By Cindy Gough
Cindy Gough holds a Bachelor of Science in Nursing and has been a certified Operating Room Nurse for 25 years. She also has a Master’s Degree from Queens University in Health and Aging and is certified in Gastroenterology with the Canadian Nurses Association.
I’ve been wearing masks for 25 years in my role as an operating-room nurse. So I have a firm grasp on masks’ risks and benefits and how to use them correctly. I’m having a hard time watching the misuse of masks all around me after the folly of the universal-mask-wearing recommendations to control COVID-19 of influential public-health officials.
For example, Canada’s Chief Public Health Officer, Dr. Teresa Tam, shifted gears on May 20 and began recommending that the public wear them. This flies in the face of her original concern that the incorrect use of masks could spread infection.
Unfortunately, Dr. Tam and other officials are ignoring compelling evidence that universal mask-wearing of healthy people is bad policy.
The World Health Organization (WHO) recommended masks only for those showing symptoms or caring for someone with COVID-19. The global organization also noted masks carry uncertainties and critical risks including “self-contamination by touching and reusing a contaminated mask.”
Yet 13 weeks into this pandemic they presented dizzying contradictions. Not only do they now recommend universal use of cloth masks — but just days after making this announcement admitted that asymptomatic viral shed is “very rare.” This statement aligns with a May 2020 study confirming the infectivity of asymptomatic SARS-CoV-2 carriers is weak. In addition, early evidence that stoked concerns of asymptomatic shed was flawed. Meanwhile, it is the threat of asymptomatic shed that now justifies mask use on healthy people.
The WHO’s new mask recommendation aligns with that of the CDC and with an open letter by a group of academics to U.S. governors asking them to require everyone to wear a cloth mask in public (the academics say even paper towels are effective).
But these experts ignore the fact that any benefit of masking is from studies on medical-grade masks not cloth ones. To date, the only randomized controlled study of cloth face coverings to reduce spread of the novel coronavirus warned against their use because they posed a 13% increased risk of infection to those wearing them.
The CDC has cautioned that cloth masks (and surgical ones for that matter) shouldn’t be considered personal protective equipment since their ability to protect workers from COVID-19 is “unknown.” This is due to inadequate filter capacity and facial fit . They also add that “currently we are not finding any data that can quantify risk reduction from the use of masks.”
A May 2020 meta-analysis published in the CDC journal Emerging Infectious Diseases that examined studies from 1946-2018 found surgical face masks don’t significantly reduce viral transmission and that improper use increases the risk of infection spread. This aligns with Scientific advice to the UK government which found inconclusive evidence to support any benefit from community mask use. Dr. Michael Osterholm, director of the Center of Infectious Disease and Research Policy, cautions against basing public masking policies on inadequate evidence. He notes the influx of poor quality studies in support of masking since the onset of the pandemic. His concern extends to the CDC’s recommendation of cloth masks, stating: “Never before in my 45-year career have I seen such a far-reaching public recommendation issued by any governmental agency without a single source of data or information to support it.”
Also, experts in masks and infectious aerosols affiliated with the University of Illinois showed in an April 2020 evidence review that masks-for-all COVID-19 policies are not based on sound data.
Closer to home, Ontario Civil Liberties researcher Dr. Dennis Rancourt showed there’s an egregious lack of evidence supporting masking in his paper “Masks don’t work: A review of science relevant to COVID-19 social policy.”
Also in Ontario, evidence that masks can prevent the transmission of influenza (and asymptomatic viral shed) was found to be “scant” in two recent labour arbitrations.
Even in operating rooms the benefit of routine masking of all staff is a hotly debated issue. Several systematic reviews have not found evidence that masks reduce infection rates in surgery. In fact, some studies suggest they may even increase the infection rate.
Masks can harbor harmful contaminants. Bacterial surveillance data found the outside surface of a surgical mask is dirtier than the floor — and the inside 100 times dirtier than that. Indeed, a 2019 paper examining the presence of viruses on the surface of medical masks concluded, “Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination.”
Even among trained medical personnel, contamination caused by the incorrect removal of masks is a persistent problem. Studies show that even under the threat of Ebola, the biggest contamination risk is from the way masks are removed
Meanwhile, we now see lay people including children routinely wearing masks. They appear unaware they’re wearing a highly contaminated filter on their face that can transmit infection if it’s handled, stored or disposed of improperly.
Their masks are often hanging under their chins or with their noses fully exposed. They’re reusing and repeatedly adjusting their masks and storing them in their pockets and purses. I have yet to see one person sterilize their hands after touching their mask.
In April 2020, leading epidemiologists pointed out in the British Medical Journal that there are other serious potential side-effects of wearing masks. They wrote, “it is necessary to quantify the complex interactions that may well be operating between positive and negative effects of wearing surgical masks at population level. It is not time to act without evidence.”
In addition, some people can’t wear masks due to anxiety or respiratory conditions. And the hard of hearing may not be able to hear someone who’s wearing a mask – leading potentially to not only alienation, but consequential miscommunication. In multicultural settings, those who do not speak English also may misunderstand what’s being said or intended by mask-wearers, as may people with cognitive impairments or mental health issues. Impacts to school children’s’ mental health must equally be considered. Further isolation from losing an essential element of communication – non-verbal somatic cues from seeing each other’s faces risks impairing important elements of a child’s development.
Certainly, there is a time and a place for masking. But Dr. Tam and other prominent public-health officials should have stuck with the evidence and continued discouraging universal mask use by the public. Because in an era where people pull masks up and down to talk or wear them when they’re driving alone in a car with the windows up, we have a long way to go before the public understands their purpose or the risk masks could pose at this critical time.
By the way, don’t even get me started on gloves……