As the incredibly transmissible variant Omicron spreads through our communities, it continues to be imperative to continue vigilant behavior to protect ourselves and our loved ones. Although it continues to appear that Omicron infection results in a milder Covid-19 course, again it is about the numbers. Record numbers. The highest since the start of the pandemic 2 years ago. More infected adults and kids inevitably leads to more hospitalization and death. In addition, long haul symptoms will occur to a greater degree (more on long-haul problems later). And YES, the vast majority of the sickest Covid patients are not vaccinated, or are not fully vaccinated (not boosted). In addition, repeat “natural” infections are occurring at a greater rate. Previous infection is not the answer.
The single most important healthcare measure we can take to protect ourselves and slow down Covid-19, is vaccination. Although not perfect, they are amazing and have saved a lot of lives. They are effective and they are safe. Billions of doses have proven it. The fact that most people hospitalized and dying from Covid-19 are unvaccinated also proves it. They are not a force field however, so other behaviour practices are also crucial.
Masking is the second most important practice. The problem is, most people are not doing it and those who are, are doing it ineffectively. Part of the concern with the CDCs recommendation to shorten isolation with asymptomatic Covid is that they also recommend 5 additional days of masking. Most people won’t do it.
Again masks are not perfect, but they help.
First, by wearing a mask, any mask, as crappy as it may be, you are reminding yourself as well as those around you that there is a pandemic going on. Others around you may also be concerned that you may be infected and keep their distance, another important behavior to limit spread and infection. It’s like behaving like a crazy person so you get a seat on the bus or train. But by wearing a crappy mask, don;t delude yourself that you are being protected.
How you wear a mask is also important. If it’s under your nose, it’s useless. The virus lives and replicates in your nose. If the mask is below it, you’re just expelling, and breathing in viruses. If you keep lifting it to talk, you are also allowing ambient air to enter and exit your mouth and nose, not to mention the fact that you are touching the front, where the virus is filtered out. We know that the virus can survive many hours on cotton and other surfaces. Don’t wear it upside down. If it has a metal piece on one end, it’s to make the fit more snug on your nose, not under your chin. I’ve stopped correcting people since probably 1/3rd of the people I see wearing such a mask are wearing it upside down.
The fit of a mask is important. If it’s loose, and air can get around the mask, it defeats the purpose of wearing it. It should be snug all the way around.
QUALITY MATTERS. All masks are NOT created equal. Many repeated studies over the last 2 years have revealed the benefits, as well as the lack of benefit, of different kinds of masks.
A doyley, or mesh mask (yes, some people try to get into my office wearing these), are obviously completely useless. Can a mesh strainer hold water?
Spandex, nylon and other synthetic materials, such as the ones gaiter-style are made of, are also pretty ineffective and can even aerosolize secretions more, spreading more virus than actually wearing nothing.
Cotton masks, both commercial and home made, are the next best thing, but are also relatively ineffective unless they are thick. Multiple layers and insertable filters definitely help. The thicker the cotton, the better. They are washable which also is an advantage.
Surgical masks. Better than cloth but they are much less effective than most people think. Someone recently sent me a video from a mask-making facility in Indonesia and it was pretty sad. Clearly no sterility. Using a sewing machine with bare hands. Folding the pleats by hand, barefoot, sitting on the floor of an overcramped facility. Hopefully, the masks you are using are not from this vendor. Ideally, you want a 3-ply surgical mask, the standard in hospitals. They can be used for a few days and then must be discarded. If wrinkled up, they lose their filtration ability so don’t reuse them for too long.
N95 / KN95. These are the gold standard. The difference is essentially where they were certified. In the US, they are called N95, R95 or P95. In China, they are referenced as KN95 and in Europe they are called FFP2. They provide the most robust protection and are the gold standard, especially if made to fit an individual face. They are readily available online and I would strongly recommend wearing one of these when travelling or when spending any significant amount of time indoors with large numbers of people.
Face shields are NOT masks. They can be used with a mask, but they essentially only protect your eyes.
As for the health impact of wearing masks, there are none. Sure they’re uncomfortable and they cause your mouth to dry out since we tend to mouth-breathe more with masks, but that is about it. If your glasses fog up, improve the seal and/or, deal with it. If you have such mad lung disease that you can’t breathe with a mask, re-consider where you go, who you interact with and your vaccination status. These people are few and far between however.
Mouth breathing, by the way, is a chronic issue I deal with in the office. The nose is for breathing and the mouth is for eating. You lose 40% more moisture by mouth breathing and lose most filtration the nose provides. We very quickly get acclimated to mouth breathing and simply need to practice nasal breathing. It’s much healthier for you. A great book discussing this topic is “The Oxygen Advantage” by by Patrick G. McKeown.
Have a safe and happy 2022.
It will be interesting to see how things continue to evolve.
Stay safe and be well.
AC