To Mask or Not to Mask?

Do you need to wear a mask to protect yourself from the Covid-19 virus? That is the question on the mind of nearly everyone in the world today.

Advice from government and healthcare officials has been contradictory on this subject.
Dr. Mark Siegel, professor of medicine at NYU Langone Medical Center, addressed this subject recently in The Wall Street Journal. Siegel admits the message from medical authorities has been confusing. Both the U.S. Surgeon General and the Centers for Disease Control and Prevention exhorted Americans not to wear masks in January and February and then reversed their advice in April. What to believe?

Mask wearing has now become mandatory in many environments, including workplaces, airlines, and other public places. People wear masks when they are outside walking and others wear them when driving alone in their cars. When does it really make sense to wear a mask and when is it unnecessary?

The Purpose of the Mask

What exactly is the purpose of the mask? As a surgeon, I have worn a mask for every surgical procedure I have ever performed. That’s over forty years of wearing masks routinely. I wear the mask to prevent spread of my germs into the surgical environment, lest the patient be contaminated by me. I do not wear the mask to prevent contracting disease from the patient except in extreme situations when the patient may be infected with a contagious disease. In such cases I will also wear a face shield.

The wearing of masks today is to prevent contracting or spreading the Covid-19 virus. To prevent contracting the virus, you must understand how the virus is spread. This virus is spread by droplets and not by aerosolized virus particles. That means your risk for contracting the virus is directly related to contact with virus droplets, not inhaling virus particles. The typical spread occurs when virus droplets contaminate a surface, or skin, and your hands touch that surface or skin. Then your hands touch your face and you contaminate yourself. Therefore, it is crucial that you be aware of what surfaces your hands touch and then you avoid touching your face. The main value of wearing the mask is to prevent you from touching your face. It will also reduce the chance of spreading infection to others if you happen to be an asymptomatic carrier of the virus.

Masks are mostly useful for preventing infected individuals from spreading their virus particles to others through coughing, sneezing, or spitting. Surgical masks and even cloth masks can be effective. A study published in Nature Medicine in April examined 246 people with acute upper respiratory illness and found that wearing a surgical mask did decrease spread of genetic material from respiratory viruses, including coronaviruses. However, another study published in the Annals of Internal Medicine in April revealed that the force of sick patients’ coughs propelled droplets through both surgical masks and cloth. This highlights the importance of isolating those infected individuals who are coughing or sneezing.

What about those N-95 masks we have heard so much about?

The N-95 masks are actually more like respirators which are made to form a tight seal around the face and to maximize filtration of the air. When properly fitted, these masks prevent inhalation of non-filtered air. They are only needed by healthcare workers in close contact with infected patients during procedures such as intubation, suctioning of airways and giving respiratory therapy.

In summary, wear a mask to keep from touching your face when potentially in contact with contaminated surfaces in public places. Wear a mask when you’re sick to prevent the spread of your germs or virus particles to others. Wear a mask when you’re in public places that require them. Don’t wear a mask in your home unless you’re sick. Don’t wear a mask when you’re outdoors and not in close contact with others. Be aware of everything you touch in public places and keep hand sanitizer readily available. You can do this!

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