The Evidence Regarding Potential Harms Caused By Breathing Barriers
A collection of "no difference" or "negative effects" from one of the non-medical counter-measures which are making people lose their minds.. Well their health ;)
Here’s my collection of the evidence regarding “Breathing Barriers”. If you are offended by the name change, don’t be as this is what they are.
Please note, in order to save some space, I’ve included the links embedded in the title headlines for your reference.
Since the 1920 Kellogg Mask Study, I’ve read/reviewed every possible study/expert opinion/expert commentary and have come up with ones which you will never see on any of the Governments or Health Agencies which is a violation of “informed consent.”
Here is the brief summary of my findings from the above “informed consent violators”.
not one study they attempt to cite has "healthy people/populations" as a control group,
there are no peer reviewed studies for "healthy people/populations" wearing masks,
terms like “statistically significant” or “clinically relevant” are no where to be found in any of their literature. “may” or “could” are not good enough,
they cite 0 studies which have masks as the only form of source control (usually mixed with hand washing, sanitizer or distancing),
many of the references have no relevance to the actual study,
a majority of the above studies are based on anecdotal observations,
any study done during the summer as proof is ridiculous as upper respiratory viruses don’t like temps over 80°F
models or mannequins DO NOT provide a adequate substitute for humans.
Bottom Line? There is still no reliable or policy-grade evidence that face masks can reduce the risk from COVID-19.
Now I know there are some still “believing” their gov’t, health authorities and DOCTORS that these breathing barriers prevent upper respiratory viral transmission but they are full of it..
Let’s see what the leading expert, Dr. Steven Petty who has 45 years of experience on the topic of PPE.
NOTE. Here’s a different link for his testimony if you want to watch it as I can’t delete it for some reason.. :(
Here’s the pdf version of his testimony which is only 65 pages and littered with actual facts and evidence - https://rebuildnh.com/wp-content/uploads/2022/03/1_Petty_New_Hampshire_Legislature_Presentation_January_27_2022.pdf
One of the take aways he mentions is proper “engineering controls”. Where are they?
Which brings me to the 2 elephants in the room - What about the negative effects or studies which show "no statistical difference" or actual studies which cite "statistical significance " or "clinical relevance"?
Studies/Expert Commentary/Expert Opinions from Non-Healthcare Related Settings
2023
Nov 13, 2023-Association between Face mask use and Risk of SARS-CoV-2 Infection – Cross-sectional study
”We examined the association between face masks and risk of infection with SARS-CoV-2 using cross-sectional data from 3,209 participants in a randomized trial of using glasses to reduce the risk of infection with SARS-CoV-2. Face mask use was based on participants’ response to the end-of-follow-up survey. We found that the incidence of self-reported COVID-19 was 33% (aRR 1.33; 95% CI 1.03 – 1.72) higher in those wearing face masks often or sometimes, and 40% (aRR 1.40; 95% CI 1.08 – 1.82) higher in those wearing face masks almost always or always, compared to participants who reported wearing face masks never or almost never.
The crude estimates show a higher incidence of testing positive for COVID-19 in the groups that used face masks more frequently, with 8.6% of participants who never or almost never used masks, 15.0% of participants who sometimes used masks, and 15.1% of participants who almost always or always used masks reporting a positive test result. The risk was 1.74 (1.38 to 2.18) times higher in those who wore face masks often or sometimes and 1.75 (1.39 to 2.21) times higher in those who wore face masks almost always or always, compared to participants who reported never or almost never wore masks.”
“Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety and impaired learning and memory. There is also data indicating testicular toxicity in adolescents at CO2 inhalation concentrations above 0.5%.”
Jan 30, 2023 Physical interventions to interrupt or reduce the spread of respiratory viruses
“Medical or surgical masks
Ten studies took place in the community, and two studies in healthcare workers. Compared with wearing no mask in the community studies only, wearing a mask may make little to no difference in how many people caught a flu‐like illness/COVID‐like illness (9 studies; 276,917 people); and probably makes little or no difference in how many people have flu/COVID confirmed by a laboratory test (6 studies; 13,919 people). Unwanted effects were rarely reported; discomfort was mentioned.
N95/P2 respirators
Four studies were in healthcare workers, and one small study was in the community. Compared with wearing medical or surgical masks, wearing N95/P2 respirators probably makes little to no difference in how many people have confirmed flu (5 studies; 8407 people); and may make little to no difference in how many people catch a flu‐like illness (5 studies; 8407 people), or respiratory illness (3 studies; 7799 people). Unwanted effects were not well‐reported; discomfort was mentioned.”
2022
“SARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an increasing trend with age was observed. Six-year-old children showed higher incidence than 5 year olds (3.54% vs 3.1%; OR 1.15 (95% CI 1.08 to 1.22)) and slightly lower but not statistically significant SAR (4.36% vs 4.59%; incidence risk ratio 0.96 (95% CI 0.82 to 1.11)) and R* (0.9 vs 0.93; OR 0.96 (95% CI 0.87 to 1.09)).
We found no significant differences in SARS-CoV-2 transmission due to FCM mandates in Catalonian schools.”
July 18, 2022 - Bacterial and fungal isolation from face masks under the COVID-19 pandemic
”We surveyed 109 volunteers on their mask usage and lifestyles, and cultured bacteria and fungi from either the face-side or outer-side of their masks. The bacterial colony numbers were greater on the face-side than the outer-side; the fungal colony numbers were fewer on the face-side than the outer-side. A longer mask usage significantly increased the fungal colony numbers but not the bacterial colony numbers”
May 11, 2022 - Inhaled CO2 concentration while wearing face masks: a pilot study using capnography
“None of the available evaluations of the inhaled air carbon dioxide (CO2) concentration, while wearing face masks, used professional, real-time capnography with water-removal tubing. We measured the end-tidal CO2 using professional side-stream capnography, with water-removing tubing (Rad-97™ capnograph), at rest, (1) without masks, (2) wearing a surgical mask, and (3) wearing a FFP2 respirator, in 102 healthy volunteers aged 10-90 years, from the general population of Ferrara province, Italy.
The mean CO2 concentration was 4965±1047 ppm with surgical masks, and 9396±2254 ppm with FFP2 respirators. The proportion of the sample showing a CO2 concentration higher than the 5000 ppm acceptable exposure threshold recommended for workers was 40.2% while wearing surgical masks, 99.0% while wearing FFP2 respirators.
Adjusting for age, gender, BMI, and smoking, the inhaled air CO2 concentration significantly increased with increasing respiratory rate (with a mean of 10,143±2782 ppm among the participants taking 18 or more breaths per minute, while wearing FFP2 respirators), and was higher among the minors, who showed a mean CO2 concentration of 12,847±2898 ppm, while wearing FFP2 respirators.”
April 19, 2022 - Correlation Between Mask Compliance and COVID-19 Outcomes in Europe
“While no cause-effect conclusions could be inferred from this observational analysis, the lack of negative correlations between mask usage and COVID-19 cases and deaths suggest that the widespread use of masks at a time when an effective intervention was most needed, i.e., during the strong 2020-2021 autumn-winter peak, was not able to reduce COVID-19 transmission. Moreover, the moderate positive correlation between mask usage and deaths in Western Europe also suggests that the universal use of masks may have had harmful unintended consequences.”
“Although titanium dioxide (TiO2) is a suspected human carcinogen when inhaled, fiber-grade TiO2 (nano)particles were demonstrated in synthetic textile fibers of face masks intended for the general public. STEM-EDX analysis on sections of a variety of single use and reusable face masks visualized agglomerated near-spherical TiO2 particles in non-woven fabrics, polyester, polyamide and bi-component fibers. Median sizes of constituent particles ranged from 89 to 184 nm, implying an important fraction of nano-sized particles (< 100 nm). The total TiO2 mass determined by ICP-OES ranged from 791 to 152,345 µg per mask. The estimated TiO2 mass at the fiber surface ranged from 17 to 4394 µg, and systematically exceeded the acceptable exposure level to TiO2 by inhalation (3.6 µg), determined based on a scenario where face masks are worn intensively.”
2021
“The primary mode of transmission (aerosol vs. droplet) for viral respiratory infections, including SARS-CoV-2, is controversial and remains unclear.40,41,42,43,44,45 If aerosol transmission plays a substantial role, the ability of masks to serve as a physical barrier to droplets becomes a less reliable surrogate of efficacy, since air expelled from the lungs necessarily penetrates the mask or flows around its edges, potentially advecting aerosols along with it.”
If aerosols can cause infection, however, then filtering capability is unlikely to be reliable surrogate for infection control, since exhaled air necessarily either leaks around a mask’s edges or passes through it.94,95,96 Such leakage has been shown to account for the vast majority (~5:1 ratio) of particle penetration of standardized surgical masks,97 and exhaled air easily passes around the edges of most cloth masks.98,99,100,101,102
Although high-quality evidence may eventually support recommendations to wear masks that are currently based on the precautionary principle or optimistic interpretations of observational data that have potentially important limitations, it is important to consider the an alternate possibility: that community masking may accelerate rather than reduce transmission of infectious disease. Although some evidence suggests masks may cause non-infection-related harms, such as breathing difficulties,269,270 psychological burdens,271 impaired communication,272,273 skin irritation or breakdown,274,275 and headaches,276 the most concerning potential harm to health is an increased rate of disease spread.
A number of studies have found higher point estimates of infection among mask wearers, some of which were statistically significant (Table 3).
Multiple household studies have found higher instances of respiratory sickness in masked intervention groups than in unmasked controls.
The World Health Organization has noted the possibility that mask wearing could accelerate disease spread by providing a false sense of security that induces individuals to forego standard sanitary measures,295
Recommendations to impose mask mandates based on the precautionary principle fail to account for the possibility that masks cause harm,318 or that masks may have varying benefits and risks in different settings.
…given the low quality of evidence, the absence of statistically significant benefit indicated by most randomized controlled trials, and the possible harm suggested by a few studies, scientists and public health officials must take care not to apply a double standard to available studies—emphasizing projections of lives saved when evidence suggests benefit, while focusing on study limitations rather than outcomes when the evidence suggests harm or the absence of benefit.
More than a century after the 1918 influenza pandemic, examination of the efficacy of masks has produced a large volume of mostly low- to moderate-quality evidence that has largely failed to demonstrate their value in most settings.”
Sept 16, 2021 Masks In Schools: Scientific American Fumbles Report On Childhood COVID Transmission
“Moreover, are the “multiple lines of evidence” strong enough to justify masks mandates in schools?
No, they're not. We can confirm this by looking more carefully at the research SciAm cited and bringing a few other studies into the discussion. SciAm in quotes, followed by my commentary:
"Researchers at the ABC Science Collaborative have collected data from more than a million K–12 students and staff members in North Carolina, which mandated masking in schools from August 2020 until July 2021. The scientists reported little in-school transmission over the fall, winter or summer months. Incidents remained low even as, in communities outside the schools, levels of COVID cases fluctuated and mitigation strategies shifted."
This study had no control group, as the authors themselves acknowledged, because every school in the state had a mask mandate in place. The researchers had no influence over North Carolina's masking policy, of course, but it's hard to investigate the efficacy of an intervention when you can't utilize the proper study design.
They tried to compensate by comparing their results to transmission rates at youth camps in Texas and Florida, as well as an unmasked school in Israel, but these numbers came from different studies; the researchers could only observe these settings from a distance. In any case, when you compare masked to unmasked settings, the outcomes aren't consistent. Many mandate-free schools around the world haven't experienced massive case surges.”
Sept 2021 - Nosocomial outbreak caused by the SARS-CoV-2 Delta variant in a highly vaccinated population, Israel, July 2021
“This nosocomial outbreak exemplifies the high transmissibility of the SARS-CoV-2 Delta variant among twice vaccinated and masked individuals.”
Aug 31, 2021 The Impact of Community Masking on COVID-19: A Cluster-Randomized Trial in Bangladesh:
“A cluster-randomized trial of community-level mask promotion in rural Bangladesh from November 2020 to April 2021 (N=600 villages, N=342,126 adults. Heneghan writes: “In a Bangladesh study, surgical masks reduced symptomatic COVID infections by between 0 and 22 percent, while the efficacy of cloth masks led to somewhere between an 11 percent increase to a 21 percent decrease. Hence, based on these randomized studies, adult masks appear to have either no or limited efficacy.”
“The CDC did not include its finding that “required mask use among students was not statistically significant compared with schools where mask use was optional” in the summary of its report.
A recent New York magazine article states that the science on masks "remains uncertain," but noted the Centers for Disease Control and Prevention (CDC) in May published a large-scale study of COVID transmission in US schools.
The study, which analyzed some 90,000 elementary students in 169 Georgia schools from November 16 to December 11, found that there was no statistically significant difference in schools that required students to wear masks compared to schools where masks were optional.
“The 21% lower incidence in schools that required mask use among students was not statistically significant compared with schools where mask use was optional,” the CDC said. "This finding might be attributed to higher effectiveness of masks among adults, who are at higher risk for SARS-CoV-2 infection but might also result from differences in mask-wearing behavior among students in schools with optional requirements. CDC link
Conspicuously, there’s no evidence of more outbreaks in schools in those countries relative to schools in the U.S., where the solid majority of kids wore masks for an entire academic year and will continue to do so for the foreseeable future,” wrote Zweig. “These countries, along with the World Health Organization, whose child-masking guidance differs substantially from the CDC’s recommendations, have explicitly recognized that the decision to mask students carries with it potential academic and social harms for children and may lack a clear benefit.”
Aug 7, 2021 Mask mandate and use efficacy for COVID-19 containment in US States
“We did not observe association between mask mandates or use and reduced COVID-19 spread in US states.”
Aug 2021 - Mask mandate and use efficacy for COVID-19 containment in US States
“We did not observe association between mask mandates or use and reduced COVID-19 spread in US states. COVID-19 mitigation requires further research and use of existing efficacious strategies, most notably vaccination.”
July 29, 2021 An outbreak caused by the SARS-CoV-2 Delta variant (B.1.617.2) in a secondary care hospital in Finland, May 2021
“Both symptomatic and asymptomatic infections were found among vaccinated HCW, and secondary transmission occurred from those with symptomatic infections despite use of personal protective equipment (PPE).”
Read the article and corresponding studies. However, this one sticks out like a sore thumb.
“We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials”
May 1, 2021 Transmission of COVID-19 in 282 clusters in Catalonia, Spain: a cohort study
“We observed no association of risk of transmission with reported mask usage by contacts, with the age or sex of the index case, or with the presence of respiratory symptoms in the index case at the initial study visit.”
"Abstract - Many countries introduced the requirement to wear masks in public spaces for containing SARS-CoV-2 making it commonplace in 2020. Up until now, there has been no comprehensive investigation as to the adverse health effects masks can cause. The aim was to find, test, evaluate and compile scientifically proven related side effects of wearing masks. For a quantitative evaluation, 44 mostly experimental studies were referenced, and for a substantive evaluation, 65 publications were found. The literature revealed relevant adverse effects of masks in numerous disciplines. In this paper, we refer to the psychological and physical deterioration as well as multiple symptoms described because of their consistent, recurrent and uniform presentation from different disciplines as a Mask-Induced Exhaustion Syndrome (MIES). We objectified evaluation evidenced changes in respiratory physiology of mask wearers with significant correlation of O2 drop and fatigue (p < 0.05), a clustered co-occurrence of respiratory impairment and O2 drop (67%), N95 mask and CO2 rise (82%), N95 mask and O2 drop (72%), N95 mask and headache (60%), respiratory impairment and temperature rise (88%), but also temperature rise and moisture (100%) under the masks. Extended mask-wearing by the general population could lead to relevant effects and consequences in many medical fields."
March 2021 Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers (RCT)
”Conclusion:
The recommendation to wear surgical masks to supplement other public health measures did not reduce the SARS-CoV-2 infection rate among wearers by more than 50% in a community with modest infection rates, some degree of social distancing, and uncommon general mask use. The data were compatible with lesser degrees of self-protection.”
Feb 18, 2021 Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden
“Social distancing was encouraged in Sweden, but wearing face masks was not.3
No child with Covid-19 died.”
“The evidence regarding the effectiveness of medical face masks for the prevention of COVID-19 in the community is compatible with a small to moderate protective effect, but there are still significant uncertainties about the size of this effect. Evidence for the effectiveness of non-medical face masks, face shields/visors and respirators in the community is scarce and of very low certainty.”
"…the COVID pandemic has laid bare our fundamental need to see whole faces. Could it be that babies and young children, who must learn the meaning of the myriad communicative signals normally available in their social partners’ faces, are especially vulnerable to their degradation in partially visible faces? … in my lab … We discovered that babies begin lip- reading at around 8 months of age. …
Crucially, once lip-reading emerges in infancy, it becomes the default mode of speech processing whenever comprehension is difficult. …
Overall, the research to date demonstrates that the visible articulations that babies normally see when others are talking play a key role in their acquisition of communication skills. Research also shows that babies who lip-read more have better language skills when they’re older. If so, this suggests that masks probably hinder babies’ acquisition of speech and language.”
Jan 23, 2021 Twenty Reasons Mandatory Face Masks are Unsafe, Ineffective and Immoral 9 potential dangers - “Cavities, Facial Deformities, Acne Vulgaris, Increased Risk of Covid-19, Bacterial Pneumonia, Immune Suppressing, Germophobia, Toxic, Psychologically Harmful.
6 proofs masks do not reduce infections - insubstantial, unreasonable, ineffective, unsanitary, no protection, unproven
5 ways forced masking is immoral - reckless, manipulative, fear-mongering, totalitarian and virtue signalling”
January 5, 2021 - Corona children studies "Co-Ki": First results of a Germany-wide registry on mouth and nose covering (mask) in children:
“ABSTRACT. Background: Narratives about complaints in children and adolescents caused by wearing a mask are accumulating. There is, to date, no registry for side effects of masks.
Methods: At the University of Witten/Herdecke an online registry has been set up where parents, doctors, pedagogues and others can enter their observations. On 20.10.2020, 363 doctors were asked to make entries and to make parents and teachers aware of the registry.
Results: By 26.10.2020 the registry had been used by 20,353 people. In this publication we report the results from the parents, who entered data on a total of 25,930 children. The average wearing time of the mask was 270 minutes per day. Impairments caused by wearing the mask were reported by 68% of the parents. These included irritability (60%), headache (53%), difficulty concentrating (50%), less happiness (49%), reluctance to go to school/kindergarten (44%), malaise (42%) impaired learning (38%) and drowsiness or fatigue (37%).
Discussion: This world's first registry for recording the effects of wearing masks in children is dedicated to a new research question. Bias with respect to preferential documentation of children who are particularly severely affected or who are fundamentally critical of protective measures cannot be dismissed. The frequency of the registry’s use and the spectrum of symptoms registry indicate the importance of the topic and call for representative surveys, randomized controlled trials with various masks and a renewed risk-benefit assessment for the vulnerable group of children: adults need to collectively reflect the circumstances under which they would be willing to take a residual risk upon themselves in favour of enabling children to have a higher quality of life without having to wear a mask.”
2020
December 31, 2020 - The intersection of COVID‐19, school, and headaches: Problems and solutions" Headache: The Journal of Head and Face Pain, 61: 190-201
"Many common triggers such as dehydration, fasting, sleep problems, and stressors were discussed above. Here we highlight screen use and mask wearing as potential additional school‐related triggers.mm ,,, Pressure created by the mask or its straps against various contact points on the face or scalp could trigger headache"
Dec 17, 2020 SARS-CoV-2 Transmission among Marine Recruits during Quarantine
“Our study showed that in a group of predominantly young male military recruits, approximately 2% became positive for SARS-CoV-2, as determined by qPCR assay, during a 2-week, strictly enforced quarantine. Multiple, independent virus strain transmission clusters were identified…all recruits wore double-layered cloth masks at all times indoors and outdoors.”
Dec 7, 2020 - Masks, false safety and real dangers, Part 4: Proposed mechanisms by which masks increase risk of COVID-19 - PEER REVIEWED Jan 8, 2021
”Conclusion
Population studies show that the use of masks either resulted in an increased incidence of COVID-19 or had no impact. None of the examined jurisdictions experienced decreased incidence of COVID-19 after the introduction of mask mandates, except two that had already begun a sharp descent in COVID-19 cases weeks earlier. Two physical mechanisms are proposed to directly contribute to this finding, based on current available research. The first is scatter mechanics of dispersed respiratory droplets becoming aerosolized on collision with the mesh of a mask on outward exhalation and then lingering in air. The second is the pressurized and distant peripheral jets of unfiltered exhaled aerosol from the nozzled edges of a mask. These phenomena result in viral particles lingering longer and traveling farther in airspace from a masked person than exhaled respiratory droplets falling close to the body from the orifices of an unmasked person. There are also chemical mechanisms for increased COVID-19 cases in masked populations. This is likely due to immune suppression caused by hypoxic and hypercapnic conditions, as well as acidotic, immobilized cilia in the lungs, and reduced skin surface available to sunlight for Vitamin D production. Caution is therefore urged against use of masks among those who wish to reduce the risk, either for themselves or others, of infection with SARS-CoV-2 or COVID-19 disease.”
Nov 27, 2020 The Strangely Unscientific Masking of America
“As rapidly as mask use became a matter of ethics, the issue transformed into a political one, exemplified by an article printed on March 27 in the New York Times, entitled “More Americans Should Probably Wear Masks for Protection.” The piece was heavy on fear-mongering and light on evidence. While acknowledging that “[t]here is very little data showing that flat surgical masks, in particular, have a protective effect for the general public,” the author went on to argue that they “may be better than nothing,” and cited a couple of studies in which surgical masks ostensibly reduced influenza transmission rates.
One report reached its conclusion based on observations of a “dummy head attached to a breathing simulator.” Another analyzed use of surgical masks on people experiencing at least two symptoms of acute respiratory illness. Incidentally, not one of these studies involved cloth masks or accounted for real-world mask usage (or misusage) among lay people, and none established efficacy of widespread mask-wearing by people not exhibiting symptoms. There was simply no evidence whatsoever that healthy people ought to wear masks when going about their lives, especially outdoors.”
Nov 22, 2020 - Facemasks in the COVID-19 era: A health hypothesis
“Abstract: … Although, scientific evidence supporting facemasks’ efficacy is lacking, adverse physiological, psychological and health effects are established. Is has been hypothesized that facemasks have compromised safety and efficacy profile and should be avoided from use. The current article comprehensively summarizes scientific evidences with respect to wearing facemasks in the COVID-19 era. …
Long-Term health consequences of wearing facemasks: Long-term practice of wearing facemasks has strong potential for devastating health consequences. Prolonged hypoxic-hypercapnic state compromises normal physiological and psychological balance, deteriorating health and promotes the developing and progression of existing chronic diseases (10 refs).
Conclusion: … Wearing facemasks has been demonstrated to have substantial adverse physiological and psychological effects. These include hypoxia, hypercapnia, shortness of breath, increased acidity and toxicity, activation of fear and stress response, rise in stress hormones, immunosuppression, fatigue, headaches, decline in cognitive performance, predisposition for viral and infectious illnesses, chronic stress, anxiety and depression. Long-term consequences of wearing facemask can cause health deterioration, developing and progression of chronic diseases and premature death."
"the trial found no statistically significant benefit of wearing a face mask. The study used “high-quality surgical masks with a filtration rate of 98%”.
Nov 2, 2020 - Masks, false safety and real dangers, Part 3: Hypoxia, hypercapnia and physiological effects - PEER REVIEWED NOV 9, 2020
”Conclusion
This paper, the third in our series, focuses on physiological changes induced by hypoxia and hypercapnia. Our findings of reduced oxygen and increased carbon dioxide in a masked airspace are not inconsistent with previously reported data.82 83 Evidence of damage to multiple organ systems from the documented levels of [O2] and [CO2] in available airspace between a facemask and the airways are cited above and are abundant in the medical literature.
The pathological triad of micro-particles as long-term hazards, and bacterial and fungal infections as mid-term hazards, as well as injury from hypoxia and hypercapnia in the short- term, are expected to have synergistic results in endangering the health of masked people. Because of the extensive risk to mask wearers documented in these three papers, we urgently recommend that no adult or child be coerced to wear a mask under any circumstances. We further recommend that facemask hazards be published prominently and that masks only be worn by adults who choose to do so, and only with freely given informed consent, with full knowledge of their hazards, and that their use be prohibited for children, adult students and workers.
If on the other hand, widespread use of masks and mandating the same continue, then the question arises, from the data shown herein, whether morbidity and mortality from mask- wearing will exceed those of COVID-19 or other known infectious diseases. What will be the long-term effects of mask wearing if it continues? And will we be able to distinguish mask injury from COVID-19 or other pathologies? The evidence presented here, in summary of clinical data from around the world, show that masks can accelerate morbidity and mortality in those who are already ill, and that masks can sicken healthy people. Before masks are forced onto school children and workers, why are animal studies not being done with all-day masking, to investigate safety issues? How much of an increase in mask-related illnesses will we have to observe before mask “mandates” end?”
Nov 4, 2020 - That Mask Is Giving You Lung Cancer
Guy Crittenden was the editor for HazMat Management.
“I happen to know a thing or two about masks and safety. Why? Because for 25 years I was the editor of an award-winning trade magazine called HazMat Management that covered such topics as pollution prevention and compliance with health & safety laws. We routinely published articles on masks, gloves, respirators and other forms of personal protective equipment (PPE). Now let me tell you a few things about that mask you’re wearing. And please note that what I’m about to share was also stated in the most recent edition of Del Bigtree’s program The Highwire when two OSHA mask experts spoke to the fact that the kinds of masks people are wearing were never (never!) designed to be worn for long periods and doing so is very harmful.
The blue typical mask depicted in the photograph contain Teflon and other chemicals. A Facebook friend reminds us: 1. Masks are “sterilized” with Ethylene Oxide — a known carcinogen. Many teachers in various school boards have been experiencing significant symptoms as a direct result of the effects of this chemical. 2. The masks contain (not sprayed with) PTFE which makes up Teflon along with other chemicals. I found and have posted the US patent to allow manufacturers to use PTFE as a filter in commercial masks… “breathing these for extended periods can lead to lung cancer.”
Don’t agree? Argue with the experts at OSHA, which is the main US agency, i.e., its Occupational Health & Safety Agency. These masks are meant to be worn only for short periods, like say if you’re sanding a table for an hour and don’t want to inhale sawdust. They don’t do anything whatsoever to stop the spread of any virus, and the emerging science of virology now understands that viruses aren’t even passed person to person. I know that sounds incredible, but it’s the case that the virus is in the air, you breath it in, there’s no way to prevent that short of living in an oxygen tent, and if you have a strong immune system you’ll be fine, and if you have a weak immune system you may have to deal with the effects of your immune system working to restore balance within your metabolism.
So let’s say you don’t wear the blue packaged masks, and instead wear a homemade cloth mask — the kind people wear over and over and hang on their rearview mirror and so on. Those masks are completely useless against a virus, and are also very dangerous. OSHA would never condone a person wearing a mask of this kind for anything more than the shortest time. Re-breathing your own viral debris is dangerous to health, and the oxygen deprivation children suffer wearing such masks all day will certainly cause brain damage. I’m not making this up. Again, you might say, well, Guy, you’re not a doctor. True, but I did edit that magazine for 25 years. That’s a long time and many articles on masks and PPE. I’ve attended numerous OH&S conferences and listened to experts discussing these matters.
You may hear people saying that surgeons and nurses wear masks like this all day. Um, no. No they don’t. They’re trained in the proper use of masks, which is to wear them in the OR, then dispose of the mask when they leave that room. Are you aware that operating rooms are actually supplied extra oxygen, to compensate for the reduction in oxygen flow from mask wearing? To my mind, it’s criminal (not hyperbole) to force children to wear masks all day. Setting aside the very real psychological effects, we’re going to have a generation of brain damaged children. Ever heard the expression, “Not enough oxygen at birth?” That’s a joke at the expense of a mentally challenged person, but that’s literally what we’re doing. And we’re told it’s to “keep us safe”! We’re told this by doctors who actually don’t know about PPE and laypeople who have no clue.
So, you can choose to believe me or not, but I was the editor for a quarter century of a magazine that had a strong occupational health and safety mandate, and I can tell you that the mask wearing currently mandated by governments and private businesses offers no health benefit whatsoever, in no way protects you or anyone else from any virus, and actually does you damage beyond wearing it for a few minutes.Got that? Good. Now please share this message and get the conversation going with parents, who must end this masking of children immediately. This is a very serious matter. And related to that, let me just state this doesn’t end for me when the lockdown ends or the masking ends. No, this ends for me when every politician and bureaucrat who inflicted this travesty, this crime against humanity, on the population of Canada (and other affected countries) is in the dock, and faces their misdeeds in a court of law.
And as for those of you who have put masks on young children, I will have a long memory on that score. A very long memory.
END NOTE: The CDC and WHO have acknowledged that asymptomatic people do not spread the virus, so the case for masks for such people is moot in the first place.
November 2020 - “Masks, false safety and real dangers, Part 2: Microbial challenges from masks”. Primary Doctor Medical Journal.
In November 2020, Borovoy et al. [32] published an extensive review of biological and medical knowledge that allowed them to infer a large potential for significant harms from masking, via microbial challenges from the masks. They rightly stress the known yet underplayed role of bacteria in viral pandemics, and also review respiratory diseases arising from oral bacteria, which can be induced by mask wearing to penetrate and infect the respiratory tract and lungs.
“Conclusion
This trial was unable to provide conclusive evidence on facemask efficacy against viral respiratory infections most likely due to poor adherence to protocol.”
“Abstract: … COVID-19 has changed the way that newborn babies are cared for within the neonatal setting due to the introduction of social distancing and wearing of face masks to limit the spread of the infection. Potential implications exist related to the normal development of bonding and connections with others. This paper discusses the importance of face to face interactions for early attachment between babies and parents within the context of relevant underpinning developmental theory. …”
Oct 9, 2020. Masks, false safety and real dangers, Part 2: Microbial challenges from masks PEER REVIEWED OCT 15, 2020
Conclusion
Masks have been shown consistently over time and throughout the world to have no significant preventative impact against any known pathogenic microbes. Specifically, regarding COVID-19, we have shown in this paper that mask use is not correlated with lower death rates nor with lower positive PCR tests.
Masks have also been demonstrated historically to contribute to increased infections within the respiratory tract. We have examined the common occurrence of oral and nasal pathogens accessing deeper tissues and blood, and potential consequences of such events. We have demonstrated from the clinical and historical data cited herein, we conclude the use of face masks will contribute to far more morbidity and mortality than has occurred due to COVID-19.
October 6th - German Neurologist Warns Against Wearing Facemasks: 'Oxygen Deprivation Causes Permanent Neurological Damage'
Dr. Margarite Griesz-Brisson MD, PhD is a Consultant Neurologist and Neurophysiologist with a PhD in Pharmacology, with special interest in neurotoxicology, environmental medicine, neuroregeneration and neuroplasticity. This is what she has to say about facemasks and their effects on our brains:
"The reinhalation of our exhaled air will without a doubt create oxygen deficiency and a flooding of carbon dioxide. We know that the human brain is very sensitive to oxygen deprivation. There are nerve cells for example in the hippocampus that can't be longer than 3 minutes without oxygen - they cannot survive.... However, when you have chronic oxygen deprivation, all of those symptoms disappear, because you get used to it. But your efficiency will remain impaired and the under-supply of oxygen in your brain continues to progress.... While you're thinking that you have gotten used to wearing your mask and rebreathing your own exhaled air, the degenerative processes in your brain are getting amplified as your oxygen deprivation continues.
The second problem is that the nerve cells in your brain are unable to divide themselves normally. So in case our governments will generously allow as to get rid of the masks and go back to breathing oxygen freely again in a few months, the lost nerve cells will no longer be regenerated. What is gone is gone. The acute warning symptoms are headaches, drowsiness, dizziness, issues in concentration, slowing down of reaction time - reactions of the cognitive system...
There is no unfounded medical exemption from face masks because oxygen deprivation is dangerous for every single brain. It must be the free decision of every human being whether they want to wear a mask that is absolutely ineffective to protect themselves from a virus.
For children and adolescents, masks are an absolute no-no. Children and adolescents have an extremely active and adaptive immune system and they need a constant interaction with the microbiome of the Earth. Their brain is also incredibly active, as it is has so much to learn. The child's brain, or the youth's brain, is thirsting for oxygen. The more metabolically active the organ is, the more oxygen it requires. In children and adolescents every organ is metabolically active.
To deprive a child's or an adolescent's brain from oxygen, or to restrict it in any way, is not only dangerous to their health, it is absolutely criminal. Oxygen deficiency inhibits the development of the brain, and the damage that has taken place as a result CANNOT be reversed.
The child needs the brain to learn, and the brain needs oxygen to function. We don't need a clinical study for that. This is simple, indisputable physiology. Consciously and purposely induced oxygen deficiency is an absolutely deliberate health hazard, and an absolute medical contraindication.
An absolute medical contraindication in medicine means that this drug, this therapy, this method or measure should not be used, and is not allowed to be used. To coerce an entire population to use an absolute medical contraindication by force, there must be definite and serious reasons for this, and the reasons must be presented to competent interdisciplinary and independent bodies to be verified and authorized.
I know how damaging oxygen deprivation is for the brain, cardiologists know how damaging it is for the heart, pulmonologists know how damaging it is for the lungs. Oxygen deprivation damages every single organ.
Where are our health departments, our health insurance, our medical associations? It would have been their duty to be vehemently against the lockdown and to stop it and stop it from the very beginning.
Why do the medical boards issue punishments to doctors who give people exemptions? Does the person or the doctor seriously have to prove that oxygen deprivation harms people? What kind of medicine are our doctors and medical associations representing?
Sept 11, 2021 - Community and Close Contact Exposures Associated with COVID-19 Among Symptomatic Adults ≥18 Years in 11 Outpatient Health Care Facilities
As a follow up to Fauci's 2008 findings, the CDC recently published data on hospital admissions which shows that those testing both positive and negative for the virus strain are presenting symptoms of covid-19, and that the vast majority of hospital admissions with severe respiratory symptoms are wearing face coverings.
August 12, 2020 - Face masks: benefits and risks during the COVID-19 crisis
“If masks are not exchanged regularly (or washed properly when made of cloth), pathogens can accumulate in the mask. When improperly used, the risk of spreading the pathogen— including SARS-CoV-2—might be critically increased.” (p. 5)
August 6, 2020 - "Masked education? The benefits and burdens of wearing face masks in schools during the current Corona pandemic. Trends in Neuroscience and Education.
“Abstract: … covering the lower half of the face reduces the ability to communicate, interpret, and mimic the expressions of those with whom we interact. Positive emotions become less recognizable, and negative emotions are amplified. Emotional mimicry, contagion, and emotionality in general are reduced and (thereby) bonding between teachers and learners, group cohesion, and learning – of which emotions are a major driver.
1. Introduction: … along with other measures of physical distancing and economic lockdowns, school closures were implemented during March 2020 affecting more than 1.5 billion students (children and adolescents) around the globe (ref). These closures of schools lasted for a few weeks only (as in Denmark) up to several months (in Italy and many other countries; (ref)) and led to marked decreases in educational gains (ref), hunger (because school meals were no longer served), increases in child abuse (because children were no longer observed by school staff), and, in general, the risk of “scarring the life chances of a generation of young people”(ref) (because of the long-term psychological, physiological, educational and even economic burden (ref), that societies put on their most vulnerable members; (ref))…
… wearing masks may have physical side effects.
Face masks impair face recognition and face identification.
Face masks impair verbal and non-verbal communication.
Face masks block emotional signalling between teacher and learner.
Given these pros and cons, it is not clear whether face masks should play a major role in educational settings in times of the current viral pandemic. … This matter should be discussed urgently, since it globally affects more than 1.5 billion students, teachers, and school staff directly, and, in addition, their families indirectly.
6. Face masks block emotional signalling between teachers and students: … In sum, recognition of, and response to, the outward emotional displays of one's peers’ faces is a critical and necessary component of social interaction in schools. It helps pupils and teachers to modify their behavior in order to align with social communication and behavioral norms. When these emotional displays are inhibited by face masks, our ability to communicate effectively with one another is reduced and we are primarily left with mimicking negative (frown) emotions. All of this happens primarily outside of conscious awareness, and hence, is hard to be consciously controlled or even corrected. Since emotions are a major driver of group cohesion, the decreased emotionality, and decreased positive emotionality in particular, may interfere with smooth classroom action. Given the fact that the very process of learning is facilitated by emotions (this is their main raison d´être), face masks are likely to cause some interference with pedagogy.” Coleen Huber
July 25, 2020 Does Universal Mask Wearing Decrease or Increase the Spread of COVID-19?
Additional Downsides of Wearing a Mask during the COVID-19 Outbreak
All masks make breathing more difficult, requiring more effort to inhale and exhale and potentially causing more viral load to be expelled into the air. Moreover, when a non-contagious person wears a cloth mask, his or her mask accumulates the coronavirus and other germs from the environment. If a contagious person wears a cloth mask, the mask also accumulates some viral load with each breath, and soon, it might discharge more viral load with each exhalation than the contagious person would otherwise exhale—and in more directions.
Masks cause heavier, deeper, and more forceful breathing as well as straining—all of the attributes believed to have caused exceptionally bad outcomes in the case of a church choir in Seattle (Read, “A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead,” 2020). Deeper breathing allows the coronavirus to go deeper into the lungs, causing infection to take hold faster. The article explains:
“Jamie Lloyd-Smith, a UCLA infectious disease researcher, said it’s possible that the forceful breathing action of singing dispersed viral particles in the church room that were widely inhaled.”
As of now, hundreds of thousands of people are breathing similarly forcefully through masks in public spaces, and other people are inhaling what mask wearers expel. Read’s article contains another illustrative passage:
“Linsey Marr, an environmental engineer at Virginia Tech and an expert on airborne transmission of viruses, said some people happen to be especially good at exhaling fine material, producing 1,000 times more than others.”
This finding had been described in an unrelated study (Edwards et al., “Inhaling to mitigate exhaled bioaerosols,” 2004).
July 23, 2020 Masking lack of evidence with politics:
“It would appear that despite two decades of pandemic preparedness, there is considerable uncertainty as to the value of wearing masks. For instance, high rates of infection with cloth masks could be due to harms caused by cloth masks, or benefits of medical masks. The numerous systematic reviews that have been recently published all include the same evidence base so unsurprisingly broadly reach the same conclusions.
The small number of trials and lateness in the pandemic cycle is unlikely to give us reasonably clear answers and guide decision-makers. This abandonment of the scientific modus operandi and lack of foresight has left the field wide open for the play of opinions, radical views and political influence.”
“Face masks in public was not associated with reduced incidence.
Relaxing stay-at-home orders and allowing reopening of non-essential businesses appeared to be the lowest risk measures to relax as part of plans to carefully lift COVID-19 lockdown measures. There is still even now relatively little unclear empirical evidence on the relative value of different interventions. And yet, the reasons to implement minimal control measures are compelling, given the social and economic harm linked to tight control measures. Hence, whilst we need to be cautious about using preliminary results, public health officials will have to use evidence as it emerges rather than expect to wait for a final full view to decide what might be (was) the best control strategy.”
July 6, 2020. Masks, false safety and real dangers, Part 1: PEER REVIEWED NOV 19, 2020
Conclusion: Friable mask particulate and lung vulnerabilitySurgical personnel are trained to never touch any part of a mask, except the loops and the nose bridge. Otherwise, the mask is considered useless and is to be replaced. Surgical personnel are strictly trained not to touch their masks otherwise. However, the general public may be seen touching various parts of their masks. Even the masks just removed from manufacturer packaging have been shown in the above photos to contain particulate and fiber that would not be optimal to inhale.
Both cotton and polymer clothing have been well-tolerated without pathology when covering any other part of the body, except over the only entry points/gateway to the respiratory system. Inhalation risks, such as the constant ventilation of the respiratory process, increased by the greater effort to attempt to fulfill bodily oxygen needs, with mostly and closely covered orifices are of great concern for those who would want to protect pulmonary health, without inhalation of unwanted particulate. When partial airway obstruction, i.e. masking, is added, deeper and more forceful breathing occurs. When this phenomenon is combined with the particles found herein on microscopic examination of the face side of newly unpackaged, never worn masks, there can arise the risk of a dangerous level of foreign material entering lung tissue. Furthermore, worn masks can only either lose these particles to lodge in the lungs of the wearer, or they would accumulate during use, to the burden (both biological and debris) of non-mask material carried on the inside of the mask.
Further concerns of macrophage response and other immune and inflammatory and fibroblast response to such inhaled particles specifically from facemasks should be the subject of more research.
If widespread masking continues, then the potential for inhaling mask fibers and environmental and biological debris continues on a daily basis for hundreds of millions of people. This should be alarming for physicians and epidemiologists knowledgeable in occupational hazards.July 6, 2020 - Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity
“Results - The pulmonary function parameters were significantly lower with mask (forced expiratory volume: 5.6 ± 1.0 vs 5.3 ± 0.8 vs 6.1 ± 1.0 l/s with sm, ffpm and nm, respectively; p = 0.001; peak expiratory flow: 8.7 ± 1.4 vs 7.5 ± 1.1 vs 9.7 ± 1.6 l/s; p < 0.001). The maximum power was 269 ± 45, 263 ± 42 and 277 ± 46 W with sm, ffpm and nm, respectively; p = 0.002; the ventilation was significantly reduced with both face masks (131 ± 28 vs 114 ± 23 vs 99 ± 19 l/m; p < 0.001). Peak blood lactate response was reduced with mask. Cardiac output was similar with and without mask. Participants reported consistent and marked discomfort wearing the masks, especially ffpm.
Conclusion - Ventilation, cardiopulmonary exercise capacity and comfort are reduced by surgical masks and highly impaired by FFP2/N95 face masks in healthy individuals. These data are important for recommendations on wearing face masks at work or during physical exercise.
July 6, 2020 - Masks are neither effective nor safe: A summary of the science
In this meta-analysis, face masks were found to have no detectable effect against transmission of viral infections. (1) It found: “Compared to no masks, there was no reduction of influenza-like illness cases or influenza for masks in the general population, nor in healthcare workers.”
This 2020 meta-analysis found that evidence from randomized controlled trials of face masks did not support a substantial effect on transmission of laboratory-confirmed influenza, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility. (2)
Another recent review found that masks had no effect specifically against Covid-19, although facemask use seemed linked to, in 3 of 31 studies, “very slightly reduced” odds of developing influenza-like illness. (3)
This 2019 study of 2862 participants showed that both N95 respirators and surgical masks “resulted in no significant difference in the incidence of laboratory confirmed influenza." (4)
This 2016 meta-analysis found that both randomized controlled trials and observational studies of N95 respirators and surgical masks used by healthcare workers did not show benefit against transmission of acute respiratory infections. It was also found that acute respiratory infection transmission “may have occurred via contamination of provided respiratory protective equipment during storage and reuse of masks and respirators throughout the workday.” (5)
A 2011 meta-analysis of 17 studies regarding masks and effect on transmission of influenza found that “none of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.” (6) However, authors speculated that effectiveness of masks may be linked to early, consistent and correct usage.
Face mask use was likewise found to be not protective against the common cold, compared to controls without face masks among healthcare workers. (7)"
“There are insufficient data to quantify all of the adverse effects that might reduce the acceptability, adherence, and effectiveness of face masks. New research on facemasks should assess and report the harms and downsides. Urgent research is also needed on methods and designs to mitigate the downsides of facemask wearing, particularly the assessment of alternatives such as face shields.”
“Abstract: … Among those on the market, surgical masks with elastic loops are the ones most chosen by parents for their children. These elastics cause constant compression on the skin and, consequently, on the cartilage of the auricle, leading to erythematous and painful lesions of the retroauricular skin when the masks are used for many hours a day. Pre- adolescent children have undeveloped auricular cartilage with less resistance to deformation; prolonged pressure from the elastic loops of the mask at the hollow or, even worse, at the anthelix level can influence the correct growth and angulation of the outer ear. In fact, unlike when using conservative methods for the treatment of protruding ears, this prolonged pressure can increase the cephaloauricular angle of the outer auricle. It is important for the authorities supplying the masks to be aware of this potential risk and for alternative solutions to be found …”
June 2020 - “Exercise with facemask; Are we handling a devil's sword?” – A physiological hypothesis
"Straying away from a sedentary lifestyle is essential, especially in these troubled times of a global pandemic to reverse the ill effects associated with the health risks as mentioned earlier. In the view of anticipated effects on immune system and prevention against influenza and Covid-19, globally moderate to vigorous exercises are advocated wearing protective equipment such as facemasks. Though WHO supports facemasks only for Covid-19 patients, healthy “social exercisers” too exercise strenuously with customized facemasks or N95 which hypothesized to pose more significant health risks and tax various physiological systems especially pulmonary, circulatory and immune systems. Exercising with facemasks may reduce available Oxygen and increase air trapping preventing substantial carbon dioxide exchange. The hypercapnic hypoxia may potentially increase acidic environment, cardiac overload, anaerobic metabolism and renal overload, which may substantially aggravate the underlying pathology of established chronic diseases. Further contrary to the earlier thought, no evidence exists to claim the facemasks during exercise offer additional protection from the droplet transfer of the virus. Hence, we recommend social distancing is better than facemasks during exercise and optimal utilization rather than exploitation of facemasks during exercise."
May 20,2020 Assessment of Proficiency of N95 Mask Donning Among the General Public in Singapore
“These findings support ongoing recommendations against the use of N95 masks by the general public during the COVID-19 pandemic.5 N95 mask use by the general public may not translate into effective protection but instead provide false reassurance. Beyond N95 masks, proficiency among the general public in donning surgical masks needs to be assessed. Policy measures that encourage mask use in the general public must be coupled with effective training materials beyond instruction leaflets, which our study and a 2013 study by Harber et al 6 found to be inadequate.”
MAY 8th 2020 - From the CDC itself which also follows the WHOs guidelines..
"If you are sick wear a cloth covering over your nose and mouth. You should wear a cloth face covering, over your nose and mouth if you must be around other people or animals, including pets (even at home). You don’t need to wear the cloth face covering if you are alone. If you can’t put on a cloth face covering (because of trouble breathing, for example), cover your coughs and sneezes in some other way. Try to stay at least 6 feet away from other people. This will help protect the people around you. Cloth face coverings should not be placed on young children under age 2 years, anyone who has trouble breathing, or anyone who is not able to remove the covering without help."
Reasons have included: (1) we don’t truly know that cloth masks (face coverings) are not effective, since the data are so limited, (2) wearing a cloth mask or face covering is better than doing nothing, (3) the article is being used by individuals and groups to support non-mask wearing where mandated and (4) there are now many modeling studies suggesting that cloth masks or face coverings could be effective at flattening the curve and preventing many cases of infection.
We do, however, have data from laboratory studies that indicate cloth masks or face coverings offer very low filter collection efficiency for the smaller inhalable particles we believe are largely responsible for transmission
The guidelines from the Centers for Disease Control and Prevention (CDC) for face coverings initially did not have any citations for studies of cloth material efficiency or fit, but some references have been added since the guidelines were first posted. We reviewed these and found that many employ very crude, non-standardized methods (Anfinrud 2020, Davies 2013, Konda 2020, Aydin 2020, Ma 2020) or are not relevant to cloth face coverings because they evaluate respirators or surgical masks (Leung 2020, Johnson 2009, Green 2012).
The CDC failed to reference the National Academies of Sciences Rapid Expert Consultation on the Effectiveness of Fabric Masks for the COVID-19 Pandemic (NAS 2020), which concludes, “The evidence from…laboratory filtration studies suggests that such fabric masks may reduce the transmission of larger respiratory droplets. There is little evidence regarding the transmission of small aerosolized particulates of the size potentially exhaled by asymptomatic or presymptomatic individuals with COVID-19.
Is wearing a face covering better than nothing?
Wearing a cloth mask or face covering could be better than doing nothing, but we simply don’t know at this point. We have observed an evolution in the messaging around cloth masks, from an initial understanding that they should not be seen as a replacement for physical distancing to more recent messaging that suggests cloth masks are equivalent to physical distancing. And while everyone appears to understand that this messaging suggests that a cloth mask is appropriate only for source control (ie, to protect others from infection), recent CDC and other guidance recommending their use by workers seems to imply that they offer some type of personal protection.
We know of workplaces in which employees are told they cannot wear respirators for the hazardous environments they work in, but instead need to wear a cloth mask or face covering. These are dangerous and inappropriate applications that greatly exceed the initial purpose of a cloth mask. We are concerned that many people do not understand the very limited degree of protection a cloth mask or face covering likely offers as source control for people located nearby.
We know of workplaces in which employees are told they cannot wear respirators for the hazardous environments they work in, but instead need to wear a cloth mask or face covering. These are dangerous and inappropriate applications that greatly exceed the initial purpose of a cloth mask. We are concerned that many people do not understand the very limited degree of protection a cloth mask or face covering likely offers as source control for people located nearby."
Apr 2020 - Effectiveness of Surgical and Cotton Masks in Blocking SARS–CoV-2: A Controlled Comparison in 4 Patients.. This article has been retracted. See Notice of Retraction.
"Whether face masks worn by patients with coronavirus disease 2019 (COVID-19) prevent contamination of the environment is uncertain (2, 3)
Objective: To evaluate the effectiveness of surgical and cotton masks in filtering SARS–CoV-2.
We compared disposable surgical masks (180 mm × 90 mm, 3 layers [inner surface mixed with polypropylene and polyethylene, polypropylene filter, and polypropylene outer surface], pleated, bulk packaged in cardboard; KM Dental Mask, KM Healthcare Corp) with reusable 100% cotton masks (160 mm × 135 mm, 2 layers, individually packaged in plastic; Seoulsa).
A petri dish... was placed approximately 20 cm from the patients' mouths. Patients were instructed to cough 5 times each onto a petri dish while wearing the following sequence of masks: no mask, surgical mask, cotton mask, and again with no mask.
All swabs from the outer mask surfaces of the masks were positive for SARS–CoV-2, whereas most swabs from the inner mask surfaces were negative" (no virus on the inside but lots on the outside from adjusting, touching, hanging on your rear view)
"Discussion: Neither surgical nor cotton masks effectively filtered SARS–CoV-2 during coughs by infected patients."
The consistent finding of virus on the outer mask surface is unlikely to have been caused by experimental error or artifact.
A turbulent jet due to air leakage around the mask edge could contaminate the outer surface." Basically the mask has to be fitted perfectly, otherwise, it will leak..
In conclusion, both surgical and cotton masks seem to be ineffective in preventing the dissemination of SARS–CoV-2 from the coughs of patients with COVID-19 to the environment and external mask surface."
The retraction on this was very questionable when you read it..
"LOD of the in-house reverse transcriptase polymerase chain reaction used in the study (2.63 log copies/mL), and we regret our failure to express the values below LOD as “<LOD (value).”
"Although mechanistic studies support the potential effect of hand hygiene or face masks, evidence from 14 randomized controlled trials of these measures did not support a substantial effect on transmission of laboratory-confirmed influenza.
In pooled analysis, we found no significant reduction in influenza transmission with the use of face masks....
....None of the household studies reported a significant reduction in secondary laboratory-confirmed influenza virus infections in the face mask group (11–13,15,17,34,35)
There is limited evidence for their effectiveness in preventing influenza virus transmission either when worn by the infected person for source control or when worn by uninfected persons to reduce exposure. Our systematic review found no significant effect of face masks on transmission of laboratory-confirmed influenza.
We did not find evidence that surgical-type face masks are effective in reducing laboratory-confirmed influenza transmission, either when worn by infected persons (source control) or by persons in the general community to reduce their susceptibility (Figure 2)."
Moreover, why did the CDC choose to leave this out of their "research" or evidence?
(April 2020).. skip to chapter 16 if you like or read the whole thing.
"There are no studies of individuals wearing homemade fabric masks in the course of their typical activities. Therefore, we have only limited, indirect evidence regarding the effectiveness of such masks for protecting others, when made and worn by the general public on a regular basis. That evidence comes primarily from laboratory studies testing the effectiveness of different materials at capturing particles of different sizes.
The evidence from these laboratory filtration studies suggests that such fabric masks may reduce the transmission of larger respiratory droplets. There is little evidence regarding the transmission of small aerosolized particulates of the size potentially exhaled by asymptomatic or presymptomatic individuals with COVID-19."
Note the word "may" but they simply don't know at this point.. But the evidence doesn't support the narrative.. Weird..
Results: A total of six RCTs involving 9 171 participants were included. There were no statistically significant differences in preventing laboratory-confirmed influenza (RR = 1.09, 95% CI 0.92-1.28, P > .05), laboratory-confirmed respiratory viral infections (RR = 0.89, 95% CI 0.70-1.11),
laboratory-confirmed respiratory infection (RR = 0.74, 95% CI 0.42-1.29) and influenza-like illness (RR = 0.61, 95% CI 0.33-1.14) 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).
Conclusion: The use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory-confirmed influenza. It suggests that N95 respirators should not be recommended for general public and non-high-risk medical staff those are not in close contact with influenza patients or suspected patients
"Asymptomatic infection may be rare, and transmission from an asymptomatic person is very rare with other coronaviruses, as we have seen with Middle East Respiratory Syndrome coronavirus.Thus, transmission from asymptomatic cases is likely not a major driver of transmission.Persons who are symptomatic will spread the virus more readily through coughing and sneezing"
Pre-Covid
Sept 2019 - N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel A Randomized Clinical Trial Findings
In this pragmatic, cluster randomized clinical trial involving 2862 health care personnel, there was no significant difference in the incidence of laboratory-confirmed influenza among health care personnel with the use of N95 respirators (8.2%) vs medical masks (7.2%).
June 2019 - Optical microscopic study of surface morphology and filtering efficiency of face masks.
" The PM10 filtering efficiency of four of the selected masks ranged from 63% to 84%. The poor filtering efficiency may have arisen from larger and open pores present in the masks. Interestingly, we found that efficiency dropped by 20% after the 4th washing and drying cycle."
Basically, after 4 washes the cloth masks are once again useless..
MARCH 2018 - Effect of a surgical mask on six minute walking distance
"Introduction: Six minutes walking test (6MWT) is regularly used in pulmonology. To minimize the risk of cross-infection, some patients must wear surgical mask at rest and sometimes during exercise.
Results: Distance was not modified by the mask (P=0.99). Dyspnea variation was significantly higher with surgical mask (+5.6 vs. +4.6; P<0.001) and the difference was clinically relevant. No difference was found for the variation of other parameters.
Conclusion: Wearing a surgical mask modifies significantly and clinically dyspnea without influencing walked distance.
2018 - Comparison of the Filter Efficiency of Medical Nonwoven Fabrics against Three Different Microbe Aerosols
“We conclude that the filter efficiency test using the phi-X174 phage aerosol may overestimate the protective performance of nonwoven fabrics with filter structure compared to that against real pathogens such as the influenza virus.”
May 2016 - “The surgical mask is a bad fit for risk reduction” (perspective)
“I propose that the surgical mask is a symbol that protects from the perception of risk by offering nonprotection to the public while causing behaviours that project risk into the future … In an annex to the Canadian pandemic influenza preparedness plan covering public health measures, the Public Health Agency of Canada (PHAC) does not recommend the use of masks by well individuals in pandemic situations, acknowledging that the mask has not been shown to be effective in such circumstances … The same annex on public health measures refers to the “false sense of security” that a mask can psychologically provide, but the converse is the real risk posed to a government unable to mollify its population.”
Nov 2014 Effects of long-duration wearing of N95 respirator and surgical facemask: a pilot study
“In conclusion, there is an increase of nasal resistance upon removal of N95 respirator and surgical facemask after 3hours wearing which potentially due to nasal physiological changes, instead of the size of nasal airways. The nasal resistance was not recovered even after 1.5hours removal of respirator/facemask. In addition, the N95 respirator caused higher post-wearing nasal resistance than surgical facemask with different recovery routines.”
Feb 2014 - Disposable surgical face masks for preventing surgical wound infection in clean surgery
Lipp and Edwards reviewed the surgical literature in 2014 and found “no statistically significant difference in infection rates between the masked and unmasked group in any of the trials.”
Vincent and Edwards updated this review in 2016 and the conclusion was the same.
June 2014 - Dubious effect of surgical masks during surgery.
Based on four studies and 6,006 patients, wrote that “none of the four studies found a difference in the number of post-operative infections whether you used a surgical mask or not.”
November 8, 2012 - “Need Satisfaction and Well-Being: Testing Self-Determination Theory in Eight Cultures”. Journal of Cross-Cultural Psychology.
"Self-Determination Theory (SDT) proposes that certain evolved psychological needs must be satisfied if individuals are to develop to their fullest potential, in the same way that plants require key nutrients to thrive (refs). SDT posits three universal needs: autonomy, competence, and relatedness. Autonomy involves the need to experience one’s behavior as freely chosen and volitional, rather than imposed by external forces. Competence involves the need to feel capable and effective in one’s actions. Relatedness involves the need for belonging, intimacy, and connectedness to others. SDT theorists view these needs as broad motivational tendencies that operate across life domains and contend that satisfaction of all three needs, not just one or two, is essential for well-being. Although the expression or means of satisfying these needs may vary across cultures, their satisfaction is viewed as essential for well-being in all cultures.”
"A shortage of disposable filtering facepiece respirators can be expected during a pandemic...
... To address the filtration performance of common fabric materials against nano-size particles including viruses, five major categories of fabric materials including sweatshirts, T-shirts, towels, scarves, and cloth masks were tested for polydisperse and monodisperse aerosols (20–1000 nm) at two different face velocities (5.5 and 16.5 cm s−1) and compared with the penetration levels for N95 respirator filter media. The results showed that cloth masks and other fabric materials tested in the study had 40–90% instantaneous penetration levels against polydisperse NaCl aerosols employed in the National Institute for Occupational Safety and Health particulate respirator test protocol at 5.5 cm s (1)."
Fauci conducted a study in which the major finding was that the majority of deaths from the Spanish Flu Pandemic of 1918/1919 was not from the influenza virus, but from bacterial infection, which we are today seeing an alarming rise in due to the social use of face coverings. The recommendation to wear face coverings is therefore a deliberate act of harm which you can no longer plead ignorance to.
April 2006 - Masks may cause hypoxia
".. [2][3][4] Third, the reproducibility of fi t testing over time has been questioned. 58 Fourth, prolonged use of N95 respirators has been shown to cause headaches, 59 facial discomfort, 60 and may result in hypoxia. 61 Therefore, we seriously question whether poor compliance would negate any potential benefi t that might be gained from their use. ..."
“Discussion: This first randomized cross-over study assessing the effects of surgical masks and FFP2/N95 masks on cardiopulmonary exercise capacity yields clear results. Both masks have a marked negative impact on exercise parameters such as maximum power output (Pmax) and the maximum oxygen uptake (VO2max/kg). FFP2/N95 masks show consistently more pronounced negative effects compared to surgical masks. Both masks significantly reduce pulmonary parameters at rest (FVC, FEV1, PEF) and at maximum load (VE, BF, TV). …
Pulmonary function: … The data of this study are obtained in healthy young volunteers, the impairment is likely to be significantly greater, e.g., in patients with obstructive pulmonary diseases (ref). From our data, we conclude that wearing a medical face mask has a significant impact on pulmonary parameters both at rest and during maximal exercise in healthy adults. 13
Cardiac function: … These data suggest a myocardial [relating to the muscular tissue of the heart] compensation for the pulmonary limitation in the healthy volunteers. In patients with impaired myocardial function, this compensation may not be possible.”
"Most patients with end-stage renal disease (ERSD) visiting our hospital for hemodialysis treatment during the SARS outbreak wore an N95 mask. Data on the physiological stress imposed by the wearing of N95 masks remains limited. This study investigated the physiological impact of wearing an N95 mask during hemodialysis (HD) on patients with ESRD.
Each patient wore a new N95 mask (3M Model 8210) during HD (4 hours). Vital signs, clinical symptoms and arterial blood gas measured before and at the end of HD were compared.
Results - Thirty nine patients (23 men; mean age, 57.2 years or 70%) were recruited for participation in the study. Seventy percent of the patients showed a reduction in partial pressure of oxygen (PaO2), and 19% developed various degrees of hypoxemia. Wearing an N95 mask significantly reduced the PaO2 level.... increased the respiratory rate.... increased the occurrence of chest discomfort.... and respiratory distress
CONCLUSION- Wearing an N95 mask for 4 hours during HD significantly reduced PaO2 and increased respiratory adverse effects in ESRD patients"
Lahme et al., in 2001, wrote that “surgical face masks worn by patients during regional anaesthesia, did not reduce the concentration of airborne bacteria over the operation field in our study. Thus they are dispensable.”
In five years of doing peritoneal dialysis without masks, rates of peritonitis in their unit were no different than rates in hospitals where masks were worn.
MEDICAL RELATED
2021
A systematic review and meta-analysis to “assess the impact of PPE use on HCWs’ physical health during the COVID19 pandemic”. Their “review included 14 studies with 11746 HCWs from 16 counties”:
“Results (Abstract): A total of 343 healthcare professionals on the COVID-19 front lines participated in this study [New York City]. 314 respondents reported adverse effects from prolonged mask use with headaches being the most common complaint (n = 245). Skin breakdown was experienced by 175 respondents, and acne was reported in 182 respondents. Impaired cognition was reported in 81 respondents. … Some respondents experienced resolved side effects once masks were removed, while others required physical or medical intervention.
Conclusion (Abstract): Prolonged use of N95 and surgical masks by healthcare professionals during COVID-19 has caused adverse effects such as headaches, rash, acne, skin breakdown, and impaired cognition in the majority of those surveyed. …”
“Conclusion (Abstract): (A total of 155 healthcare workers responded to the questionnaire [Morocco].) The increased use of PPE, especially high filtrating masks during the COVID-19 outbreak is responsible for generating headaches in healthcare workers on frontline (62%) either De novo (33%) or as an aggravation of pre-existing one (29%). Working conditions have the greater impact on generating these types of headaches more than any pre-existing comorbidity.”
2020
“Results: … Out of 241 [Pakistan], 68 participants (28.2%) reported de novo headaches since the start of the pandemic, with majority describing the headache as bilateral in location ( n= 47, 69%), with pressure/heaviness in quality ( n = 31, 45.5%) and moderate in intensity ( n =45, 66%). … Out of the 68 participants with new-onset headaches, 16 (23.5%) stated that the headache started more than 2 hours after donning PPE, while 19 (27.9%) participants stated that the headache ended between 1-2 hours after doffing of PPE. Fifty-three respondents (77.9%) experienced the headaches for 4 or less days per month. …”
“…Several dermatoses [skin defects or lesions on the skin] have been reported due to PPE, such as pressure injury, contact dermatitis, pressure urticaria [hives] and exacerbation of pre‐existing skin diseases, including seborrheic dermatitis [scales] and acne.(2 refs) We report a preliminary data of HCW who experienced facial dermatoses due to the use of PPE. From 24 March 2020 to 16 April 2020, we came across with 43 patients comprising physicians, nurses and paramedical staff who involved (directly/indirectly) in managing patients of COVID‐19 [India]. … The most commonly noted dermatoses were irritant contact dermatitis (ICD; 39.5%) followed by friction dermatitis (25.5%). Goggles were the most common culprit agent among all PPE causing any one of the dermatoses (51.92%), followed by N95 masks (30.77%) and face shields (17.31%). Nasal bridge (63%) was the commonest anatomical site affected due to dermatoses followed by cheeks and chin (26%). However, there was a considerable overlap of different dermatoses with affliction of multiple sites. The most common symptom experienced by patients was pruritus [itchiness] (67.44%), while erythema [redness] (53.49%) was the most common sign observed. Interestingly, we observed two distinct dermatoses, i.e. whole face erythema (suffusion; 21%) attributed to doffing after a long shift and lip lick dermatitis due to constant licking of lips, because of feeling of intense thirst due to restricted fluid intake after donning PPE. The duration of wearing the goggles and mask, excessive sweating and ill‐fitting masks, all were associated with increased sensation of irritation. Most of these dermatoses responded well to topical moisturizer, calamine lotion and oral antihistamines. Overall, 21% patients suffered from work absenteeism due to one of the dermatoses. Personal protective equipment‐induced dermatoses occur mainly due to the occlusion and hyper‐hydration effect of PPE and friction leading breach in the epidermal integrity.(ref) Recently, in China, authors noted a very high prevalence, i.e. 97% of skin damages in first‐line HCW fighting COVID‐19.(ref)”
Results (Abstract): (315 participants, Turkey) … New-onset symptom rate was 66% (n=208).
The most common new-onset symptom was headache (n=115, 36.5%) followed by breathing difficulty-palpitation (n=79, 25.1%) and dermatitis (n=64, 20.3%). Extended use of PPE, smoking, and overweight were independently associated with developing new-onset symptoms. A clear majority of symptomatic participants pointed out impact on working performance (193/208, 92.7%).
“Results (Abstract): The subjects are n=306, 244 women (79.7%), with an average age of 43 years (range 23–65) [Spain]. Of the total, 129 (42.2%) were physicians, 112 (36.6%) nurses and 65 (21.2%) other health workers. 208 (79.7%) used surgical masks and 53 (20.3%) used filter masks. Of all those surveyed, 158 (51.6%) presented ‘de novo’ headache. The occurrence of a headache was independently associated with the use of a filter mask, OR 2.14 (95% CI 1.07 to 4.32); being a nurse, OR 2.09 (95% CI 1.18 to 3.72) or another health worker, OR 6.94 (95% CI 3.01 to 16.04); or having a history of asthma, OR 0.29 (95% CI 0.09 to 0.89). According to the type of mask used, there were differences in headache intensity, and the impact of a headache in the subjects who used a filter mask was worse in all the aspects evaluated.
Conclusion (Abstract): The appearance of ‘de novo’ headache is associated with the use of filter masks and is more frequent in certain healthcare workers, causing a greater occupational, family, personal and social impact.”
“Results (Abstract): A total of 158 healthcare workers participated in the study [Singapore].
Out of 158 respondents, 128 (81.0%) respondents developed de novo PPE-associated headaches. A pre-existing primary headache diagnosis (OR = 4.20, 95% CI 1.48-15.40; P = .030) and combined PPE usage for >4 hours per day (OR 3.91, 95% CI 1.35-11.31; P = .012) were independently associated with de novo PPE-associated headaches. Since COVID-19 outbreak, 42/46 (91.3%) of respondents with pre-existing headache diagnosis either "agreed" or "strongly agreed" that the increased PPE usage had affected the control of their background headaches, which affected their level of work performance.
Conclusion (Abstract): Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.
On 13 August 2020, the surgeons Frountzas et al. warned that COVID-19 enthusiasm for imposing personal protective equipment (PPE) on surgeons could put surgery patients at risk (the equivalent can be said of train, tram, and bus drivers, and a large sector of workers servicing the public):
“Either in the case of a second lockdown or not, the safety of PPE use against COVID-19 for surgeons should be investigated. All parts of PPE increase surgeon's body temperature and sweating, leading to an impairment of surgeon's comfort, especially during prolonged and complicated surgical procedures. As mentioned above, PPE seems to be associated with important side effects, like dermatoses and headaches for healthcare workers. The PPE-associated discomfort and side effects during surgery may increase surgeons' anxiety and fatigue while performing difficult operations.”
"The study carried out by Ong et al.1 is noteworthy for the high level of clinical detail and the originality of the observation. The topographical relationship between the points of skin contact of the N95 face mask as well as protective eyewear with headache is novel and suggestive, and could give indications for the technical improvement of the devices. However, this research has some weaknesses, which only subsequent investigations can clarify.
In workplaces, where no pollution problems are reported, a significant share of indoor workers (6% of males, 9% of females) suffer “often, at least once a week” from headaches attributed to the working environment.2 This symptom is significantly associated with occupational stress.3 The individual characteristics of workers, in particular anxiety and depression, significantly influence the reporting of headache.4 Among health care workers, headache is associated with occupational stress5 and with sleep problems,6 as well as with anxiety and depression that were significantly increased during the COVID‐19 pandemics.7
This study did not take into account these variables. This may be a major limitation because the study population was drawn from high‐risk hospital areas such as isolation wards (designated as “pandemic wards”), the emergency rooms and medical intensive care unit. In these settings, workers are highly likely to experience emotional overload. The association between Personal Protective Equipment (PPE) and headache could be, therefore, spurious and the real factor should be sought among the psychosocial factors associated with the pandemic.
Furthermore, the study is entirely based on what workers remember of the situation before the epidemic, and this inevitably exposes to a possible recall bias.
We are convinced that the association between PPE and headache is worthy of controlled longitudinal studies, which compare different types of PPE and take into account all confounding factors."
“Abstract: … All participants wore either surgical masks or N95 respirators for a minimum of 4 h per day [India]. … A total of 250 healthcare workers participated in the study … The acquired results were excessive sweating around the mouth accounting to 67.6%, difficulty in breathing on exertion 58.2%, acne 56.0% and itchy nose 52.0%. This study suggests that prolonged use of facemasks induces difficulty in breathing on exertion and excessive sweating around the mouth to the healthcare workers which results in poorer adherence and increased risk of susceptibility to infection.”
May 21, 2020 - Universal Masking in Hospitals in the Covid-19 Era
“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.
It is also clear that masks serve symbolic roles. Masks are not only tools, they are also talismans that may help increase health care workers’ perceived sense of safety, well-being, and trust in their hospitals. Although such reactions may not be strictly logical, we are all subject to fear and anxiety, especially during times of crisis. One might argue that fear and anxiety are better countered with data and education than with a marginally beneficial mask, particularly in light of the worldwide mask shortage, but it is difficult to get clinicians to hear this message in the heat of the current crisis. Expanded masking protocols’ greatest contribution may be to reduce the transmission of anxiety, over and above whatever role they may play in reducing transmission of Covid-19. “
“The most commonly noted dermatoses were irritant contact dermatitis (ICD; 39.5%) followed by friction dermatitis (25.5%). Goggles were the most common culprit agent among all PPE causing any one of the dermatoses (51.92%), followed by N95 masks (30.77%) and face shields (17.31%). Nasal bridge (63%) was the commonest anatomical site affected due to dermatoses followed by cheeks and chin (26%). However, there was a considerable overlap of different dermatoses with affliction of multiple sites. The most common symptom experienced by patients was pruritus (67.44%), while erythema (53.49%) was the most common sign observed. Interestingly, we observed two distinct dermatoses, i.e. whole face erythema (suffusion; 21%) attributed to doffing after a long shift and lip lick dermatitis due to constant licking of lips, because of feeling of intense thirst due to restricted fluid intake after donning PPE. The duration of wearing the goggles and mask, excessive sweating and ill-fitting masks, all were associated with increased sensation of irritation.”
May 2020 - “Headaches Associated With Personal Protective Equipment - A Cross-Sectional Study Among Frontline Healthcare Workers During COVID-19”. Headache: The Journal of Head and Face Pain.
“Conclusion: Most healthcare workers develop de novo PPE-associated headaches or exacerbation of their pre-existing headache disorders.”
"Results"
A total of 343 healthcare professionals on the COVID-19 front lines participated in this study. The majority were female (n = 315) and 227 were located in New York City. 225 respondents identified as White, 34 as Hispanic, 23 as African American, and 61 as "other" ethnicity. 314 respondents reported adverse effects from prolonged mask use with headaches being the most common complaint (n = 245). Skin breakdown was experienced by 175 respondents, and acne was reported in 182 respondents. Impaired cognition was reported in 81 respondents. Previous history of headaches (n = 98), skin sensitivity (n = 164), and acne (n = 121) were found in some respondents. Some respondents experienced resolved side effects once masks were removed, while others required physical or medical intervention.
"Conclusion"
Prolonged use of N95 and surgical masks by healthcare professionals during COVID-19 has caused adverse effects such as headaches, rash, acne, skin breakdown, and impaired cognition in the majority of those surveyed. As a second wave of COVID-19 is expected, and in preparation for future pandemics, it is imperative to identify solutions to manage these adverse effects. Frequent breaks, improved hydration and rest, skin care, and potentially newly designed comfortable masks are recommendations for future management of adverse effects related to prolonged mask use."
Pre-Covid
“Given that there is no evidence that they cause any harm either, proponents would rather err on the side of caution and encourage their continued use, stressing that there is no room for complacency when it comes to ensuring patient safety.25
Another unavoidable aspect of this debate is that of public perception. In the public psyche, facemasks have become so strongly associated with safe and proper surgical practice that their disposal could cause unnecessary patient distress.
It is important not to construe an absence of evidence for effectiveness with evidence for the absence of effectiveness. While there is a lack of evidence supporting the effectiveness of facemasks, there is similarly a lack of evidence supporting their ineffectiveness. With the information currently available, it would be imprudent to recommend the removal of facemasks from surgery. Instead, in the medical field where common practice can so easily become dogma, it is necessary to recognzse the constant need to maintain a healthy scepticism towards established beliefs and to periodically re-evaluate and critically assess their scientific merit.”
June 17, 2015 - “Unmasking the surgeons: the evidence base behind the use of facemasks in surgery”
"overall there is a lack of substantial evidence to support claims that face masks protect either patient or surgeon from infectious contamination"
Sept 2013 - Surgical attire and the operating room: role in infection prevention
An investigated the necessity of scrubs, masks and head coverings in the operating room and concluded that “there is no evidence that these measures reduce the prevalence of surgical site infection.”
Mar 2010 - Use of face masks by non-scrubbed operating room staff: a randomized controlled trial
“Conclusion: Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.”
“Results: Thirty-two health care workers completed the study, resulting in 2464 subject days. There were 2 colds during this time period, 1 in each group. Of the 8 symptoms recorded daily, subjects in the mask group were significantly more likely to experience headache during the study period (P < .05). Subjects living with children were more likely to have high cold severity scores over the course of the study.
Conclusion: Face mask use in health care workers has not been demonstrated to provide benefit in terms of cold symptoms or getting colds. A larger study is needed to definitively establish non-inferiority of no mask use.
Apr-June 2009 - Does evidence based medicine support the effectiveness of surgical facemasks in preventing postoperative wound infections in elective surgery?
A systematic literature review in 2009 and found that “no significant difference in the incidence of postoperative wound infection was observed between masks groups and groups operated with no masks.”
May 2008 - Surgical mask filter and fit performance (DENTAL)
Methods: Filter penetration was measured for at least 3 replicates of 9 surgical masks using mono disperse latex sphere aerosols (0.895, 2.0, and 3.1 micron) at 6 L/min and 0.075-micron sodium chloride particles at 84 L/min. Facial fit was measured on 20 subjects for the 5 masks with lowest particle penetration, using both qualitative and quantitative fit tests.
Results: Masks typically used in dental settings collected particles with significantly lower efficiency than those typically used in hospital settings. All subjects failed the unassisted qualitative fit test on the first exercise (normal breathing). Eighteen subjects failed the assisted qualitative fit tests; 60% failed on the first exercise. Quantitative fit factors ranged from 2.5 to 9.6.
Conclusion: None of these surgical masks exhibited adequate filter performance and facial fit characteristics to be considered respiratory protection devices.
July 1, 1991 - Surgical face masks in modern operating rooms—a costly and unnecessary ritual
“Oral microbial flora dispersed by unmasked male and female volunteers standing one metre from the table failed to contaminate exposed settle plates placed on the table. The wearing of face masks by non-scrubbed staff working in an operating room with forced ventilation seems to be unnecessary."
May 1991 - Postoperative wound infections and surgical face masks: A controlled study
“It has never been shown that wearing surgical face masks decreases postoperative wound infections. 'On the contrary, a 50% decrease has been reported after omitting face masks......
After 1,537 operations performed with face masks, 73 (4.7%) wound infections were recorded and, after 1,551 operations performed without face masks, 55 (3.5%) infections occurred. This difference was not statistically significant (p> 0.05) and the bacterial species cultured from the wound infections did not differ in any way, which would have supported the fact that the numerical difference was a statistically “missed” difference.
These results indicate that the use of face masks might be reconsidered. "
1981 - “Is a mask necessary in the operating theatre?”
(pg 391 first paragraph under Table 1)
"There was no increase in wound infections be interesting to see whether comparable results when masks were discarded in I980; in fact are obtained in emergency, orthopaedic, or designed only to see whether wound infection in- there was a significant (p<o.o5) decrease." Note, their references date back as far as 1905.