Masks Work

 I posted this on social media, and it garnered some notice:

At almost half a million distinct views in four days, it's doing considerably better than my entire blog! Of course many viewers were not also likers and I've had to set aside some blocking time each day to weed out the bots. Many non-bots, however, appear to really believe that masks do nothing to stop the virus and may even bring us significant harm, so I'm taking the time and trouble here to debunk their rabid misinformation.  

But first, check out the post-mandate rules in my board that go further in our quest to avoid encouraging masks:

We're treating people who don't wear masks as if they're another race that must be accepted with open arms. School rules around not "segregating" them basically ask us not to acknowledge any difference at all despite the increased risk of transmission in the room. We must mix groups of masked and unmask regardless if we have any immunocompromised students who would profoundly benefit from not having close face-to-face interactions with someone unmasked. I get around it all by not assigning groups and by not having one-on-one meetings in person with any kids. 

Principles of inclusion are vital for things we can't control, like our race, gender, orientation, identity, disability, age, height, etc. We also include religious beliefs on the list, which is important because we should all have a right to worship something greater than ourselves and follow traditions important to our culture, but not because we all have a right to believe whatever we want to believe! We don't even accept all the ins an outs of canonic religious text, for instance we won't allow intolerance of homophobic attitudes despite it being baked into the Old Testament. 

But we cross a line when we invoke principles of inclusions for behaviours that are well within our control, especially if they are potentially harmful behaviours. Before Covid started we were already teetering at the top of a slope of accepting misbehaviours to a degree that we aren't always reinforcing appropriate manners and rudimentary decorum in classes. No phones? Inclusivity means accepting that students sometimes need to access supports on their phones, so they must be allowed continuous access. For many kids, it provides a necessary sense of security. No food during class? Kids have to eat!! We shouldn't be judging when or where they eat. At least these eroded rules, now bent into pretzels, don't harm anyone in the room, as long as there are no nuts involved.

I believe that it should be expected of teachers to reinforce behaviours that prevent harm to other kids in the classroom, yet we're using the loaded term segregation to refer to moving an unmasked child a little downwind of an immunocompromised child. We're risking actual lives to accommodate people's comfort levels. I've always stayed far from students because I'm strongly affected by the scent of perfumes and cigarette smoke, but now I feel like I'm not allowed to distance, as if they have a right to be within six feet of me once the mandates dropped regardless my own need for personal space. Elementary teachers don't have that luxury, but they likely have fewer smokers in the room too.

At this point it feels like we're not even allowed to suggests that masks are useful, despite the CMOH continuing to say that they're strongly recommended even though they're not mandated, and despite that WRDSB posted this weak support of masks on their instagram page in March:

Although the CMOH and Minister of Education have lifted mask restrictions, and as we continue to learn more about the impact of the Omicron variants, students and staff are encouraged to continue wearing masks if they feel more comfortable doing so, especially during the first two weeks after March Break. As a community, we try to look after one another. Masks help to protect immunocompromised members of our school communities and people with complex medical needs. We also have many students as well as students with siblings who are under age 5 who are unable to be vaccinated. Please hep us to keep all students and staff safe as we return to school. 

It feels like we have to let kids eat during class now, even if we never did before. And we have to keep windows closed even if we opened them before because of debilitating hot flashes. We have to go out of our way to make sure we're not doing anything that might appear to be anti-virus and discriminatory. We must present the appearance of being completely unaffected by the pandemic at all times or risk being seen as... biased? So bizarre!

"Protection against Covid is NOT a personal choice. It is a community responsibility and requires collective action." - Summer Brennan

 But anyway...

Mask, vax, ventilate, and stay home if you have any symptoms, and then test twice to return. Then we can get through the worst of this. Why is that so controversial?? That part is all cheap and easy. I bought my own N95s, but I have to hide them because first they weren't allowed at all, and now we can only wear the ones they provide, which don't fit my face, so won't work as well. And I bought my own Corsi-Rosenthal box which is considered contraband to the school system, and a CO2 monitor. It cost them nothing for me to make my room safer, but it's not allowed, and has to be removed. I will never get over the inanity of these rules! The really controversial part that I can understand people worried about is we also need to expand health care by increasing the number of well-paid medical professionals. We need to add enough that they aren't working to exhaustion and to be able to access regular health care again, and it's going to be expensive because we let it get really, really bad.

Masks work, and vaccines work, and ventilation works, but none of them work 100%, so we have to do them all in order to increase our odds of avoiding this virus. Definitely there are some people who do all the things, and still end up getting it, which is just really crappy luck. The risks are significantly lower the more we do, definitely, but there will always be people who do everything and get it, and others who do nothing and don't. Those anecdotal pieces are meaningless in the grand scheme of things, and they clearly don't indicate that the guidelines are useless or a conspiracy of some sort.

My grandmother lived to be almost 100. She chain-smoked and drank all day every day and just kept on living. My dad used to say she'll never die because she's smoked and pickled! A good friend's husband was a triathlete who never touched cigarettes or alcohol, yet died in his 40s of cancer. Life's a bit of a crap-shoot, for sure. But, we know by gathering data of tons of people, that we're each much more likely to live a longer life if we avoid smoking and drinking as much as possible, even though. Right?! Similarly, we're at far less risk of getting Covid if we do all the things! When people tell me that they're not wearing a mask anymore because they know someone who wears a mask but got it anyway, I ask them if they still wear a seatbelt. Lots of people die in car accidents with a seatbelt on, but a much lower percentage of seatbelt wearers than those who die without one. Seatbelts work, and we should keep them as a mandatory protection, for sure.

Wearing a seatbelt isn't a great analogy for masks, though, because seatbelts just protect the wearer, and masks are there to protect everybody else. The drunk vs sober driving analogy is a better fit because we're all at greater risk if we let people drive around drunk. Ride programs were put in place, despite infringing on our legal rights as defined by the Charter, in order to save lives. We need masks to be put in place for the same reason. Two-way masking works in ways that one-way masking never will. 

Some protection is better than no protect, but following all four: masks, vax, ventilate, and isolate if sick (and double test to return), will have longterm benefits as the number of new mutations decrease and the hospitals are able to work within a much more reasonable capacity. Lifting mask mandates is like suggesting that sobriety is no longer required to drive but some may wish to remain sober based on their own comfort level. It completely ignores the effect this behaviour will have on others. Instead of suggesting that we wear a mask if it's comfortable for us, they should suggest we wear one unless we're comfortable with the possibility of sending someone to the hospital! 

THE CLAIMS AND THE SCIENCE:

#1. Masks don't work and are harmful to us.

This retracted study, by Baruch Vainshelboim, is circulating again. It wrongly claims that face masks harm more than they help with no proof of efficacy and many adverse effects established. The researcher claims to have some affiliation with Stanford, but they've openly clarified no connection. Claims that the paper was released by the NCBI are also false. It got some traction from W.M. Briggs, a known anti-climate writer affiliated with Heartland, which is funded by Exxon. But despite being retracted, that bit of garbage out there is enough to get people riled up again as proof that this is all a conspiracy trying to kill us with masks - the same masks worn for 12 hour shifts by nurses and doctors everywhere without incident. 

It's curious to me how often the trolls that show up are climate deniers, anti-pronouns, pro-convoy, and often "proud" Americans, or Canadians with an upside-down maple leaf. What does white nationalism have to do with protecting ourselves from a virus? Are they outraged that people are daring to try to take care of one another instead of letting them rig the game forever? Paula Larsson documented the history of racist outrage at vaccinations. Apparently this white upper class objection to the infringement of freedoms from imposed vaccination has been going on since 1860. She ends with this analysis: "In the end, the individuals who bear the brunt of an increased burden of disease are those from historically vulnerable communities whose concerns continue to be co-opted and overshadowed by anti-vaccination activists."

It sounds like a cull. The message I'm hearing is, We know that the disease mainly affects people in a lower SES, typically made to work in crowded conditions and without sick days, so just let it carry on harming them while we important people go about our lives: 

FYI - Marina will be in charge of the Toronto Star effective June 1st. 

On the less insidious side, there's also the problem that the WHO took forever to acknowledge that the virus is airborne for, possibly, innocuous reasons, as explained in this Nature article: 

The WHO's reluctant to accept and communicate evidence for airborne transmission was based on a series of problematic assumptions about how respiratory viruses spread. . . . The WHO relies on a narrow band of experts, many of whom haven't studied airborne transmission, and it eschews a precautionary approach that could have protected countless people in the early stages of the pandemic. . . . The WHO also failed to adequately communicate its changing position.

I try to keep in mind that some anti-masking people have been duped, and sympathize while gently prodding them with the most recent studies, but I'm also aware that some could possibly have a nefarious intention to keep all the goodies to themselves and callously weed out any competition. 

Here's the thing: We all have to acknowledge that we could possibly be carrying the virus unawares, so we wear a mask to prevent inadvertently spreading it to anyone else. There are people getting a mild version of this one, and spreading the news that we can all relax, but they're failing to recognize how lucky they were. 

#2. The size of pores in the masks is much bigger than the virus, so masks can't stop the virus from moving in or out of a mask (but somehow can stop oxygen).

The virus is tiny but travels in larger droplets. This article, that came out at the beginning of it all when we were using cloth masks to save the N95s for medical professional, explains why tiny Covid molecules don't all pass through the pores in masks. 

The virus that causes COVID-19 is about 0.1 micrometer in diameter. The holes in woven cloth are visible to the naked eye and may be 5-200 micrometers in diameter. It is counter-intuitive that cloth can be useful in this setting--it's been compared to putting up a chain-link fence to stop mosquitoes. However, that analogy is wrong in many ways. . . . Even though there are gaps between the threads in cloth, the threads are usually wider than the gaps. Also, at this microscopic level, the thread has thickness, and depth, so the gap is more a tunnel than a window. . . . A particle with momentum will run into a fibre, even though the air stream is diverted around it, like a ball hitting a wall. . . . Cloth can be used in multiple layers, adding a second and third gauntlet for the particle to run before it reaches the other side. The point is not that some particles may penetrate the cloth, but that some are blocked.

There are many, many videos that show how masks work under lab conditions and in the real world here, here, here, here, and here.

Many studies have proven the effectiveness of masks, particularly N95s as well as documented no significant harm. A study from February 2021 concluded that, "Compelling data now demonstrate that community mask wearing is an effective nonpharmacologic intervention to reduce the spread of this infection, especially as source control to prevent spread from infected persons, but also as protection to reduce wearers' exposure to infection. And another in May 2021 explained "the observed efficacy of face masks in preventing the spread of COVID-19." Then in October 2021, a study on the effects of masks in young adults found, "The results indicate small but significant changes in cerebral hemodynamics while wearing a mask. However, these changes are comparable to those of daily life activities." And another study from February 2022 says, "Current epidemiological data indicates that wearing a mask can reduce the emission of SARS-CoV-2 particles into the environment. The surgical mask had a greater filtration efficiency for viral aerosols; however, the filtration efficiency was inferior to that of an N95 mask." A study out in March 2022: "The current study was set in Arkansas and compared K-12 school districts with full or partial mask mandates with those that had no mandate. . . . They found that COVID-19 incidence among students and staff was significantly lower in districts with full masks requirements than those with no mask requirements." Another analysis at that link saw a 50% drop in cases before and after mask mandates were implemented in a district. An Ontario collection of studies found that "Schools open with no masks had 80% more infections. . . . There was no objective evidence of impaired respiratory function in children wearing masks during experiments, only reports of subjective complaints. . . . reported no significant differences in oxygen saturation or pulse rate during normal play."

And here's 49 more studies that show mask effectiveness.

Finally, last February, a study published on the CDC site compared types of masks and demonstrated that, "Consistent use of a face mask or respirator in indoor pubic setting was associated with lower odds of a positive SARS-CoV-2 test result. Use of respirators with higher filtration capacity was associated with the most protection." Comparing matched pairs of participants who regularly wear masks to those who don't they found positive Covid tests in 68% of unmasked, 52% of cloth mask wearers, 45% of surgical mask wearers, and 32% of N95 wearers. They estimate an 83% reduction in risk with an N95 compared to not wearing a mask at all. 

David Fisman, explains that the 83% is a lowball estimate because they're focusing "only on the protection of the wearer, not the bidirectional impact of masks used as source control." Doing some calculations he determined that if nobody masks, and nothing else changes, our R value (reproductive value) will be 2, producing dramatic exponential growth. (For every case, there will be 2 more people infected.) If, instead, just 80% of people wear a mask, the R value is down to 0.4, which indicates a decrease in cases. He adds, "Yes, it really is that simple."

In the most recent study, out last week, "researchers found that a combination of distancing of six feet, universal mask-wearing, and increased room ventilation could reduce the risk of infection by more than 98% in more than 95% of scenarios studied." 

#3. Mask mandates don't works since they don't always lead to lower rates. 

Dr. Lucky Tran addresses this one, 

If masks work, then why did places with mandates and high mask wearing like NYC and South Korea experience Omicron surges? A big reason: bars, restaurants, and large events where masks come off were still open. Mask policies don't exist in a vacuum. It's why we need layered measures. So if we are keeping places where masks come off like bars, restaurants and large events, what's the point of mandates? Universal masking works, and it helps ensure everyone, particularly our most vulnerable, can access essential services like healthcare, transportation, and groceries. People have a choice to go eat out or attend entertainment events, where there are higher risks of transmission. But people shouldn't have to make the impossible choice between going to work or getting healthcare and risking getting COVID. Masks keep these spaces safe for all. I'm seeing a lot of misinformation saying mask mandates don't work. You can't use a graph like this (below) to conclude causation because there are many confounding factors: e.g. places where people eat and drink were fully open. Mandates didn't apply to all public spaces.

If we want to keep spaces where there is a higher risk of transmission like bars, restaurants, and crowded events open, we need to do a lot better with layered measures like getting more people boosted, doing more testing, and making sure there is good ventilation. We can also help increase the effectiveness of mask mandates by doing a lot more to provide high quality N95-equivalent masks for free for everyone. It's unacceptable that we haven't seriously followed through with this.

Although Tran forgets that people who shouldn't have to work in conditions where they're exposed to the virus also include people who work at restaurants, bars, and big venues. For further proof, we can just listen to ER doctors who have noticed a huge difference since mandates have been lifted:

And another doctor weighs in with this:

ETA: This study (Feb. 22) that says, "On average, the daily case incidence per 100,000 people in masked counties compared with unmasked counties declined by 23% at four weeks, 33% at six weeks, adn 16% across six weeks postintervention." And this study (Jan 22) that found, "This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education." And this study in which, "we conclude that 20 days after becoming mandatory, face masks have reduced the number of new infections by around 45%. As economic costs are close to zero compared to other public health measures, masks seem to be a cost-effective means to combat COVID-19." And this study that found, "COVID-19 incidence decreased in 24 counties with mask mandates but continued to increase in 81 counties without mask mandates."

#4: It's just a cold!

Herd immunity is becoming herd mentality despite findings that show people can get reinfected as early as 23 days after a prior infection. Covid can trigger massive inflammation as the virus kills critical immune cells in the blood and lungs. This is a brain-invasive disease. Brain scans before and after Covid point to a need for widespread neurodevelopmental assessments on kids and adults to reduce "the likelihood of pre-existing risk factors being misinterpreted as disease effects." Covid cases had reduction in grey matter thickness, greater changes in tissue damage, and greater reduction in brain size.

Trying to make sense of Ontario CMOH Moore's complacency about rapid spread of COVID in schools and elsewhere, Dr. Colin Furness writes, 

There are two ways to understand COVID:

1. "It's a respiratory virus, and if we can keep people out of the ICU, it's a win. Wear a mask if you want."

2. "It's a vascular and neurotropic disease that causes microclotting and brain tissue loss, plus debilitating long-term effects for some. Really avoid this; if you did get it, REALLY avoid getting it again." 

Moore is a respiratory-only adherent. How do we know? Easy. Moore measures success in ICU avoidance. Children are not in the ICU, ergo to him COVID isn't a problem for children. Dangerously wrong.

There is plenty of scientific evidence about the vascular and neuro harm of COVID even when the respiratory phase is mild. In adults, some have horrible brain fog from brain damage. But many adults report no symptoms, yet do really badly on cognitive tests. It's possible to be badly harmed an not be aware of it. This is not uncommon with brain damage. Worse still: We can't even do proper cognitive assessment in very young kids. We have no idea what the harm is. We HAVE known since late 2020 that 100% of child COVID cases have biomarkers for microclotting. It's miles beyond negligent to frame COVID as only a respiratory virus. 

I urge you: don't give in. Don't consent to this harm for yourself or your kids. Keeping them out of the ICU isn't the victory that Moore says it is. Victory is avoiding permanent brain tissue loss and serious vascular damage. That means avoiding infection and reinfection. It would be one thing if we prevented mask mandates in schools because we didn't know what the virus does to our bodies. But we DO know. Preventing mask mandates in schools is purely a political/ideological move. I refuse to accept this.

The worry about Long Covid is that damage to the brain or heart can be quiet and insidious until it hits all at once with a stroke at 40 or an inability to write university exams at 21. An article by Danny Altmann in the Guardian today uses U.K. stats to estimate 5% of long Covid cases in vaccinated breakthrough cases, which is a very conservative estimate. 

Lest any who made a full and rapid recovery from infection still wonder whether long Covid might be a self-reported creation of the indolent, this is now a large, well-documented, convergent cluster of clear physiological symptoms, and it is common to every part of the globe affect by Covid-19. Many sufferers of my acquaintance were keen cyclists, runners, skiers and dancers, but are now disabled and deprived of their former passions. . . . The chances of long Covid in those who are vaccinated but suffer breakthrough infections may be halved, but when you apply this to the huge waves we've experienced - 3.5 million people infected at a given time - each 3.5 million cases becomes another 175,000 people with long Covid. . . . and many of the new sufferers are children. . . . .This is a tangible price being paid for turning a blind eye to the high incidence of cases in schools over recent months. . . . If we renege on mitigations as each round of infection draws more of all ages into chronic disability, this may be the blunder that we rue for decades to come.

Others estimate 30%, but explain how even 5% will have a huge effect on society.

While many more people will be affected by Long Covid than will die from Covid, there's still this concern to acknowledge: 

Wear a mask, get vax'd if you can, and clean and ventilate indoor public places (open windows AND add air filteration); isolate if sick and double test to return. Protect yourself and protect your community. It's not rocket science.