Face Masks Ė Ending the Confusion
Dr Vernon Coleman MB ChB DSc FRSA
Everyone in the world seems confused about whether or not we should wear masks to protect us from the coronavirus. The general consensus among politicians and the so-called experts quoted in the media appears to me to be that wearing masks does no good but that we should wear them anyway and that we donít need to wear them although they are very useful. This advice is given freely by commentators who are untroubled by facts or research or annoying things of that nature and conflicting pronouncements are regularly made by politicians who clearly know so little about medical matters that they probably couldnít even manage to spell technical medical words such as diarrhoea.
The World Health Organisation, which has loads of highly paid doctors and specialists investigating such matters, appears to lead the confusion. Indeed, their confusion seems to me so confusing that they have confused me. They initially said that healthy individuals only needed to wear a mask if they were taking care of someone suspected of having the coronavirus. The science doesnít seem to me to have changed but the advice from the WHO has changed. Iíll come on to why that might be in another video.
Governments everywhere are collectively confused although individual politicians everywhere all seem to have firm views on the matter, usually derived from the bloke who cuts their hair or the woman in the corner shop who knows about these things.
Hospitals and doctors also seem confused. You find me 1,000 hospital staff who think that masks are a good idea and that we should all wear them all the time, even when we are in the bath, and I will find you 1,000 hospital staff who think they are useless or dangerous or both.
The odd thing is that there donít seem to be any studies relating to the use of masks with the coronavirus.
Nevertheless, around the world the mask industry is booming. The people who arenít working on a new wonder vaccine are making masks.
There are videos and books explaining how to make your own mask out of unwanted bits and pieces found lying around the home. It is possible to make two excellent face masks out of the cups of an old brassiere, using the straps to fashion loops to go around the ears or the back of the head. Naturally, the size of the bra has a big influence on its suitability for turning into a face mask and a bra measuring 44GG is probably going to be a little on the loose side for most people. And if you need fresh masks every day you will need a large supply of bras.
Despite the confusion, the British Government announced that from June 15th everyone in England must wear a mask when using public transport. You can travel on public transport on the 14th without a mask but on the 15th you will need a mask, presumably because the Government knows that the virus will suddenly become more dangerous then. I have absolutely no idea what the rules are in Scotland or Wales but theyíre bound to be different to England because both Scotland and Wales are desperate to prove that they are independent countries, but if they donít follow the English law then if you are on a train which crosses a border you can presumably remove your mask until your return journey. You may also have to wear a mask if entering a shop or a public building or an office though this doesnít appear to be a law. There doesnít seem to be much in the way of guidance for police officers but the Government says it doesnít expect there to be any problems. Thatís probably not quite the firm ruling that the police would have liked so we can presumably expect the confusion to spread into the courts.
In the UK, the Government that appears now to be only looking after England, has previously admitted that wearing a mask does not protect the wearer but it may protect other people if the wearer has the infection but doesnít know it. And the Government has added that you donít have to wear a mask if you are under the age of two, if you find it difficult to manage a mask properly or if you have a respiratory problem of any kind which may make breathing difficult. I take this to mean that anyone who has asthma, hay fever, emphysema, bronchitis, a smokerís cough or anything else a bit chesty doesnít have to wear one. I suffer from hay-fever and get a bit wheezy from time to time so Iím afraid I canít possibly wear one. Officer. Iíll write myself a little note saying that I have an intermittent chest condition and cannot possible wear a mask and if a policeman stops me Iíll show him that. I should mention here that there is evidence that people who donít wear masks in public may be harassed and abused by people who are wearing them. I think thatís a risk that Iím prepared to take.
No one with mental illness of any kind should be expected to wear a mask. Nor should anyone with dementia though I am not sure they are on the list of exclusions. No one seems to have worried much about this but the hearing impaired who rely on lip reading will obviously be badly affected if everyone wears a mask. People with skin conditions might find that wearing a mask causes eczema, dermatitis or other problems Ė particularly if the mask has been washed in a biological detergent. In my view patients who are ill in hospital shouldnít wear a face mask, especially if they are in bed, because of the risk of them inhaling their vomit if they are sick.
The world is now awash with conflicting reports on how or when or whether to wear a mask to protect you against the flu, the lurgy or the embarrassment of having egg on your chin.
Some people, such as the Mayor of London, want masks to be compulsory though no one has provided evidence for the compulsion. Early on in this farce, Act 1 scene 2 I think it was, the Mayor allegedly threatened to order people to wear masks in London if the Government did not do so. In the end I got so darned confused myself that I decided to put a cold compress on my forehead, settle down with some research papers and set out on an expedition to find the truth. In the end I came to a very firm, definitive conclusion which I shall now add to the mix. If the mayor of London, who was I believe trained as a lawyer, can have a view then Iím damned sure I am entitled to a firm view too. Maybe we can do a deal. Iíll promise not to do any legal eagle stuff if heíll promise to shut up about medical stuff.
Incidentally, talking of lawyers, I think Mr Khan can consider himself trumped because on 30th March, the former Supreme Court Justice Jonathan Sumption QC told us all that the police have no power to enforce Ministersí preferences and that there was nothing in the existing legislation which empowered a police officer to force a citizen of the UK to wear a mask on public transport or anywhere else.
Lord Sumption pointed out that even if the Government rushed through new legislation the laws would have to be justified and proportionate in order to avoid violating our human rights and civil liberties.
He went on to suggest that since masks may endanger the wearer they are a contravention of Article 2 of the Human Rights Act.
`I hope,í he said, `that UK citizens will unite in civil disobedience to the unlawful, unjustified and disproportionate violation of our human rights and refuse either to wear a mask or to pay the fixed penalty notice for not doing so. If enough of us take a stand against the further encroachment on our civil liberties, we can look forward to hundreds of thousands of court cases in which the Crown tries to prove the scientific validity of wearing masks to combat a virus that has been circulating in the UK for five months.í
That statement was made over two months ago, so its seven months now.
Iíve been unable to find out if Lord Sumption still believes that but Iím really looking for medical facts so I offer his two month old views only out of curiosity and a sense of respect.
One thing I need to point out before I forget is that there is, as always, a good deal of fake news around about masks. In particular, some main stream media outlets delight in dismissing the risks associated with face masks as fake news. The fact is that masks can be dangerous and need to be worn only when necessary. Anyone who denies that has either been bought or is woefully ignorant. Thereís a good deal of both around these days.
First, I want to give you some facts about face masks themselves which are, of course, much more complicated than they appear to be at first sight. Governments donít seem to bother differentiating between different types of mask and I think that tells us a good deal about why they want us to wear them Ė again, thatís something Iíll explore in another video.
1. The World Health Organisation recommends that disposable masks should be discarded after one use.
2. The WHO doesnít seem to have any guidelines for masks made out of washable material but itís a fair guess that it would recommend washing thoroughly at a high temperature after every use. Unfortunately, washing cloth face masks makes them even less effective. The more you wash the mask the less effective it becomes.
3. Masks are effective only when used in combination with frequent hand washing with soap and water or an alcohol based hand rub.
4. Fabric masks may allow viruses to enter and are not considered to be anywhere near as protective as surgical masks. A study I have seen entitled `Optical microscopic study of surface morphology and filtering efficiency of face masksí concluded that face masks made of cloth are not very good at filtering out viruses because the pores are much bigger than the particulate matter that needs to be kept out. One study showed that facemasks may have pores five thousand times larger than virus particles. If this is accurate it means that the virus will wander through the face mask much like a mouse wandering through Marble Arch.
5. Masks are only really effective if they fit perfectly and if the wearer does not move their head while wearing them. Touching a mask appears to stop the mask providing protection. It has been suggested that you should put on a new mask if you have touched the one you are wearing.
6. Surgical masks are worn to stop bits of food or hair falling from the surgeon or nurse into a wound. They will stop some bacteria but will not usually stop viruses.
7. Much of the air we breathe in and out goes around the side of the mask unless it is very tight fitting. The effectiveness of a mask depends massively on the nature of the mask, how it is worn and how often it is changed. How long will it be before we are expected to attend facemask wearing classes?
So much for the masks themselves.
Next, I want to look at the serious health problems which might be associated with wearing a mask and which have been largely ignored or dismissed by politicians and the sort of media which has been bought by governments.
Does wearing a face mask reduce your immunity levels?
No one seems to know the answer for sure but it seems possible that if people wear face masks for long periods (months or years) then the absence of contact with the real world might well have a harmful effect on immunity Ė if the face mask works. Do face masks prevent us developing immunity to particular diseases? This depends on many factors Ė mainly the effectiveness of the face mask. But if the mask isnít preventing the development of immunity then it probably isnít worth wearing.
The two widely acknowledged hazards of wearing a face mask are first that the mask may give a false sense of security and stop people taking other precautions Ė such as washing their hands. Secondly, if masks arenít worn properly Ė according to the guidelines I have listed Ė they can do more harm than good.
There is no doubt that face masks can be dangerous. In China, two school boys who were wearing face masks while running on a track both collapsed and died Ė possibly, I would surmise, because the strain on their hearts by the shortage of oxygen proved fatal.
A report published in the British Medical Journal summarised some other risks.
First, when you wear a face mask some of the air you breathe out goes into your eyes. This can be annoying and uncomfortable and if, as a result, you touch your eyes you may infect yourself.
Second, face masks make breathing more difficult and, as I have already pointed out, anyone who has a breathing problem will find that a mask makes it worse. Also, some of the carbon dioxide which is breathed out with each exhalation is then breathed in because it is trapped. Together these factors may mean that the mask wearer may breathe more frequently or more deeply and if that happens then someone who has the coronavirus may end up breathing more of the virus into their lungs. If a mask is contaminated because it has been worn for too long then the risks are even greater. How long is too long? No one knows. No research has been done as far as I know.
Third, there is a risk that the accumulation of the virus in the fabric of the mask may increase the amount of the virus being breathed in. This might then defeat the bodyís immune response and cause an increase in infections Ė other infections, not just the coronavirus.
Another report, again written with medical authority, offers more problems.
Dr Russell Blaylock, a retired neurosurgeon, reported that wearing a face mask can produce a number of problems varying from headaches to hypercapnia (a condition in which excess carbon dioxide accumulates in the body) and that the problems can include life threatening complications.
The risk of side effects developing when wearing a mask depend to some extent on whether the mask is made of cloth or paper or is an N95 mask filtering out at least 95% of airborne particles.
One study of 212 healthcare workers showed that a third of them developed headaches with 60% needing pain killers to relieve the headache. Some of the headaches were thought to be caused by an increase in the amount of carbon dioxide in the blood or a reduction in the amount of oxygen in the blood. Another study, this time of 159 young health workers showed that 81% developed headaches after wearing facemasks Ė so much that their work was affected.
A third study, involving 53 surgeons, showed that the longer a mask was worn the greater the fall in blood oxygen levels. This may lead to the individual passing out and it may also affect natural immunity Ė thereby increasing the risk of infection.
An N95 mask can reduce blood oxygenation by as much as 20% and this can lead a loss of consciousness. Naturally, this can be dangerous for car drivers, for pedestrians or for people standing up.
Dr Blaylock also pointed to a study entitled `The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence.í This study looked at 17 separate studies and concluded that none of the studies established a conclusive relationship between the use of masks and protection against influenza infection.
`When a person has TB we have them wear a mask,í concluded Dr Blaylock, `not the entire community of the non- infected.í
I wonder if our leaders know all this? If they do then why are they so keen to make face masks compulsory despite the dangers. And if they donít know all this then they should do.
The one remaining question is: why, when the disease is fading throughout the world, has the British Government decided that we should wear masks when there are so clearly very real dangers with wearing them.
I suppose they will say it is because the lockdown is being eased a little but they lie about everything so I donít believe that for a second.
I think they have another reason.
Iíll discuss the psychological problems associated with the wearing of face masks in another article. And I will also explain how the Government is using masks to make us fearful so that we are easier to control.
Copyright Vernon Coleman June 2020
Vernon Colemanís book Coming Apocalypse is the story of how the coronavirus `crisisí developed Ė and what will happen next. It is available as a paperback and as an eBook.