Covid 19 Mask Recommendations UNMASKED

by Brian Hale May 8, 2020

This article originally appeared in SCANNER NEWS. Used by permission.

One of the primary controversies in the United States in the field of preventive medicine is whether or not to wear a mask to prevent the spread of the coronavirus. 

It’s a hot topic of conversation due to the confident insistence from both sides claiming to know what’s best for us.  Let’s dig deeper…

The Centers for Disease Control (CDC)

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.

CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.  Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.The cloth face coverings recommended are not surgical masks or N-95 respirators.  Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

The National Institute of Allergy and Infectious Diseases (NIAID)National Institute of Health (NIH)

https://www.niaid.nih.gov/news-events/nih-study-validates-decontamination-methods-re-use-n95-respirators

Although the CDC and the NIH list N95 respirator masks as single-use, here is there double take on that. They are giving us advice on how to DECONTAMINATE a mask for RE-USE. Please take note of the methods they determined to be effective enough to ensure successful decontamination, including UV LIGHT and High HEAT.

NIH Study Validates Decontamination Methods For Re-Use of N95 Respirators ; Three Methods Effectively Sanitized Masks for Limited Re-Use

N95 respirators can be decontaminated effectively and maintain functional integrity for up to three uses, according to National Institutes of Health scientists. N95 respirators are designed for single-use and are worn by healthcare providers to reduce exposure to airborne infectious agents, including the virus that causes COVID-19.

The study was conducted in a controlled laboratory setting, and the results were posted on a preprint server today. The findings are not yet peer-reviewed but are being shared to assist the public health response to COVID-19.  The study investigators are with NIH’s Rocky Mountain Laboratories (RML) in Hamilton, Montana, part of the National Institute of Allergy and Infectious Diseases (NIAID). With collaborators from the University of California, Los Angeles, they tested the decontamination of small sections of N95 filter fabric that had been exposed to SARS-CoV-2, the virus that causes COVID-19.Decontamination methods tested included vaporized hydrogen peroxide (VHP), 70-degree Celsius dry heatultraviolet light, and 70% ethanol spray. 

Food and Drug Administration (FDA)

https://www.fda.gov/medical-devices/personal-protective-equipment-infection-control/n95-respirators-and-surgical-masks-face-masks#s4

It seems there is a big discussion as to WHO the mask is intended to protect. Many people are saying we wear the masks to protect others. That would make sense to most people. Well, here is what the NIH has to say about the reason for PPE or PERSONAL Protective Gear.

N95 respirators and surgical masks (face masks) are examples of personal protective equipment that are used to protect the wearer from airborne particles and from liquid contaminating the face. Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) also regulate N95 respirators. People with chronic respiratory, cardiac, or other medical conditions that make breathing difficult should check with their health care provider before using an N95 respirator because the N95 respirator can make it more difficult for the wearer to breathe. Some models have exhalation valves that can make breathing out easier and help reduce heat build-up.

Note that N95 respirators with exhalation valves should not be used when sterile conditions are needed. All FDA-cleared N95 respirators are labeled as “single-use,” disposable devices. If your respirator is damaged or soiled, or if breathing becomes difficult, you should remove the respirator, discard it properly, and replace it with a new one. To safely discard your N95 respirator, place it in a plastic bag and put it in the trash. Wash your hands after handling the used respirator.

Department of Labor (DOL)Occupational Safety and Health Administration (OSHA)

https://www.osha.gov/SLTC/covid-19/

OSHA is following CDC guidelines, but list PPE last on their list of Infection Control Procedures.

The Centers for Disease Control and Prevention (CDC) currently recommends that Health Care Providers (HCP), who are providing direct care of patients with known or suspected COVID-19, practice infection control procedures. These include engineering controls (e.g., airborne infection isolation rooms), administrative controls (e.g., cohorting patients, designated HCP), work practices (e.g., handwashing, disinfecting surfaces), and appropriate use of personal protective equipment (PPE), such as gloves, face shields or other eye protection, and gowns.

World Health Organization

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-maskshttps://www.who.int/publications-detail/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak


The World Health Organization recommends wearing a mask only in specific instances;

If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.

Wear a mask if you are coughing or sneezing.

Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.

If you wear a mask, then you must know how to use it and dispose of it properly.The World Health Organization also put out a nice poster to help remind us that we should wear a mask, right? Wrong, there is no sign of mask recommendations on this marketing piece. Inconsistent and confusing, at best.WHO Covid RecommendationsJohns Hopkins Medicine

https://www.hopkinsmedicine.org/coronavirus/for-johns-hopkins-patients.html#masks

Johns Hopkins is not shy about it when they admit that the government protocols are in place to make people ‘feel’ safer. It is NOT STANDARD INFECTION PREVENTION. We are told to wear masks to make people feel better, however, the masks are turning into a constant reminder of the fear they instilled in the public, and it has caused division among us.

Use of Face Masks by Johns Hopkins Medicine Staff Effective April 3, 2020, all Johns Hopkins staff working where patients are present will wear a surgical, procedural or cloth face mask across any of Johns Hopkins Medicine healthcare facilities.

We recognize that this is a departure from standard infection prevention guidance. 

However, we find ourselves in extraordinary times, and, given current circumstances, we believe this guidance will help many employees and the public feel more comfortable. Our knowledge regarding COVID-19 is rapidly expanding, and the situation and degree of community transmission are also rapidly evolving.
Similar to influenza and other respiratory viruses, the virus that causes COVID-19 appears to be transmitted primarily through large respiratory droplets. Surgical masks provide protection against respiratory droplet spread. In contrast, fit-tested N95 respirators provide a higher level of filtration and are important in clinical situations where infectious droplets could become aerosolized. This primarily occurs in specific clinical situations, such as when a patient is intubated or undergoes bronchoscopy. Fit-tested N95 respirators are difficult to wear for long periods of time and are impractical for generalized use.

Furthermore, here are there recommendation in an article by Lisa Lockerd Maragakis, M.D., M.P.H. where the final recommendation is to follow the CDC guidelines on cloth facemasks.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/how-can-i-protect-myself-from-coronavirus

The American Medical Association (JAMA)

https://jamanetwork.com/journals/jama/fullarticle/2764955

Their recommendations are pretty consistent with the CDC, however a couple things seem to really stick out. 1) ‘health individuals can consider wearing masks in public’ does not sound like ‘Masks are recommended or required’. 2) Physicians wear a mask to protect themselves from infectious patients during acute moments like in surgery, but this statement says we wear masks to prevent the spread of the virus (even if we don’t know we have it) to others. This would indicate a recommendation with no expiration date.

Bottom line, if you believe you need to wear a mask to protect others from a disease you may or may not have, then it’s time to hang up the spurs unless you plan to be facemasked for THE REST OF YOUR LIFE. 3) Has anyone asked the question WHY kids under 2, who are usually full of sniffles and such are somehow magically safe or non-contagious? Of course they are not. The government just did not want to deal with 160 million pissed off moms, so the exception is there. I agree with the exception, FOR CONVENIENCE, but NOT if they are TRULY concerned about PUBLIC Safety.

Recent studies suggest that coronavirus disease 2019 (COVID-19) may be transmitted by infected persons even in the absence of symptoms of disease. While social distancing and good hand hygiene are the most important methods to prevent virus transmission, new guidelines state that healthy individuals can consider wearing masks in public settings, particularly when physical distancing is difficult (like in grocery stores or pharmacies).

Primary benefits of wearing a mask include limiting the spread of the virus from someone who knows or does not know they have an infection to others. Masks also remind others to continue practicing physical distancing. However, nonmedical masks may not be effective in preventing infection for the person wearing them. Masks should not be worn by children younger than 2 years or by individuals who are unable to remove the mask by themselves or are unconscious.

Physicians across America are speaking up. Here is another video you might find interesting.

One thing we know is that we can be sure that people have different opinions on the subject of public safety. We hope this article helps you understand where the confusion might lie with the inconsistent messaging we are getting from varying sources. Please feel free to leave your comments and share this article. 

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