* against masking. It's a profession uniquely qualified to weigh in.
In the same vein as your question about the positive harms of masking, I've often wondered, given the age-mortality gradient of COVID, what damage was done if we convinced elderly people they could resume normal life as long as they wore an, at best, partially effective mask.
Having worked during the recent pandemic as an APRN, I agree that masking is difficult and creates challenges to many- however, I wore a mask throughout as a courtesy to my patients and their families, as well as my own family members at risk. Do we always know if we are walking into a room with someone with a co-morbidity such as suppressed immunity, or perhaps they had a family member at home with this and were at greater risk from potential airborne infection? Washing hands before, during and after patient contact, and being mindful of staff practices as well I am sure reduced the potential for spread of infection. Patient's are not always honest when asked about recent or concurrent URI symptoms. When a patient is politely advised of the reasons to wear a mask, they usually submit. There is no reason to politicize this catastrophic infection or any other and sometimes, well constructed studies to prove something are just too slow and too difficult to conduct in real time.... I support the use of masks and honestly, if I were undergoing a surgical procedure, I would expect my surgeon and technicians to have the courtesy to protect me from their runny noses, their sneezes and their coughs....somehow this just makes sense.
Surgical masks are less meant to protect the patient from the surgeon but to protect the surgeon and others from splash contamination, which is very common in a surgical theater.
Julie, I think there's actually very little evidence that mask wearing does much in surgery - definitely not for anyone else but the surgeon, and I'm not sure that we have any hard evidence that it makes much difference if they're wearing one either! So if that's the crux of your point, it's a very weak one. We mask in surgery because it's a convention, not because we have any convincing peer reviewed evidence that it actually does anything. Sucked in by biological plausibility yet again...
It's rarely so simple, even in the extreme case of surgeons in theatre. Cochrane investigated this topic and found an absence of good evidence for decreased wound infection in the masked arm of the RCTs they selected https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002929.pub3/ful
Here's another review https://pmc.ncbi.nlm.nih.gov/articles/PMC4480558/#bibr8-0141076815583167 that comes to the same conclusion.
Indeed, on the back of the Cochrane review NICE removed the mask guideline for theatre staff in the UK. Likely it's returned now.
None of these are home run trials, but they probably point to the fact that any signal, even in the most critical environment, is small.
*It may not be the most critical environment given the number of engineering and social controls that are already in place.
There's a surprising amount of literature on this if you chase the references in the papers.
Yes, I still want my surgeon to wear a mask. Unless it interferes with her technique, makes it difficult to breathe or see.
That's not a courtesy, it's a virtue-signalling lie. You are selling the lie that face diapers do anything at all.
Enabling lies is lying.
You are certainly entitled to an opinion on the use of masks in a health care setting. Let us not confuse opinion with fact here. Perhaps you would like to comment further and be specific about what you believe to be a "lie" as it relates to the importance of masks in reducing the transmission of certain infectious diseases. I can certainly cite recent studies and reviews about the effectiveness of respirators/surgical masks. Let me know if you would like to see the data. Civil exchange is welcome.
Just one brief question: Do you realize that surgery, where an incision is made creating a potential transmission route that *does not exist in nature*, is a very different case from a simple office visit? That’s why surgical teams have worn masks for decades, maybe even centuries, even at times when masking in other contexts was unheard-of. (Ditto for dentistry and other procedures requiring you to work inside the patient’s open mouth). It disturbs me that a degreed health professional can lose sight of such elementary distinctions.
A simple office visit is a rare event these days. And yes, working in the outpatient setting is very different than a surgical suite and oncology unit or ICU. If you are given a choice of walking into an exam room to see a patient who has respiratory symptoms, mild or severe, acute or chronic, would you yourself choose to err on the side of caution and wear a mask in that setting? Or would you roll the dice and hope the patient does not have TB or RSV? And your next patient is a mom with her baby who was recently discharged from the NICU due to prematurity....Think about that. The variables on any given day in any given setting are vast. That is my distinction for you to ponder.
Julie, it seems you see this as a simple, dramatic moral question: “Do we care enough to protect our patients and ourselves from harm?”
This would make sense if it were supported by the facts. You assume that if Patient #1 has a respiratory virus and you don’t mask, you WILL catch it – and transmit it to the baby (seroconversion within 15 minutes I guess!). If you do mask, you WILL NOT catch it and will keep everyone safe.
If wearing a disposable N95 were really that kind of magic talisman, I think we would have known it long, long before 2020. But it’s not, and to believe this requires something much closer to religious faith than scientific confidence.
The closest we have to solid evidence, I think, is that Cochrane Review meta-analysis from 2022 – which failed to find a significant benefit. That matches my own “anecdotal” experience. Particularly since the dawn of the Omicron Era three years ago, which forced me to face facts: the Covid virus was definitely aerosolized (not droplets), and masking was clearly pretty feeble to prevent its spread. Luckily, it had also become much less lethal.
So what can we say? As you put it, “the variables on any given day in any given setting are vast.” Are you sitting across a desk from me; briefly putting a stethoscope to my back; leaning in for a long hard look at my tonsils; or opening up my abdominal cavity with a scalpel? Am I sniffing slightly every five minutes, or sneezing and coughing uncontrollably? How old or young, how healthy or fragile are each of us? And what is circulating in the community: Tuberculosis, or RSV? There’s a difference, you know.
It may be that wearing an N95 makes transmission of “a respiratory virus” at least 8% less likely. Maybe even 12%. Depending on the circumstances. So, if I am bending low over a newborn, premature baby, perhaps it makes sense to invoke every protection possible: masks, latex gloves, alcohol wipes, maybe even grandma’s rosary.
But if I am sitting in my PCP’s office trying my best to hear and speak clearly, breathe freely and produce an accurate blood-pressure reading so he can figure out what's ailing me? In that case I think it makes sense to let my PCP use his clinical judgment (and let us do some shared decision-making) rather than impose a mandate on either of us.
How does that sound?
Stupid never dies until the head is cut off and a stake driven through it’s heart. Even then, some fool always wants to pull the stake out, because “ now, we know how to do it right!”