COVID-19—Unmasking the truth

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Since the start of the Covid-19 pandemic, the recommendations and common practices regarding face mask use by the general public have varied greatly.

Both the CDC and the WHO now recommend cloth face masks for the general population although earlier in the pandemic they advised just the opposite.

These shifting guidelines have contributed to a great deal of confusion regarding the use of facemasks. For public health officials, the continuing mixed messages can also erode the trust that people might have in them.

This debate around wearing face coverings in public demonstrates the challenges that health experts continue to face. The issue of whether to advise t

he population to wear face masks, or whether to even make it a requirement, has affected many countries including the US, Canada and the UK.

For Trinidad and Tobago, the government is currently looking at instituting laws to make mask-wearing mandatory.

It is clear however that masks do indeed help prevent the spread of COVID-19, and the more people wearing them the better.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus the causes Covid-19, has infected more than 20 million people worldwide, causing over 750,000 deaths. Emergency lockdowns have been used in numerous countries around the globe and the effects on health, well-being, business, education, and other aspects of daily life have been staggering.

With no known effective pharmacological treatment or currently available vaccine, reducing the rate of infection (what is commonly known as flattening the curve) has become a priority. The best way to achieve this is to try to prevent infection.

COVID–19 spreads mainly from person to person by respiratory droplets when an infected individual cough, sneezes, or even talks, sings, or shouts.

These droplets can land in the mouths or noses of those nearby and inhaled into the lungs. There is also now growing evidence that coronavirus may linger in the air long enough for someone to breathe it in and become infected.

The premise of protection by wearing a mask is simple. In addition to protecting the wearer from respiratory droplets that contain the virus, they can also shield surrounding persons from the mask wearer as he or she may well be infected and not know it.

It is this latter role that has been now embraced by multiple governments and regulatory agencies that encourage the use of masks. After all, there are more than a dozen studies that show that many people with COVID-19 have little or no symptoms and can still spread the disease despite not being aware that they are sick.

A comprehensive review published several weeks ago by prominent medical journal The Lancet supported the use of face masks to reduce person to person transmission of SARS-CoV-2.

This report also confirmed the use of simultaneous physical or social distancing, as a mask alone may not be sufficient to provide absolute protection.

Still, determining the level of efficiency of various masks is an area of active research, made even more difficult because the infection pathways for COVID-19 are not yet fully understood, and continue to be complicated by many factors such as correct usage and fit of masks and other environmental variables.

From a public’s perspective however, shortages in supplies of surgical and N95 masks as well as issues like cost and discomfort from prolonged use have led to the use of a variety of solutions such as homemade cotton masks, which are generally less restrictive but we don’t know too much about their ability to reduce infection.

Another recent study from Duke University in North Carolina has now tested 14 types of masks using a fairly simple and low-cost method.

These scientists made use of a black box fitted with a laser and a mobile phone camera (no less).

Someone wearing a face mask would speak in the direction of the laser beam inside the box. Then, the number of respiratory droplets scattered by the beam were recorded by the camera in the back of the box. A computer algorithm counted the droplets seen in the video to determine how many had leaked through the mask.

Good performers included N95 masks, three-layer surgical masks and cotton masks, while they found that bandanas and knitted face coverings did not offer much protection.

Obviously, these finding need to be confirmed by much larger studies.

In the end, face masks can protect against COVID-19 and limit the spread of infection. Many myths and misconceptions abound, and people should look to reliable sources and discuss with your doctor if any further concerns, (while of course wearing a mask!)