The Journal Gazette
Friday, July 24, 2020 1:00 am

Door against disease

Masks serve the same useful function as life's other barriers

Dr. Cindy Vanderbosch

I know how terribly conflicting the information coming from the medical community has been about COVID-19 and the wearing of masks.

“Masks don't work.”

“Masks can be harmful.”

“Masks are a necessity.”

There truly is a paucity of informative and unbiased studies about the use of masks and prevention of disease in a pandemic. A great deal of what we are reading is opinion on the appropriate thing to do.

However, even without the availability of data, we can use some fundamentally basic examples to evaluate masks to see whether it makes sense to us as individuals to wear them to help lessen the spread of COVID-19.

A mask is a barrier. Like any barrier, it is not impenetrable. But the fact that it is not a perfect barrier does not mean it has no value in slowing down this virus.

Consider the purpose of a door. I know of no door that cannot be breached, so why do we have doors on our homes and places of work? We have doors to impede the entrance by people or animals not welcome there.

Consider a little less substantive example. Why do we have screens on our windows? They certainly are no barrier to people or animals intent on gaining access, nor are screens a hindrance to tiny insects – no-see-ums come to mind. However, screens do prevent most birds, small animals and flying, disease-carrying insects from coming into our spaces. Therefore, screens definitely have a purpose.

Now, how about we look at masks used in surgery. If they are not effective in preventing contamination to the surgical area, why do surgical units mandate the use of masks in those areas?

The answer is because they are effective! They help prevent the spread of microorganisms to patients. And yes, I realize viruses are substantially smaller than bacteria – the main reason for masks – but they still help deter the direct spread of viruses. Remember the pollen/dust that gets hung up on the screen?

Again, a mask is not perfect. It can be harmful to some people with asthma, emphysema or other medical ailments. But, for most people, wearing a mask for a short period of time is not medically problematic.

The wearing of a mask is really not much more than an annoyance and, unfortunately in this day and time, possibly a statement of your political leaning. Let's exclude people who can't medically wear a mask and move beyond the political connotations for a minute.

I hope, after reviewing these examples, we can agree that barriers of any sort can slow the transportation of anything. I know of no study touting a perfect disease-preventing mask, but there are several studies that have shown that masks, combined with other activities such as hand washing and social distancing, can hamper the spread of bacteria and viruses.

This is similar to what happens during surgery in hospitals globally. These practices – wearing a mask, hand washing and social distancing – limit a person's viral load. A viral load is the number of microorganisms – in this case, COVID-19 – that invade a body.

The number of viral organisms of COVID-19 needed to cause disease in a person is debatable. In my opinion, the viral load needed to cause a COVID-19 illness varies from person to person depending on their immune response or lack thereof. Regardless of the actual number, fewer is better in this case.

A common misconception is that a mask helps keep you from getting sick. This is where I think most of the confusion has occurred.

A number of people asked why they aren't wearing a mask have responded by saying they “aren't afraid of getting sick.” In reality, a mask worn by you can only help you from spreading germs to surfaces and other people. A mask that you wear is minimally effective, if at all, in keeping you from being exposed to germs.

So, what does this mean practically? It means I wear my mask to help keep you from getting sick, and you wear your mask to help keep me from getting sick. By not wearing a mask, one is not being cavalier about one's own health, but rather one is projecting a complete lack of concern, or perhaps ignorance, about the potential to cause illness in others.

Remember, even if you are not sick, you could be an asymptomatic carrier and spread the disease.

With the relaxing of the rules from the shutdown, we are seeing a rise in the number of cases across the country. Fortunately, the virus does not seem to be as lethal as it was initially. However, it is still killing people, especially those at risk.

This increase in cases is also starting to strain the health care system in some cities. Because of the rise in the number of cases, there are cities starting to close again. I think a mask, hand washing and social distancing is a small enough inconvenience to tolerate to have our jobs and country back open.

Please remember the newly issued order to wear a mask when in public, as well as to wash or sanitize your hands frequently and keeping a safe, social distance for now.

As my mom always said, “This too shall pass.” We will get through this one way or the other.

A mask is not a punishment, sign of weakness, political statement or infringement of our rights. A mask is a tool we can and should use to help protect others.

We can't keep everyone from getting sick or passing away, but we can have the least loss of life possible if we all chip in and do our part.

Dr. Cindy Vanderbosch is a family practice physician with IU Health Fort Wayne.

1 The mask should be worn over your nose and mouth -- not under your nose, nor under your chin.

2 Sanitize your mask frequently if possible. Dispose of masks that cannot be sanitized.

3 Do not touch the mask with hands that are not sanitized, and be sure to sanitize your hands after you touch your mask.

4 Wear a mask that fits well to your face.

5 Wash or sanitize your hands after touching your face, mask or any surface.

6 Maintain social distancing as much as possible.

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