Mask or No Mask
Before you read this post, check the video out at this link (click on the little image “laser light experiment” in the article). This is from an academic article.
To most, this is the big question: do we really have to wear a mask every time we go out of our homes? SARS-Cov2 (SC2) is the virus, and Covid-19 (C19) is the disease it causes.
To answer this, we need to look at many questions:
- Are masks equal in how they protect and whom?
- C19 is seasonal, right?
- I already had C19 so I cannot catch it again and I am safe without a mask
- Can one have C19 without symptoms?
- Can one show C19 symptoms without having the virus that caused it?
- What about Herd Immunity?
Lots of unanswered questions, so let me jump in. Let me start with the last question and continue from there coming to the first question at the end.
What About Herd Immunity?
Herd immunity means that after many people have caught the virus and built up immunity to it, they won’t pass the virus to others and so fewer people can catch it as a result. This is the idea behind vaccinations: vaccinations provide immunity against a virus and so anyone getting the vaccine cannot catch the bug and therefore won’t pass it to others, reducing viral spread. Think of herd immunity as a chain-reaction of falling dominoes. The domino that is not falling (hasn’t caught the bug) will not knock over the dominoes in line after it (other people).
To achieve herd immunity, it is necessary to develop immune cells such that the person who caught the disease retains what is referred to as immune memory. Immune memory is created by memory T-cells, whose job is to remember and recognize the virus n the future, should the virus attempt to break in again. Not ever virus develops a response such that memory T-Cells are activated. For example, the common cold doesn’t develop immune memory and hence we can catch the same cold virus many times. Several cold viruses are corona-viruses, like SC2.
We have 2 primary immune responses: innate and adaptive. Innate refers to the instant immune system we constantly have circulating in our blood, which encapsulates everything suspect and clears it out of the body. The innate immune system doesn’t analyze the virus so the immune system doesn’t retain any memory of what it cleared. As a result, if someone has caught SC2 and developed very mild symptoms or no symptoms at all, there is a very strong chance that there will be no immune memory kept. So there is no immunity from catching it again. This is one reason why herd immunity may not work and why even conventional vaccines that depend on immune memory may not work either. And this is one reason why Sweden announced that it made a mistake of not locking down and not enforcing masks; they counted on herd immunity working, before they understood the virus and before we realized that herd immunity may not exist.
By contrast, adaptive immunity calls on killer T-Cells, Memory T-Cells, and many other immune cells to get rid of the virus. If the adaptive immune system got involved, the symptoms of C19 are severe enough for the person to feel sick. There is a greater chance for immune system memory in this case to give immunity against the same virus twice infecting shortly one after the other.
You can read about the two different types of immune systems and their responses here.
Can one show C19 symptoms without C19 in the body?
Yes, one can. This has been one of the biggest surprises to the medical system: at the height of the symptoms, SC2 virus is usually completely gone. In fact, it appears that the virus is gone pretty fast. What is left, and what is causing the illnesses, is the response of the immune system. You can read more about some of the immune response causes and symptoms here. One of the main reasons why many of the antiviral and hydroxychloroquine drugs were shown to not work for a long time is because both of these types of drugs can only work when the virus is still young in the body and the replication of the virus can be interfered with. Once the virus is gone, there is nothing that an antiviral drug can do. Hydroxychloroquine, for example, interferes with viral replication and so it cannot possibly do anything once there is no virus that’s replicating. You can see some of the changing understanding from Kaiser Permanente on this here.
Can one have C19 without symptoms?
Yes. This surprises most everyone but indeed, there are lots of cases in which the person tests positive for C19 and either doesn’t ever have any symptoms or develops symptoms several days later. A lot more C19 patients have no symptoms than you think; here is one paper discussing this in detail. If the person doesn’t know that he/she is infected, there is a greater chance of infecting others, because one is less concerned or careful. Many people tell me “we should not mandate that the healthy wear mask” but then if one can be sick without any symptoms, and may also feel totally healthy while being ill, how can we say with certainty that “healthy people” can be identified? Since we cannot, all people, with or without symptoms, should be equally concerned and cautious.
I already had C19 so I cannot catch it and I am safe without a mask
Absolutely false. Given that C19 doesn’t appear to initiate a long-lasting immune response (if any), it is highly likely that a person can catch C19 more than once. It seems immunity may depend on the severity of the disease, with those afflicted with the lightest symptoms conferring the least amount of immunity–and those without symptoms likely no immunity at all. This means that if someone had mild or no symptoms while having C19, they have a higher likelihood of catching it again! We have heard of this some time ago in the news but everyone ignored it and suggested that those people likely didn’t recover yet instead of believing that they caught C19 the second time. Yet there are many reports—from patients as well as doctors; people are on record for having caught C19 more than once.
C19 is seasonal, right?
Nope, it doesn’t appear to be so at the moment. I live in Southern California, where we are in the middle of the hottest mid-summer season and C19 is raging. I just watched the news about how C19 is also raging now in South Africa–it is winter there. Quite cold, in fact. It seems to also be strong around in the equatorial countries at the same time. So it seems that in all seasons at once C19 is happily spreading. Therefore, at this stage, C19 doesn’t appear to be seasonal.
Are masks equal in how they protect and whom?
No they aren’t, so let’s talk about masks. There is a lot of misinformation everywhere so it is good to clear the air. By OSHA regulation, masks are rated to be protective against certain things and each mask is different. The most discussed N95 mask provides 95% protection for the person who is wearing the mask. However, if you wear nothing and are talking to a sick person up close and personal, who has C19, is infectious, and wears an N95 mask, you may catch C19 because N95 protects the that person and not you. To be fully 95% protected, you too would need to wear an N95 mask.
Surgical masks that are easily accessible by us all now protect the person we talk to and not us, the ones wearing it. This is why surgical masks are worn during surgery: they protect the patient from the possible droplets released by the surgeon. Therefore, if you wear a surgical mask, you are protecting others and not yourself. It follows that if people around you wear no mask at all or they all wear N95 mask, your surgical mask is not protecting you! This is why the plea is to have everyone wear a surgical (or homemade cloth) mask. Your mask will protect me and my mask will protect you.
Fabric or homemade masks provide less protection than N95 but may provide more protection to you, who wears it, than a surgical mask, because you can use materials that are very tightly woven and can use additional layers of materials in between, including filters. You can add additional things to a surgical mask as well but it is harder since they don’t come with pocket.
By now we know that C19 spreads by air in aerosol droplets, that are microscopic in size. And most certainly a homemade fabric mask will not be made of a tight-enough woven fabric to keep aerosol size droplet out of landing on the mask. However, there is a huge limitation for the aerosol to be able to carry the virus into your mouth or nose from there because the mask has the chance of drying out the moisture from the droplet and deactivate the virus. Remember that the virus cannot swim or walk or crawl or fly. The droplet itself must make it through the mask to get you infected.
While homemade masks are clearly not nearly as protective as the N95 mask is, they are way better than nothing. You need to be sure you change your mask frequently and clean/wash/bake in oven/sun/ to deactivate the virus before you use it again. It is best to have several disinfected masks with you and change masks every couple of hours–depending on heat and moisture. And remember to disinfect every mask after every use. If you use surgical mask, they are disposable, and they are only meant to be worn once.
Do Masks Help?
Wearing a mask is not 100% guarantee against catching or transmitting the virus, but much better than not wearing a mask at all. While it is totally up to you how you hedge your personal risk bets, it is not up to you how you relate to the risk you pose to others! If you were at a high risk of getting very ill from the virus, you would expect others to wear a mask around you to protect you. So treat others accordingly and wear a mask around others! You never know who around you is high risk and may die as a result of your ignorance of, perhaps, being an asymptomatic C19 carrier.
Comments are welcome, as always, and are moderated for appropriateness