Rehess,

We don't know positively that the virus ONLY travels in large water vapor molecules. It could just as easily travel in much smaller molecules like aerosols and even by itself. Check this story discussed on the University of Minnesota website - "Data do not back cloth masks to limit COVID-19, experts say." https://www.cidrap.umn.edu/news-perspective/2020/04/data-do-not-back-cloth-masks-limit-covid-19-experts-say

"The National Academies' Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats said that, because no studies have been done on the effectiveness of cloth masks in preventing transmission of coronavirus to others, it is impossible to assess their benefits, if any." Should we ignore these "experts'" analysis and conclusions?"

The report goes on to say,

"Committee members point out that research suggests that COVID-19 can spread via invisible droplets as small as 5 microns and by tiny bioaerosol particles as well as via visible respiratory droplets just by breathing.

"Infected yet asymptomatic people are of particular concern because the particles they breathe are predominantly bioaerosols. "To complicate matters further, different individuals vary in the extent to which they emit bioaerosols while breathing," they said.

"Because different masks have different filtering capacities and the role of droplet size on disease transmission is unknown, it is difficult to predict the effectiveness of these masks, the authors said. "The extent of any protection will depend on how the masks are made and used," they wrote. "It will also depend on how mask use affects users' other precautionary behaviors, including their use of better masks, when those become widely available."

When done reading that article, check out this updated one from the same site,
https://www.cidrap.umn.edu/news-perspective/2020/04/commentary-masks-all-covid-19-not-based-sound-data

The important point here is that a cloth mask, by itself, is not as effective in preventing infection as most people think it is. Wearing a mask is only one small part of a more complete mitigation program to reduce our risk to this virus. Remember, the most effective method of eliminating our risk to the virus is to stay away from the virus and anyone who has has it. If you are not exposed to the virus, you will not get infected. If you must potentially be exposed, take a multitude of mitigation actions - distance, reduced exposure time, good masks properly worn, decontamination (proper washing), and healthy living. Do not risk your life on a simple cloth mask as your only protection!

Daryl

I probably should have finished her story. Eventually the hematologist determined that autoimmune disease had destroyed her bone marrow; he had seen only one case of this, but they were able to rebuild it. Right now, she is ‘normal’, but we assume that she might quickly become a Covid-19 victim, but she needs the presence of others much more than I do {our daughters say I am a natural hermit}; the main force holding her back is her awareness that I am the one she would bring the virus home to. So, we cautiously go through life trying to follow the best advice we can find. Ever since that experience, a small bottle of sanitizer has been resident in her purse, so she does a better job of cleaning her hands, and I do a better job of staying away from people.

Daryl,
I read the two articles you referenced; important contributions to the discussion. They are too long and detailed to comment on all specifics. But here are some thoughts. By way of background: I do not have any medical expertise. I do have some experience related to the design and use of respiratory protection. And I have extensive experience working with the scientific community.

As pointed out in the articles, scientific knowledge for Covid-19 is incomplete. Significant issues, such as the nature of the mask filter challenge (both larger droplets and aerosols? what percentage?) seem to be unresolved. Scientists need data to draw conclusions. So do most of us. But we can draw our conclusions based on whatever data is available supplemented by common sense. Scientists can’t do that. (Of course I’m not saying they have no common sense; just that they can’t make it part of the scientific method of arriving at conclusions….)

The authors seem to focus on “worst case” situations. This may be somewhat typical of scientists and, given their role, is perhaps understandable. But I don’t want to dwell on worst case. I want to reduce the risk to myself and others. Will masking help me do that? I think so….

Note that after painting a rather bleak picture of the effectiveness of masks (specifically cloth masks) the authors of one of the articles state “Despite the current limited scientific data detailing their effectiveness, we support the wearing of face coverings by the public when mandated and when in close contact with people whose infection status they don't know.”

And to come back to your main point, and I agreed with you before, absolutely, masking should be part of a behavior pattern that includes distancing and hygiene…and common sense!

Daryl,
Thank you for your contributions to the discussion. There is much we agree on (maybe most things!), but some of your comments I take issue with. As I said before, you seem to endorse an "all or nothing" approach. I can't agree to that. We should all strive for maximum risk reduction for ourselves and others. But that is not to say that achieving a lower level isn't also worthwhile. My concern is the people that refuse to wear a mask. Your "all or nothing" message is counterproductive in that it could reinforce their view that mask wearing is too much of a hassle and not worth it.

Quote: "If a mask allows a contaminant to enter your lungs either because the contaminant bypasses it, or the mask traps some contaminants and allows them to build up and then the increased amount enters your lungs, how can that be considered effective? How much contaminant can a mask allow to pass into your lungs before it is considered ineffective?"

There are too many possible scenarios regarding the contaminated environment and too many unknowns. Without quantifiable cause-effect data, I will fall back on the answers science has provided us so far and common sense and say that any reduction in the risk of inhaling this bug is worth pursuing. And lets not forget what has been touted as the main reason for wearing masks: keeping your bugs to yourself and not spreading them around. Do you also believe that that use of a mask requires a perfect fit?

Quote: "Is it better than no mask? I say, "YES". But that doesn't mean that by wearing a mask we are protected. My point is that we need the right kinds of masks, we need to wear them properly, and we need to do additional mitigation activities to be protected."

By wearing a mask we are protected at least to some extent. We are also protecting others. Your calling for “the right kinds of masks” raises interesting questions and could be the subject of lengthy discussions. N95 masks are tested to a standard protocol for both filtration effectiveness and fit. Other masks, like dust masks and, of course, homemade masks are not. There should be more guidance from the experts. But for me the bottom line is still that any mask properly worn will REDUCE THE RISK. I absolutely agree with you that masks need to be worn properly (we’ve all seen pictures of folks running around with mouth covered but nose exposed!) and that mask wearing should be in conjunction with other “mitigation activities”.

Quote: "Do we know if the COVID-19 virus still enters our lungs while the water vapor molecule stay trapped in some mask fibers? What happens at the fiber saturation point? How many of these water vapor molecules pass through the single ply masks most people wear? Then, how many pieces of the virus must a person inhale before he or she gets infected?"

“What if” analyses can obscure goals and muddy the waters of clear thinking. I suggest we go with what we know and add a good dose of common sense. I will agree that more research is needed about the filter challenge posed by the virus. You make reference to the viral load required for infection. I sure don’t know what it is for coronavirus. But masking will reduce the viral load we take in and that’s good enough for me to act on at this point.

Quote: "A simple mask COULD educe the viral load, but don't solely bet your life on it. There are just too many unknowns with this virus to say definitively that a simple mask will protect us. I don't believe it. The science so far is also all over the place about it, so which "experts" to believe? We need to take multiple mitigation measures to better protect ourselves at least until a vaccine or medicines are available to treat it."

This sounds like “all or nothing” again. Nothing is definite and nobody is saying that wearing a simple mask “will protect us”. RISK REDUCTION. And I don’t quite agree with you that “science…is all over the place”. But I definitely agree with you that we need “to take multiple mitigation measures”.

Quote: "My big issue with this is like telling a person to lock their house door while leaving the windows open. Sure the door is locked and that will slow down a thief from entering that way, but are you really safe (protected)? Are your risks really reduced by the locked door, or do you only think they are? Same concept applies with the masks."

Interesting analogy but I don’t buy it. Again this “all or nothing” view seems to downplay the value of masking unless it’s done in conjunction with other actions. When I go to the grocery store I think of masking as the primary means of protecting myself and others regardless of any other actions. I do also use sanitizing lotions and wash my hands. And I try to stay away from other people, especially those not wearing a mask!

Quote: "If you really want protection (risk reduction) from the virus, properly wear a good mask, clean and/or change it out after each use, stay away from sick or potentially infected people, stay at least 6 feet away from others, wash your hands and arms properly to keep from accidently spreading contaminants to your face and eyes, reduce stress, exercise, eat healthy, sleep 7 - 8 hours per night, maintain a routine, take your vitamins and other medicines, and finally, enjoy life. You will live better and longer following these recommendations. These are what I do."

Good summary of what we should do, Daryl! You get no argument from me! My basic disagreement with you is, that in your desire to encourage, as you say, “multiple mitigation measures”, you seem to downplay the value of masking. And that, in my opinion, is counterproductive to the goal of getting people to accept that masking is good for them and good for their fellow citizens…

Thanks again for your participation!

Is it possible to have a civil and unemotional discussion of the issue of masking? I’d like to think so and want to give it a try. By way of background, I’ve been called a “Constitutional Conservative” by friends; I consider myself an independent, espousing a liberal or conservative view depending on the issue. In other words, my thinking and judgment is issue-based and, hopefully, always independent of political bias.

I have firm beliefs concerning the masking issue but I fully recognize that there are other, to me perhaps incomprehensible, points of view. I would like to understand these better. Please help me do that with thoughtful, civil and unemotional responses to my positions.

#1 – Covid-19 is a very large and nasty threat to our personal and national health and welfare: Yes, it is a bigger threat to older folks and those with preexisting health issues but it attacks all ages. It is much worse than the common flu. It makes no sense to downplay the magnitude of the problem. So the first step to an effective national response is for all of us to agree that this is a very serious problem. Some people get hung up on what they consider false statistics, how deaths are categorized, how testing results are published, etc. Can we stop this sideshow, folks, and agree that we’ve got a helluva problem and that we all need to contribute to the solution?

#2 – Mask effectiveness: Some argue that masks are ineffective in filtering out viruses and are therefore useless. Generally true that they can’t trap single, individual virus particles. But the virus isn’t dispersed that way. The biggest threat is viruses attached to droplets of fluids expelled in an infected person’s breath, sneeze or cough. True, recent findings suggest the viruses may also travel in aerosol “clouds” that could be airborne for some time (an aerosol can be loosely defined as a cloud of small particles or droplets whose travel is influenced more by air movement than by gravity). But threat aerosol droplets/particles are still bigger than individual viruses. And speaking of individual viruses, the “viral load” (or viral "dose") is a factor in that it determines the severity of the illness. So, do masks offer perfect protection? No. Do they reduce the risk? Absolutely....

#3 – Masks reduce the probability of an infected person infecting others: This one would seem to be tough to argue against. We know that face coverings can stop droplets expelled with breath air, sneezing and coughing. Many infected people have no symptoms and don’t know they are carriers. Doesn’t it make sense to sacrifice a little of your personal freedom and put up with a little discomfort in order to further the safety of others, including your families and friends? What would be your reasons for not doing it?

#4 – Self-protection - masks reduce the probability of you getting infected: Much has been made of the value of face coverings in reducing the dispersion of coronavirus by infected persons. Not much has been said of the protection against coronavirus provided to the individuals wearing the mask. I’ve seen this denied or downplayed. I don’t understand why. The filtration material works the same way, whether the air stream is going one way or the other. Granted, the dynamics of the filter challenge are different. In preventing the spread of coronavirus by an infected person we are trying to stop the droplets at the source. When considering the self-protection aspect of wearing a mask we may be faced with a somewhat different filter challenge in that our physical position relative to the airborne threat, as well as the size of the droplets, may be different. Mask construction and fit are also issues. But masks will reduce the risk of infection to the wearer. How much? There are too many variables to allow accurate assessment. But for me, even a slight risk reduction (and I believe it is significantly more than “slight”) is worth putting up with the downsides. Isn’t it for you?

#5 – Positive effect of mask-wearing on businesses: We all lament the terrible effect coronavirus has had on small businesses and the economy in general. Nobody wants to see local stores and businesses shut down. I believe that businesses would be helped if everyone wore a mask and acted prudently when in public. Mask-wearing would reduce the overall spread of the virus thus moving faster towards relaxation of closures. But it also could have another positive effect. Many people are reluctant to go anywhere because of fear of infection. With everyone wearing masks there would be less fear and more willingness to support business establishments. Isn't this a positive effect of wearing masks in public?

#6 – “It’s an infringement on my rights”: Some say that universal mask requirements are an encroachment on their rights and freedoms. I don’t understand that. I’m not free to shout “Fire!” in a movie theater, talk about bombs when sitting in an airplane, run around the streets naked or urinate in public. I believe in individualism but gladly give up these rights for the common good. But there is another way to look at this. Why not just wear a mask voluntarily based on the benefits discussed above?

#7 – Denial of service to those not wearing a mask: We’ve seen examples of people getting very upset and aggressive when told they can’t come into a store without a mask. This is another one I don’t understand. Why can’t a store insist on mask-wearing? Do you also object to their restrictions against shoeless and shirtless customers? I understand that some people can’t wear masks (difficulty breathing, etc.). But these are special cases and there should be ways to handle them.

#8 – Mask design and availability: In my opinion we are in a war. The government, under the Defense Production Act, should take steps to ensure availability of quality masks not just for health care providers but for all. There should also be a review of mask designs and some guidelines provided for what constitutes an acceptable mask for the public. Should everyone have an N95 mask? Maybe. The masks should be easily decontaminable for reuse. Necessary research and development should be identified and acted on. Some might say it’s too late for that. But what about the next time?

Folks, it’s not an “all or nothing” situation. The name of the game is risk reduction and we should all do our share….wearing a mask is a big part of that.

As I said, I’m interested in understanding why all the negativism regarding mask-wearing. I would appreciate hearing your reasons if you disagree with any of what I’ve said above . But, please, no politics!

Thank you if you got this far!

Your points are up to date and accurate in this ever evolving topic. We hear much about people who refuse to wear masks in the U.S., and perhaps the tide of opinion is at last beginning to move against them which is a good thing. Interestingly...

1. Anti-mask groups are in other countries. We hear much about Brazil, but also they are a serious problem in England and they are also present in Germany. Similar dis-informed arguments are used by all, as far as I have seen.
2. There was a similar problem during the 1918 pandemic, even though that was far more dangerous. Same arguments were used then by those people. The press referred to them as "mask slackers", I kid you not.

Is it possible to have a civil and unemotional discussion of the issue of masking? I’d like to think so and want to give it a try. By way of background, I’ve been called a “Constitutional Conservative” by friends; I consider myself an independent, espousing a liberal or conservative view depending on the issue. In other words, my thinking and judgment is issue-based and, hopefully, always independent of political bias.

I have firm beliefs concerning the masking issue but I fully recognize that there are other, to me perhaps incomprehensible, points of view. I would like to understand these better. Please help me do that with thoughtful, civil and unemotional responses to my positions.

#1 – Covid-19 is a very large and nasty threat to our personal and national health and welfare: Yes, it is a bigger threat to older folks and those with preexisting health issues but it attacks all ages. It is much worse than the common flu. It makes no sense to downplay the magnitude of the problem. So the first step to an effective national response is for all of us to agree that this is a very serious problem. Some people get hung up on what they consider false statistics, how deaths are categorized, how testing results are published, etc. Can we stop this sideshow, folks, and agree that we’ve got a helluva problem and that we all need to contribute to the solution?

#2 – Mask effectiveness: Some argue that masks are ineffective in filtering out viruses and are therefore useless. Generally true that they can’t trap single, individual virus particles. But the virus isn’t dispersed that way. The biggest threat is viruses attached to droplets of fluids expelled in an infected person’s breath, sneeze or cough. True, recent findings suggest the viruses may also travel in aerosol “clouds” that could be airborne for some time (an aerosol can be loosely defined as a cloud of small particles or droplets whose travel is influenced more by air movement than by gravity). But threat aerosol droplets/particles are still bigger than individual viruses. And speaking of individual viruses, the “viral load” (or viral "dose") is a factor in that it determines the severity of the illness. So, do masks offer perfect protection? No. Do they reduce the risk? Absolutely....

#3 – Masks reduce the probability of an infected person infecting others: This one would seem to be tough to argue against. We know that face coverings can stop droplets expelled with breath air, sneezing and coughing. Many infected people have no symptoms and don’t know they are carriers. Doesn’t it make sense to sacrifice a little of your personal freedom and put up with a little discomfort in order to further the safety of others, including your families and friends? What would be your reasons for not doing it?

#4 – Self-protection - masks reduce the probability of you getting infected: Much has been made of the value of face coverings in reducing the dispersion of coronavirus by infected persons. Not much has been said of the protection against coronavirus provided to the individuals wearing the mask. I’ve seen this denied or downplayed. I don’t understand why. The filtration material works the same way, whether the air stream is going one way or the other. Granted, the dynamics of the filter challenge are different. In preventing the spread of coronavirus by an infected person we are trying to stop the droplets at the source. When considering the self-protection aspect of wearing a mask we may be faced with a somewhat different filter challenge in that our physical position relative to the airborne threat, as well as the size of the droplets, may be different. Mask construction and fit are also issues. But masks will reduce the risk of infection to the wearer. How much? There are too many variables to allow accurate assessment. But for me, even a slight risk reduction (and I believe it is significantly more than “slight”) is worth putting up with the downsides. Isn’t it for you?

#5 – Positive effect of mask-wearing on businesses: We all lament the terrible effect coronavirus has had on small businesses and the economy in general. Nobody wants to see local stores and businesses shut down. I believe that businesses would be helped if everyone wore a mask and acted prudently when in public. Mask-wearing would reduce the overall spread of the virus thus moving faster towards relaxation of closures. But it also could have another positive effect. Many people are reluctant to go anywhere because of fear of infection. With everyone wearing masks there would be less fear and more willingness to support business establishments. Isn't this a positive effect of wearing masks in public?

#6 – “It’s an infringement on my rights”: Some say that universal mask requirements are an encroachment on their rights and freedoms. I don’t understand that. I’m not free to shout “Fire!” in a movie theater, talk about bombs when sitting in an airplane, run around the streets naked or urinate in public. I believe in individualism but gladly give up these rights for the common good. But there is another way to look at this. Why not just wear a mask voluntarily based on the benefits discussed above?

#7 – Denial of service to those not wearing a mask: We’ve seen examples of people getting very upset and aggressive when told they can’t come into a store without a mask. This is another one I don’t understand. Why can’t a store insist on mask-wearing? Do you also object to their restrictions against shoeless and shirtless customers? I understand that some people can’t wear masks (difficulty breathing, etc.). But these are special cases and there should be ways to handle them.

#8 – Mask design and availability: In my opinion we are in a war. The government, under the Defense Production Act, should take steps to ensure availability of quality masks not just for health care providers but for all. There should also be a review of mask designs and some guidelines provided for what constitutes an acceptable mask for the public. Should everyone have an N95 mask? Maybe. The masks should be easily decontaminable for reuse. Necessary research and development should be identified and acted on. Some might say it’s too late for that. But what about the next time?

Folks, it’s not an “all or nothing” situation. The name of the game is risk reduction and we should all do our share….wearing a mask is a big part of that.

As I said, I’m interested in understanding why all the negativism regarding mask-wearing. I would appreciate hearing your reasons if you disagree with any of what I’ve said above . But, please, no politics!

Thank you if you got this far!