Poll: Masks and Face Shields

[Fidelio]

Here is the problem with masks.

1. They don't work to prevent respiratory infections. Here is a rigorous review of the studies to date and they found zero evidence for wearing of masks:
https://www.rcreader.com/commentary/mas ... ial-policy

2. Folks doing above study asked people to send in studies that refute their conclusions, some did, but none refuted the conslusion that masks don't work:
https://www.rcreader.com/commentary/sti ... tory-masks

3. Masks are harmful to the wearer:
https://www.technocracy.news/blaylock-f ... e-healthy/

Are we to obey the government (assuming they have authority to order mask wearing), if they tell us to do something that is harmful to our health?

[Bootstrap]

Here is the problem with masks.

1. They don't work to prevent respiratory infections. Here is a rigorous review of the studies to date and they found zero evidence for wearing of masks:
https://www.rcreader.com/commentary/mas ... ial-policy

Clearly, this is not a "rigorous review of the studies to date", most of these references are from before Covid-19 and the "River City Reader" fails to discuss the main studies that I find in literature reviews.

For instance, here is a literature review I found on the National Institutes of Health site, it seems similar to others I have seen.

Main studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission

Each of the following bullet points is the finding of one of these studies. Percentages describe the population that one of these studies was about, so they will differ between studies:

• 50–75% of infected individuals were asymptomatic, representing “a formidable source” of contagion. Isolation of asymptomatic individuals was essential for controlling virus spread and epidemic seriousness.
• 130 (78%) of 166 new infections identified in the 24-h period to the afternoon of Wednesday 1 April 2020 were asymptomatic. Asymptomatic infections would not be able to cause another major outbreak of COVID-19 if such individuals were kept in isolation.
• Higher viral loads were detected soon after symptom onset and the viral load in an asymptomatic patient was similar to that in symptomatic patients.
• The fact that asymptomatic persons are a potential source of COVID-19 infection may warrant a reassessment of the transmission dynamics of the current outbreak.
• The routes of COVID-19 transmission are via droplet, fomites and airborne transmission of droplet nuclei (<5 µm), with less evidence of intestine transmission. WHO continues to recommend droplet and contact precautions and not airborne precautions.
• Aerosol and fomite transmission of SARS-CoV-2 is plausible (but not proven), as the virus can remain viable and infectious in aerosols for hours and on surfaces up to days.
• Wearing surgical masks in public could help slow COVID-19 pandemic's advance; masks may limit the spread of diseases, including influenza, rhinoviruses and coronaviruses.
• 69 (76.6%) of 90 control guinea pigs became infected, compared with 36 (40%) of 90 intervention guinea pigs, representing a 56% (95% CI 33–70.5%) decreased risk of TB transmission when patients used masks. Surgical face masks on patients with MDR-TB significantly reduced transmission and offered an adjunct measure for reducing TB transmission from infectious patients. (Yes, this was an experiment using guinea pigs with masks, I bet they were cute)
• 246 patients were studied. Surgical face masks significantly reduced the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. The results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.
• 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 should not be recommended for the general public and non-high-risk medical staff (those are not in close contact with influenza patients or suspected patients).
• The practice of droplet precaution and contact precaution is adequate in significantly reducing the risk of infection after exposure to patients with SARS. The protective role of masks suggests that in hospitals, infection is transmitted by droplets.
• USA Guidance to the public Core recommendations are: 1) clean your hands often; 2) avoid close contact; 3) cover your mouth and nose with a cloth when around others; 4) cover coughs and sneezes; 5) clean and disinfect.

A few of these are summary guidelines rather than studies. To see the references for the footnotes, look to the main article:

Universal use of face masks for success against COVID-19: evidence and implications for prevention policies

The reason public health experts give us these recommendations is simple: it's the consensus of medical experts who have reviewed the available studies.

[Josh]

Boot,

Do you support mandatory face masks for mankind from now on? Do you support having an end date for this, or just mandating them perpetually?

[Soloist]

Clearly, this is not a "rigorous review of the studies to date", most of these references are from before Covid-19 and the "River City Reader" fails to discuss the main studies that I find in literature reviews.

For instance, here is a literature review I found on the National Institutes of Health site, it seems similar to others I have seen.

Main studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission

Each of the following bullet points is the finding of one of these studies. Percentages describe the population that one of these studies was about, so they will differ between studies:

• 50–75% of infected individuals were asymptomatic, representing “a formidable source” of contagion. Isolation of asymptomatic individuals was essential for controlling virus spread and epidemic seriousness.
• 130 (78%) of 166 new infections identified in the 24-h period to the afternoon of Wednesday 1 April 2020 were asymptomatic. Asymptomatic infections would not be able to cause another major outbreak of COVID-19 if such individuals were kept in isolation.
• Higher viral loads were detected soon after symptom onset and the viral load in an asymptomatic patient was similar to that in symptomatic patients.
• The fact that asymptomatic persons are a potential source of COVID-19 infection may warrant a reassessment of the transmission dynamics of the current outbreak.
• The routes of COVID-19 transmission are via droplet, fomites and airborne transmission of droplet nuclei (<5 µm), with less evidence of intestine transmission. WHO continues to recommend droplet and contact precautions and not airborne precautions.
• Aerosol and fomite transmission of SARS-CoV-2 is plausible (but not proven), as the virus can remain viable and infectious in aerosols for hours and on surfaces up to days.
• Wearing surgical masks in public could help slow COVID-19 pandemic's advance; masks may limit the spread of diseases, including influenza, rhinoviruses and coronaviruses.
• 69 (76.6%) of 90 control guinea pigs became infected, compared with 36 (40%) of 90 intervention guinea pigs, representing a 56% (95% CI 33–70.5%) decreased risk of TB transmission when patients used masks. Surgical face masks on patients with MDR-TB significantly reduced transmission and offered an adjunct measure for reducing TB transmission from infectious patients. (Yes, this was an experiment using guinea pigs with masks, I bet they were cute)
• 246 patients were studied. Surgical face masks significantly reduced the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. The results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.
• 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 should not be recommended for the general public and non-high-risk medical staff (those are not in close contact with influenza patients or suspected patients).
• The practice of droplet precaution and contact precaution is adequate in significantly reducing the risk of infection after exposure to patients with SARS. The protective role of masks suggests that in hospitals, infection is transmitted by droplets.
• USA Guidance to the public Core recommendations are: 1) clean your hands often; 2) avoid close contact; 3) cover your mouth and nose with a cloth when around others; 4) cover coughs and sneezes; 5) clean and disinfect.

A few of these are summary guidelines rather than studies. To see the references for the footnotes, look to the main article:

Universal use of face masks for success against COVID-19: evidence and implications for prevention policies

The reason public health experts give us these recommendations is simple: it's the consensus of medical experts who have reviewed the available studies.

Well were is the data supporting face coverings? I've posted WHO data before showing the effectiveness of a piece of cloth.

[Fidelio]

Here is the problem with masks.

1. They don't work to prevent respiratory infections. Here is a rigorous review of the studies to date and they found zero evidence for wearing of masks:
https://www.rcreader.com/commentary/mas ... ial-policy

Clearly, this is not a "rigorous review of the studies to date", most of these references are from before Covid-19 and the "River City Reader" fails to discuss the main studies that I find in literature reviews.

For instance, here is a literature review I found on the National Institutes of Health site, it seems similar to others I have seen.

Main studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission

Each of the following bullet points is the finding of one of these studies. Percentages describe the population that one of these studies was about, so they will differ between studies:

• 50–75% of infected individuals were asymptomatic, representing “a formidable source” of contagion. Isolation of asymptomatic individuals was essential for controlling virus spread and epidemic seriousness.
• 130 (78%) of 166 new infections identified in the 24-h period to the afternoon of Wednesday 1 April 2020 were asymptomatic. Asymptomatic infections would not be able to cause another major outbreak of COVID-19 if such individuals were kept in isolation.
• Higher viral loads were detected soon after symptom onset and the viral load in an asymptomatic patient was similar to that in symptomatic patients.
• The fact that asymptomatic persons are a potential source of COVID-19 infection may warrant a reassessment of the transmission dynamics of the current outbreak.
• The routes of COVID-19 transmission are via droplet, fomites and airborne transmission of droplet nuclei (<5 µm), with less evidence of intestine transmission. WHO continues to recommend droplet and contact precautions and not airborne precautions.
• Aerosol and fomite transmission of SARS-CoV-2 is plausible (but not proven), as the virus can remain viable and infectious in aerosols for hours and on surfaces up to days.
• Wearing surgical masks in public could help slow COVID-19 pandemic's advance; masks may limit the spread of diseases, including influenza, rhinoviruses and coronaviruses.
• 69 (76.6%) of 90 control guinea pigs became infected, compared with 36 (40%) of 90 intervention guinea pigs, representing a 56% (95% CI 33–70.5%) decreased risk of TB transmission when patients used masks. Surgical face masks on patients with MDR-TB significantly reduced transmission and offered an adjunct measure for reducing TB transmission from infectious patients. (Yes, this was an experiment using guinea pigs with masks, I bet they were cute)
• 246 patients were studied. Surgical face masks significantly reduced the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. The results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.
• 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 should not be recommended for the general public and non-high-risk medical staff (those are not in close contact with influenza patients or suspected patients).
• The practice of droplet precaution and contact precaution is adequate in significantly reducing the risk of infection after exposure to patients with SARS. The protective role of masks suggests that in hospitals, infection is transmitted by droplets.
• USA Guidance to the public Core recommendations are: 1) clean your hands often; 2) avoid close contact; 3) cover your mouth and nose with a cloth when around others; 4) cover coughs and sneezes; 5) clean and disinfect.

A few of these are summary guidelines rather than studies. To see the references for the footnotes, look to the main article:

Universal use of face masks for success against COVID-19: evidence and implications for prevention policies

The reason public health experts give us these recommendations is simple: it's the consensus of medical experts who have reviewed the available studies.

Send the list to the "River City Reader." I am sure they would be glad to look at them.

[Fidelio]

Well were is the data supporting face coverings? I've posted WHO data before showing the effectiveness of a piece of cloth.

Send it to the "River City Reader." I gladly await their next update, however it may turn out.

[ragpicker]

I’m in a local diner in Ohio. Maybe 10% are coming in with a mask.

[Soloist]

https://www.medpagetoday.com/hospitalba ... trol/54905

Physicians and other healthcare workers who refuse influenza immunization at 535-bed Children's Hospital of Philadelphia can't work in patient care.

"If you don't want to get the vaccine, you have two weeks of unpaid leave to think about it, and if you still don't want to get it, you're fired," said Paul Offit, MD, CHOP's Chief of Infectious Diseases and Director of the Vaccine Education Center.

There's no provision to let workers wear a mask instead, like many healthcare facilities allow, because he said, "masks aren't particularly effective."

CHOP makes exceptions only for a very few workers with documented medical contraindications. But even they don't have to wear a mask.

To Mask or Not

As healthcare organizations rush to comply with new federal immunization reporting requirements for their workers, many infection control experts are questioning the mask option, saying it's an inefficient, ineffective, and dehumanizing alternative to immunization, one that gives workers an excuse not to get their annual flu vaccines.

Mask mandates are "a silly half-way measure that really doesn't serve any useful purpose other than to identify a person as a healthcare worker who is choosing not to get vaccinated -- selfishly," Offit said. "You might as well wear a scarlet letter for all the good it does."

Why are masks ineffective? For starters, they're only 60% effective in blocking viral particles, about the same efficacy rate as the vaccine in a good year. But the real problem is the inconsistency in both use and fitting of the mask to the face.

"Sometimes healthcare workers wear the masks below their chin or below their nose. After awhile it gets wet and therefore permeable," Offit said. "It's not tight fitting so you can still breathe in and out along the side, and small droplets can spread."

Around the country, however, what to do with the unvaccinated healthcare worker remains controversial. Organizations with mask mandates -- from community clinics to skilled nursing and long-term care facilities and hospitals -- are realizing that enforcing mask wearing for the unimmunized is impossible without embarrassing colleagues and disrupting routines.

Priya Sampathkumar MD, chair of immunization and infection control committees at the Mayo Clinic said Mayo facilities in Jacksonville, Rochester and Scottsdale do not require the roughly 9% of workers who refuse the vaccine to mask.

"They're difficult to wear for several hours at a time," Sampathkumar said. The discomfort prompts workers "to remove them, and not put them back on. I don't think they forget; I think they deliberately don't put them on again."

Enforcement also would be a constant struggle, she said. "Managers' time would be spent walking around to make sure everyone without the correct sticker has a mask on -- that's a waste of resources that could be used somewhere else."

Requiring masks may also violate the Health Insurance Portability and Accountability Act by indirectly releasing protected health information, Sampathkumar said. "Some patients can't receive the flu vaccine for medical reasons, so by making them wear a mask, you're marking those people, or unfairly singling them out."

The Stay Home Solution

Instead, the Mayo Clinic's system-wide policy urges workers to "stay home when they're sick, and make sure they're washing their hands before touching a patient or leaving a patient room," Sampathkumar said.

"Taking a punitive approach when employees don't comply with one element of good practice may not be working in the patient's best interest."

The national average for vaccine refusal by hospital workers is 18%, and some hospitals report they have reduced the refusal rate to 10%, but other hospitals' have lagged.

During last year's flu season, roughly 30% of the hospital workforce in New Jersey, Florida, and Alaska declined vaccination, according to Medicare's Hospital Compare database. For 966 of the nation's 3,662 hospitals reporting, one in four or more of their workers declined, and for 140, half or more said no.

Some hospitals have exceptionally low rates. For example, 95% of the workers at Jefferson County Hospital in Fayette, Miss., 88% at Lakeside Medical Center in Belle Glade, Fla., and 87% at Florence Hospital in Florence, Ariz. declined last year.

For hospitals with low vaccination rates but strict mask enforcement, a lot of patients would wake up to personnel wearing masks, and that might be frightening to patients who are severely ill or cognitively impaired.

"It could be very scary," said Sampathkumar.

"I'm not sure that anyone has ever proven that wearing a mask cuts down on influenza transmission," she said. Transmission could happen even with vaccinated employees, "because the vaccine efficacy varies from year to year and is never anywhere near 100%," she said.

But mask mandates are now enforced in several states and localities. In many California counties, for example, public health officers now require that healthcare workers in nearly all settings but physicians' practices get vaccinated or else "wear a mask for the duration of the influenza season (Nov. 1 to March 31) while in contact with patients or working in patient care areas." Physician practices are strongly urged to follow suit.


(cut out unrelated, you can read in article)

Other variations include how close to a patient an unimmunized healthcare worker must be when the mask requirement kicks in. Some hospitals say it's within 6 feet of a patient. Some say 6 feet of a patient care area. Still others don't specify any distance, thus covering the entire property.

Some hospitals require vaccine documentation of vendors and contractors entering the building while some don't. Some organizations mandate immunization for students, clerical, and janitorial personnel, and even pastors, while others don't.

Neosho Memorial Regional Medical Center in Chanute, Kansas requires workers who decline for medical, religious or personal to wear "a bright pink badge to help others identify them (helps maintain compliance for mask wearing in ALL areas of the hospital.)"

Other organizations, like Frisbie Memorial Hospital in Rochester, N.H., designate its immunized workers with a sticker on their ID badges.

The American Hospital Association encourages all workers to get annual flu vaccines, but there's no clear solution for what hospitals should do if they won't, said Nancy Foster, the AHA's vice president for quality and patient safety.

"There are no clear data telling us what the second best alternative would be," she said. "Do they get more rigorous about telling people to stay home if they're under the weather? Do they move people from patient contact to other areas of the hospital? Without clear evidence of a second strong alternate policy, we're not advising them what that alternative should be."

Foster acknowledged that for many hospitals with high rates of vaccine refusal, transfer to nonpatient care areas is not a practical solution. "If it's a third of your workforce, you wouldn't have enough administrative jobs for that," she said.

National Nurses United, a labor organization representing 186,000 nurses, "highly recommends that nurses get all their vaccinations," said Bonnie Castillo, director of NNU's Registered Nurse Response Network. But policies about what hospitals should do with those who refuse "are all over the map. It's a mishmash. And there's no enforcement mechanism."

NNU vehemently opposes vaccination or masking as a condition of employment because of the potential to be punitive, she said.

"What we're seeing is that there are very coercive measures, including requiring masks, which have no scientific basis for preventing the spread of the flu, and instead give a false sense of security ... and a sense of mistrust," she said.

"If we in the healthcare and science communities are spreading bogus science on one hand, how do we expect to be credible on any other topic of infectious disease, or worker and patient protection? You have to be consistent."

A more sensible option, she said, is for hospitals and other healthcare settings to relax their strict limits on sick days so that when nurses do feel ill, they can stay home without financial consequence.

For Offit, a focus on getting all healthcare workers immunized is really the only solution to keeping patients safe from infection. One must remember that patients' lives are at stake, he said.

"Healthcare workers have a responsibility to their patients, and it is not their inalienable right to catch and transmit a potentially fatal infection. It's not their right to not be vaccinated," Offit said.

Several years ago, a child with cancer "came into this hospital for care, but caught the influenza virus in this hospital and died from it," he said. "She no doubt caught it from us."

Last Updated November 30, 2015

[Josh]

I’m in a local diner in Ohio. Maybe 10% are coming in with a mask.

What’s the compliance rate once they’re eating?

[Soloist]

I’m in a local diner in Ohio. Maybe 10% are coming in with a mask.

What’s the compliance rate once they’re eating?

0.0001% I'd hazard.
https://www.reuters.com/article/us-heal ... SKBN22U1ZO