HERE'S TO YOUR HEALTH: Covid myth busting; wading through the misinformation

Dr. Wayne Strouse, MD

I recently had the opportunity to listen in on a discussion before a subcommittee of the Yates County Legislature. There was also a meeting before the full Legislature.

Dr. Wayne Strouse

The matter at hand was mask wearing, specifically, whether mask wearing should be required in County Office buildings. After a presentation by Yates County Public Health, comments were taken from those present and on Zoom. The misinformation shared was abundant, thus stirring me to write this column.

Mask wearing in epidemics is settled science. Going back to the Granddaddy of all Pandemics, the 1918 flu, cities that had mask wearing mandates fared better – far better – than cities that did not. However, listening to the comments, one would think that masks were nothing more than a fashion accessory – to be worn if you feel comfortable.

Time to bust some myths:

Myth #1: Masks have not been proven to work—there's no science behind them.

This is absolutely false. On the CDC website, there are a number of references showing the benefits of mask wearing. There is a particularly comprehensive article to be found in the Proceedings of the National Academy of Sciences entitled “An Evidence Review of Face Masks against Covid-19.”

Some articles are a bit nerdy and scientific—describing the specifications of various masks.

Some are “natural experiments”, meaning that the infection rate was compared before and after mask mandates came into effect.

Some studies showed decreases of 70 – 80% in the risk of transmission with mask use. One showed that for every 10% increase in mask wearing, you get 3 times the decrease in community spread. There have been at least 10 studies showing masks, when used universally, are helpful in preventing spread.

Masks are source control primarily, meaning they stop someone with Covid from spreading Covid. (That will be important to understand later in this column). They do reduce the wearer's risk of getting Covid, but not as effectively.

And really, if you are about to be operated upon by a surgeon—would you prefer he or she wore a mask, or operated on you without a mask? It is the same principle—source control reduces the operating room and in County offices.

Myth #2: Dr. Fauci said masks were ineffective.

This is true! But that was very early in the pandemic. Then, like any good scientist, he continued to learn and look at the data. And when we understood that COVID-19 was mainly spread by respiratory droplets and not as much by surface contact, he revised his recommendation. That's exactly what you want a scientist to do. In science, it is not flip-flopping—it is following the data, and revising your theory based on newly acquired information. We also used to recommend masks indoors and outdoors. But the data showed that outdoor transmission was exceedingly rare, so the recommendation was changed. People don't seem to have any problem complying with that change.

Myth #3: The N-95 masks work best, but the CDC on their website tells you not to wear them! Why don't they recommend the most effective mask?

It is true that N-95 masks work best (though they are harder to wear). It is not true that CDC doesn't recommend their use at this time. The only reason that the initial recommendation was not to wear N-95 masks was that early in the pandemic, they were in short supply. The fear was that there wouldn't be enough masks for the doctors and nurses working in the ICU's and hospitals. If you read the whole sentence on the CDC site, it says that N-

95 masks are fine to wear once the supply of them is adequate. You can buy N-95 and KN95 masks easily at this time. If you want to wear one, go ahead. They are more expensive than surgical masks, BUT they do provide the wearer with better protection against the virus than surgical masks. It is harder to breathe through these masks; that's how they work, by keeping out smaller particles.

Myth #4: Wearing a mask should be a personal choice.

I disagree. Personal choices are activities that do not affect the health and welfare of someone else. The clothes you choose to wear each day is a personal choice (unless you are a uniformed officer or in the military). But even personal choices have limitations—remember “No shoes, no shirt, no service?" You can sit at home and chain smoke all day (as a doctor, I would say that is an unwise choice), but if you decide to do that inside a restaurant, you no longer have that choice, because your second hand smoke can harm others. There are limits, even with personal choices.

Mask wearing should not be a personal choice, because not wearing a mask can harm others. Remember the previous comment about “source control?" Masking works optimally when everyone wears a mask. Masks prevent droplets and aerosols that you create from reaching others. If you have Covid, you may not realize it, but you can still spread it. If you make the “personal choice” not to wear a mask, you are then a spreader of disease. In medicine, we call that a “vector." Vectors should not have the personal choice to spread disease. It is contrary to the public health and welfare.

Wearing a mask is something we do to protect others. It should be required in County Office Buildings because our county civil servants deserve no less than our protection of them while they do their jobs.

Bottom line: Masks work!

There may be an ugly, nasty, mudslinging debate in the political arena, but the scientific evidence is clear. Wear your mask. Ask others around you to wear your mask. Make sure it covers your mouth and nose. And don't pull it down to talk, or even to cough or sneeze.

Here's To Your Health!

(Next column: Vaccine myth busters)

Dr. Wayne S. Strouse, M.D., is a Family Practitioner in Penn Yan.