Here’s my official take on “Mask-gate”. But first I want to let all readers know that my bias or take on this whole issue is informed by several factors, 1.) I have been in the occupational safety field for nearly 20 years and respiratory protection has been a part of my bailiwick, 2.) I am Certified as a Safety Professional through the Board of Certified Safety Professionals, 3.) I hold a Bachelor’s and Master’s degree of Science in the field of Occupational Safety and Health, 4.) I have more useless knowledge about face mask than I know what to do with, and 5.) have kept up with the evolution of protection and PPE strategies promulgated by the Trump Administration.
So with that said, let me just say that masks work, but it largely depends on the type of mask you wear and how you wear it. For starters, there are a variety of different types of masks available out there, but we’ll primarily discuss the N-95 respirator. The N95, protects both the wearer and those around the wearer. The ‘N’ means that it should be used when there is no oil present in the air, and the ‘95’ means that it will filter out at least 95 percent of airborne particles, assuming it is worn correctly. The common name for these types of respirators are called filtering facepieces, and in the workplace there is a requirement that employers perform a medical evaluation on workers to ensure that it does not obstruct the airway of any respiratory compromised employee. Additionally, when these are worn, there is usually a qualitative or quantitative Fit Test that is performed, that usually involves some sort of banana smell, and the recital of the Rainbow Passage (I know, it seems weird but true…look it up), 29 CFR 1910.134:
“When the sunlight strikes raindrops in the air, they act like a prism and form a rainbow. The rainbow is a division of white light into many beautiful colors. These take the shape of a long round arch, with its path high above, and its two ends apparently beyond the horizon. There is, according to legend, a boiling pot of gold at one end. People look, but no one ever finds it. When a man looks for something beyond reach, his friends say he is looking for the pot of gold at the end of the rainbow.”
N95 masks, on average, have filtration efficiencies for the most penetrating particle sizes (0.1 to 0.3 micron) if they were tested to the National Institute of Occupational Safety and Health’s (NIOSH) requirements (42 CFR Part 84). In case you’re wondering a human red blood cell is about 5 microns across and a human hair is about 75 microns across. All of that gibberish to say, that these are the best non-cartridge dependent respirators you could wear, and thus the reason they should be reserved for medical health workers or, IMO, workers who are exposed to other dangerous particles (i.e.: crystalline silica dust).
As stated earlier, these are the only masks that protect you and the people around you. The other types of masks protect others, but only if you are wearing your mask correctly. Now, I’m not here to mask shame anyone because I recognize not everyone CAN wear a mask for a variety of different reasons. Additionally, I'm willing to concede that the evidence of harm due to prolonged mask usage is inconclusive, but would caveat that statement by stating I have seen no anecdotal evidence that it causes any long term harm, and I have had employees in much more restrictive masks that impedes the gaseous exchange much more significantly than an N95.
Of special note, the National Institute of Health (NIH) did produce a report highlighting that breathing through N95 mask materials has been shown to impose an additional workload on the metabolic system of pregnant healthcare workers, so if you're looking to rage about something, that's something. Also, it goes without saying, that when you cover your mouth, the O2 and CO2 levels will be disproportionately lower and greater, respectively. And as Americans, we should be concerned in rising CO2 levels, but could we start with climate change first? Anyhow, I digress...
But like all protection methods, and PPE use, the benefits of using a N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage.
Ok, now for the political part...the COVID-19 response will likely be debated until the next pandemic strikes, but here is my quick take. The confusion surrounding masks early on made many think that masks were not necessary, but most people who could read the tea leaves knew better. I started looking for kid masks in early January, with an understanding that they would be hard to find! the Trump administration has had a difficult time with how they present their message about the virus, and its risks, but with regard to wearing masks it was abysmal.
There are many examples I can draw from, but here are just four examples that highlight the confusion in mask messaging from the government...
1. February 29th, In a tweet Surgeon General Jerome Adams, said:
STOP BUYING MASKS! They are NOT effective in preventing the general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! “
2. March 31st U.S. Surgeon General Jerome Adams said on “Fox & Friends” that “the data doesn't show” that wearing masks in public will help people during the coronavirus pandemic.
3. April 3, the Centers for Disease Control and Prevention recommended that Americans wear "cloth face coverings fashioned from household items or made at home from common materials ... as an additional, voluntary public health measure."
4. May 26th, President Donald Trump shared a tweet mocking his presumptive 2020 Democratic presidential challenger, Joe Biden, for wearing a face mask at a public Memorial Day appearance.
I can admit that the messaging was wrong due to the presence of new data that became available which may affect the PPE strategy, but that's not what we were told...As a matter of fact, the story we have been told about the virus has changed on multiple occasions. One in particular deals with the CDC revising its guidelines on surface contact, prompting an outbreak of misleading headlines.
Look, I get it...You hate wearing masks, So do I, and so do many other Americans. Most people that refuse to wear masks seem to fit in one or more of these categories:
Have a respiratory condition that makes them medically incapable of wearing one;
Feel their constitutional rights are being taken away;
Don't believe that the virus is real or as bad as we're told;
Are completely apathetic to the situation at hand
With the exception of one of those, I think refusing to wear a mask is just irresponsible, I'm not saying that to make someone feel bad, it's just my opinion. Frankly, the way I see a lot of people wear their masks, I don't think it's providing very good protection anyways. We shouldn't be beating each other up, but rather we should direct our collective energies at pushing the Trump administration to increase testing capacity, and develop a vaccine, and also provide physical training materials to every single household and workplace in America. Most of the material about making your own masks, or resources about COVID-19 can be found on the internet, but if you're fortunate enough to read this, you're one of the lucky ones who have access to these resources; many don't (roughly 19 million households). In this country we talk a lot about our appreciation for the selfless service of first responders, the military, etc., well I think it's our turn to not only serve our country, but serve each other.