With the novel Covid-19 virus causing mayhem ac this year, it is advised that the first preventive measure is wearing a face mask (surgical mask) or N-95 respirator mask if you will be in close contact with others in public places.

However, while this will help reduce the spread of germs, don not wear them casually. It has been observed that over reliance on face-mask has caused people to forget to do other things that are even more important to help prevent the flu, like hand washing and coughing into a tissue or your sleeve, not your hands.

When should you wear a face mask?
  • When you are seeking medical treatment for flu-like symptoms. If you have flu-like symptoms such as cough, fever, sore throat and muscle aches, you may be asked to wear a mask to avoid infecting others.
  • Before you go out in public with flu-like symptoms or where others have flu-like symptoms.
  • When you are sick with the flu, wear a face mask when you are in the common areas of your home around other people.
  • If you have the flu and you are breastfeeding your doctor may suggest that you wear a face mask so that you don't give the flu to your baby.
  • If you are a designated caregiver for someone who has the flu and are at high risk of serious complications from the flu you may want to wear a face mask.
NOTE: Because a face mask will restrict the flow of air, a face mask should NOT be used by people who already have difficulty breathing due to an existing medical condition, such as asthma.

The Potential DANGERS of Wearing FACE MASKS
Image Courtesy Airport Technology

Where can you get a face-mask?

Face masks are sold in pharmacies, hardware and home improvement stores, medical supply stores or through the Internet. Remember: face-mask use – by itself – can't prevent the flu.

How to handle Placemarks
  • Always wash your hands immediately after you take off a mask. Use soap and water, if possible, or alcohol-based hand sanitizer if you are not near a sink.
  • Don't handle your face mask and then touch your eyes, nose or mouth. Germs spread that way.
  • Change your face mask whenever it gets moist. Never wear a mask for longer than one day.
  • Cloth face masks may be laundered using hot water but disposable face-masks can be used just once and then thrown away.
What are the disadvantages of wearing a mask?

Most scientific articles and guidelines in the context of the Covid-19 pandemic highlight two potential side effects of wearing surgical face masks in the public, but we believe that there are other ones that are worth considering before any global public health policy is implemented involving billions of people.

Wearing a face mask may give a false sense of security and make people adopt a reduction in compliance with other infection control measures, including social distancing and hands washing.

Inappropriate use of face mask: people must not touch their masks, must change their single-use masks frequently or wash them regularly, dispose them correctly and adopt other management measures, otherwise their risks and those of others may increase.

The quality and the volume of speech between two people wearing masks is considerably compromised and they may unconsciously come closer. While one may be trained to counteract side effect n.1, this side effect may be more difficult to tackle.

Wearing a face mask makes the exhaled air go into the eyes. This generates an uncomfortable feeling and an impulse to touch your eyes. If your hands are contaminated, you are infecting yourself.

Face masks make breathing more difficult. For people with COPD, face masks are in fact intolerable to wear as they worsen their breathlessness. Moreover, a fraction of carbon dioxide previously exhaled is inhaled at each respiratory cycle. Those two phenomena increase breathing frequency and deepness, and hence they increase the amount of inhaled and exhaled air. This may worsen the burden of covid-19 if infected people wearing masks spread more contaminated air. This may also worsen the clinical condition of infected people if the enhanced breathing pushes the viral load down into their lungs.

While impeding person-to-person transmission is key to limiting the outbreak, so far little importance has been given to the events taking place after a transmission has happened, when innate immunity plays a crucial role. The main purpose of the innate immune response is to immediately prevent the spread and movement of foreign pathogens throughout the body.

The innate immunity’s efficacy is highly dependent on the viral load. If face masks determine a humid habitat where the SARS-CoV-2 can remain active due to the water vapour continuously provided by breathing and captured by the mask fabric, they determine an increase in viral load and therefore they can cause a defeat of the innate immunity and an increase in infections. This phenomenon may also interact with and enhance previous points.

IMPORTANT:

Face masks will do little to reduce the spread of flu unless they are used properly and by the people who really need them. If you must take care of someone with the flu, and are at high risk of serious illness if you get sick, you should wear a mask. 

A better choice, if at all possible, is to have someone else be the designated caregiver. If you have the flu and must be around other people, you should wear a face mask.




REFERENCES
1) Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (COVID-19) outbreak. https://www.who.int/publications-detail/advice-on-the-use-of-masks-in-th.(2019-ncov)-outbreak (accessed 18 Apr 2020).

2) Chen Y, Zhou Z, Min W. Mitochondria, Oxidative Stress and Innate Immunity. Front Physiol 2018;9:1487. doi:10.3389/fphys.2018.01487

3) Desai AN, Aronoff DM. Masks and Coronavirus Disease 2019 (COVID-19). JAMA Published Online First: 17 April 2020. doi:10.1001/jama.2020.6437

4) Greenhalgh T, Schmid MB, Czypionka T, et al. Face masks for the public during the covid-19 crisis. BMJ 2020;:m1435. doi:10.1136/bmj.m1435

5) https://health.ny.gov/publications/7224/

6) Kyung SY, Kim Y, Hwang H, et al. Risks of N95 Face Mask Use in Subjects With COPD. Respir Care 2020;:respcare.06713. doi:10.4187/respcare.06713

7) Potts M, Prata N, Walsh J, et al. Parachute approach to evidence based medicine. BMJ 2006;333:701–3. doi:10.1136/bmj.333.7570.701

8) Vu YA, London WM, Vu YA, et al. Precautionary Principle. 2013;:9780199756797–0046. doi:10.1093/obo/9780199756797-0046

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