“Fear is driving this recommendation for healthy people to wear masks, not science.”

Healthy People Wearing Masks, Should They or Shouldn’t They?

Does wearing a mask help prevent coronavirus infection?

An important study using science to evaluate cloth mask use to prevent infection was conducted in March 2011. It is a large, prospective, randomized clinical trial; and the first randomized clinical trial ever conducted of cloth masks. The international team of researchers concluded:

This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.”

This study doesn’t provide evidence for effectiveness in high-risk populations; it certainly does not support healthy people wearing cloth masks.

More recently, researchers from University of Illinois at Chicago School of Public Health reviewed the scientific literature. While not an exhaustive review of masks and respirators as source control and personal protection equipment (PPE), this review was made in an effort to locate and review the most relevant studies of laboratory and real-world performance to inform our recommendations. The review, which has 52 citations, concludes:

We do not recommend requiring the general public who do not have symptoms of COVID-19-like illness to routinely wear cloth or surgical masks because:

  • There is no scientific evidence they are effective in reducing the risk of SARS-CoV-2 transmission
  • Their use may result in those wearing the masks to relax other distancing efforts because they have a sense of protection
  • We need to preserve the supply of surgical masks for at-risk healthcare workers.

A 2020 study in Seoul, South Korea looked at the effectiveness of surgical and cotton masks in blocking COVID-19 in a controlled comparison of four patients. The COVID-infected patients were put in negative pressure isolated rooms. The scientists compared disposable surgical masks (3 layers) with reusable cotton masks.

Patients were instructed to cough 5 times while wearing no mask, surgical mask, or cotton mask. Interestingly, all swabs from the outer masks—including surgical masks—were positive for COVID-19. Inner masks were also found to be contaminated. That means the mask did not effectively filter out the COVID virus since it is too small. The authors assert:

Neither surgical nor cotton masks effectively filtered {COVID-19} during coughs by infected patients.” Conclusion: “both surgical and cotton masks seem to be ineffective in preventing the dissemination of SARS–CoV-2 from the coughs of patients with COVID-19 to the environment and external mask surface.”

The World Health Organization does not support healthy people wearing masks

The CDC’s mixed mask messages

Wearing masks does not stop the spread of influenza viruses

Fear is driving this recommendation for healthy people to wear masks, not science.

As a nurse for over 25 years and holding a Master’s Degree in Science, I cannot in good conscience allow my grandchild to be subjected to an intervention that may cause physical, emotional, and psychological harm without being provided significant evidence that the benefits of such intervention outweigh the risks.

Should we be encouraging healthy people to wear masks? The answer is unequivocally no.

Sincerely,
Patricia Neuenschwander, M.S.N., R.N., C.P.N.P.-P.C.