Who else is tired of the great mask debate? Time to educate!

BY SIMONE J. SMITH

To be honest with you, I am tired of this mask debate. I truly believe that people should be free to do what they feel fit for themselves and their families. Unfortunately, it has become a debate, one so heated that we have seen physical altercations ensue because of it.

What is important here is that in order for you to make an educated decision or to have a position on a topic, you have to be educated on it. Educating yourself on a topic does not mean turning on CNN, or CTV, and listening to what a reporter tells you. Educating yourself means taking the time to hear what is being said, and then doing the necessary research. Once you have done this, now you have the ability to make qualified decisions.

What I am going to quickly do for our readers this week is present you with peer-reviewed studies that discuss the pros and the cons of mask wearing. You will be provided with topics and links that you can take and conduct your own research. Let’s first talk a little bit about what we know about the influenza virus.

Influenza remains a global public health concern; the World Health Organization (WHO) estimates show that annual epidemics may cause up to 5 million severe illnesses and 500,000 deaths worldwide, and this was back in 2018. Influenza outbreaks have and continue to represent an important health concern worldwide, but this is not a new phenomenon.

There are cases in which vaccines are only partially successful in reducing the infection rate, and the use of respiratory protective devices are usually seen as a countermeasure. Respiratory protective devices include medical masks and N95 respirators.

What has been difficult for some people to understand is why public health authorities are not providing established scientific studies that show the effectiveness of masks. What is reported is all the positives, but what is not mentioned is the unknown potential harm that they can cause.

When I did literature reviews in the alternative media space, I found that once again, journalists and reporters were only including studies that defended their point of view. Regardless of what I think about mask or mask wearers, my job is not to convince; my job is to share information so that our readers are able to make their own decisions.

Below is some scientific literature about the effectiveness of wearing surgical masks and respirators.

Jacobs, J. L. et al. (2009) “Use of surgical face masks to reduce the incidence of the common cold among health care workers in Japan: A randomized controlled trial,” American Journal of Infection Control, Volume 37, Issue 5, 417-419. https://www.ncbi.nlm.nih.gov/pubmed/19216002

Conclusion
This study concluded that facemask use in health care workers has not been demonstrated to provide benefit in terms of cold symptoms or getting colds. Researchers agreed that a larger study is needed to definitively establish whether no mask use is better than wearing a mask.

Cowling, B. et al. (2010) “Face masks to prevent transmission of influenza virus: A systematic review,” Epidemiology and Infection, 138(4), 449-456. https://www.cambridge.org/core/journals/epidemiology-and-infection/article/face-masks-to-prevent-transmission-of-influenza-virus-a-systematic- review/64D368496EBDE0AFCC6639CCC9D8BC05

Conclusion
During the 2009 influenza H1N1 pandemic, national and international health agencies recommended the use of facemasks. There was some evidence to support the wearing of masks when someone was sick to help reduce the transmission of influenza. There was less data to support the use of masks or respirators to prevent becoming infected.

COWLING, B., ZHOU, Y., IP, D., LEUNG, G., & AIELLO, A. (2010). Face masks to prevent transmission of influenza virus: A systematic review. Epidemiology and Infection, 138(4), 449-456. doi:10.1017/S0950268809991658

Conclusion
Their review highlights the limited evidence base supporting the efficacy or effectiveness of face masks to reduce influenza virus transmission. They explain that if airborne transmission were important, it would be less likely that surgical masks lead to reductions in infectiousness or protection against infection.

bin-Reza et al. (2012) “The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence,” Influenza and Other Respiratory Viruses 6(4), 257-267. https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1750-2659.2011.00307.x

Conclusion
The review of studies did not establish a conclusive relationship between wearing a mask/respirator and its ability to protect you against the influenza infection. The researchers concluded that mask use is best undertaken as part of a package of personal protection and healthcare settings.

Smith, J.D. et al. (2016) “Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis,” CMAJ Mar 2016 https://www.cmaj.ca/content/188/8/567

Conclusion
In this study N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings. What they wanted to determine but were unable to was whether N95 respirators were superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings.

Offeddu, V. et al. (2017) “Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta–Analysis,” Clinical Infectious Diseases, Volume 65, Issue 11, 1 December 2017, Pages 1934–1942, https://academic.oup.com/cid/article/65/11/1934/4068747

Conclusion
Researchers found evidence to confirm the effectiveness of medical masks and respirators against SARS. Disposable, cotton, or paper masks were not recommended. They also noted that the effectiveness of the mask is related to the baseline risk of infection. Outbreaks with higher attack rates offer more opportunities for infection.

I guess the question to ask would be, is COVID-19 considered a high attack rate, or is it being made out to be one?

Long, Y. et al. (2020) “Effectiveness of N95 respirators versus surgical masks against influenza: A systematic review and meta-analysis,” J Evid Based Med. 2020; 1- 9. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12381

Conclusion
In this study the research was clear; the use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory confirmed influenza. It suggests that N95 respirators not be recommended for general public use.

Believe me when I say, if you really want to go down this rabbit hole you can. There needs to be more research done to determine the importance of different modes of transmission of influenza and the effectiveness of respiratory protection devices in real-world use.

Not one of the studies presented established a conclusive relationship between mask/respirator use and protection against influenza infection, and if that is the case, should mask mandates be enforced the way that they have been by the Canadian government?