To Mask or Not to Mask, that is the Question

Most of us have accepted that masks help avoid spreading COVID-19, mostly protecting others from the wearer. Many US states have implemented some version of mask mandates. But it’s been mixed messages, and contradictory information all the way.

My wife and I have been wearing masks in any indoor place with other people since at least mid-March, maybe earlier. It seems the logical thing to do. But let’s question the common knowledge. If I was just waking up from an 8 month coma, where do I start on understanding whether I should be wearing a mask? Who are the experts here? What are they saying? Are there any experts saying a mask is counterproductive? What is the evidence either way?

Inspired By this and the preceding few posts.
I was surprised to find there didn’t seem to be a thread for this anywhere.

It’s pretty simple. If you are a human being and you breathe, you should be wearing a mask anytime you are out in the public in a place where you might be in the vicinity of other people.

People who say this: Doctors, scientists, health experts, intelligent people, and those who listen to any of the above.

People who disagree with this: Idiots.

Got it in one, Little Nemo. Good job!

And another one from UCSF (top dogs in the infectious disease world, btw) regarding the benefit masks provide in reducing viral load. That seems to be a key factor in how sick you get, if you get sick.

Wear a f**king mask!

Little Nemo, I hope I don’t sound like a skeptic, I’m not. It’s just that I’m pretty sure I wasn’t reasoned into my position, and I’d rather I was. I just want to be sure we’re not just doing it because it ‘makes sense’ and vaguely-defined ‘experts’ say so. It’s so easy to just say ‘experts say’ without following up with why those people are qualified to comment or what they actually said. It’s so easy to follow the crowd. On this forum it’s been almost universally accepted to help, but I don’t think it was ever discussed rationally in one place.

I fully expect the result to be, “wear a mask”. I’m just asking if we can all check our assumptions for a minute.

mikecurtis’s link cites these places:

https://www.nejm.org/doi/full/10.1056/NEJMc2007800
https://www.nature.com/articles/s41591-020-0843-2#Sec3
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00818
https://www.researchgate.net/publication/342198360_Association_of_country-wide_coronavirus_mortality_with_demographics_testing_lockdowns_and_public_wearing_of_masks_Update_June_15_2020

Also these two anecdotes:

This is a good start (I haven’t looked through them all yet). That last one in particular about the hair stylist vastly deepened my conviction that masks were a good idea back when I first heard it. But it’s just an anecdote, and I know it was hugely influential in my thinking, which is why I want to revisit this question.

The effectiveness of wearing masks was known 100 years ago during the Spanish flu pandemic. Some cities even passed laws requiring the wearing of masks.

Cite

Not really. We don’t even know today how effective mask wearing was then because it was just part of a patchwork of measures done in different jurisdictions. Japan wears masks all the time. Do they have exceptionally low influenza rates? No, they don’t.

The evidence currently is at the “good enough to do it” stage mostly because it is a low cost measure that might help.

Please provide a cite for this claim. Thanks!

I would consider the Center for Disease Control a credible place to look for information about controlling diseases. Here’s what they says in their official statement:

Masks may help prevent people who have COVID-19 from spreading the virus to others. Wearing a mask will help protect people around you, including those at higher risk of severe illness from COVID-19 and workers who frequently come into close contact with other people (e.g., in stores and restaurants). Masks are most likely to reduce the spread of COVID-19 when they are widely used by people in public settings. The spread of COVID-19 can be reduced when masks are used along with other preventive measures, including social distancing, frequent handwashing, and cleaning and disinfecting frequently touched surfaces.

Found the following poem on Facebook–I dunno who Ralph is, but listen to Ralph!

Cover your snout if you want to survive,
muzzle your mug and we’ll get out alive.
Liberal, conservative, wealthy or poor,
we’re basically fucked, so until there’s a cure…
Cover your pie hole, stop spewing your spit,
red state or blue state I don’t give a shit.
Corona don’t care what flag that you fly,
it fucks up your lungs, 'til you suffer and die.
Mask up your yap and you’ll save us all grief,
give doctors and nurses some needed relief.
It’s not a conspiracy, cut out the crap.
Stop being a dickhead and cover your trap.

–A poem by Ralph

Scintillating logic!

Signs seem to indicate that wearing masks may help slow the spread. That’s good enough for me. It’s no hardship. If it turns out that mask-wearing doesn’t make too much of a difference with CV-19, I can live with that. Maybe I’ll have caught fewer colds in the meantime.

Sorry, I mispoke. I meant to say that mask wearing is very common in Japan. Japan itself can’t wear a mask of course. Lol.

I want you to back up your statement that the people in Japan wear masks all the time, when there’s not a pandemic. Thanks.

This review of the literature on the effectiveness is very much worth a read. Source is the University of Minnesota Center for Infection Disease and Policy.

In short, there isn’t much evidence for the effectiveness of cloth masks in the general population. The authors are worried about people thinking a mask is more effective than the data shows and getting sloppy on other preventative measures, like social distancing.

Do we support cloth mask wearing where mandated?

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. However, we also encourage everyone to continue to limit their time spent indoors near potentially infectious people and to not count on or expect a cloth mask or face covering to protect them or the people around them. The pandemic is not over and will not likely be over for some time. As states and local jurisdictions reopen, we encourage people to continue to assess and limit their risks. Cloth masks and face coverings likely do not offer the same degree of protection as physical distancing, isolation, or limiting personal contact time.

I lived there for three years when I was a kid, late '60s. It is extremely common in Japan to wear a mask when you have any sort of illness to prevent spreading it around, and also for those who are sensitive to poor air quality, as was the norm in Tokyo at the time, especially in summer. Watching videos from the country or looking at more current photographs (albeit pre-COVID) shows that a goodly percentage of people still DO wear masks routinely, probably because they have a cold and don’t want to share it. If you’ve ever been on a rush hour train out of Shinjuku station you’d understand because that’s an excellent way to get olfactory knowledge of everything at least six people around you have eaten, how recently they’ve showered and what colognes they prefer. Bleah. Did not like rush hour.

I’m trying to find stats on flu cases in Japan vs. the US, but I’m not having any luck. That’s the other part of the statement, I guess – if that poster is right that they wear masks “all the time” in Japan, it would be interesting to see if it reduces the per capita flu rate (although it’s much more densely populated, and I don’t know how they are about vaccinations vs. the US. So many factors…).

It would probably make sense to look at flu cases in Tokyo vs. NYC or something, to try and get close to apples-to-apples.

Why do you keep insisting that he said “all the time” when he clearly retracted that: