Unmasking the Mask

Angie Szumlinski Health

In a recent video/transcript published in Medscape on August 16, 2020, Dr. Mark Lewis, MD discussed the many myths surrounding the use of facemasks. The link to the video is below and here are a few of the “tidbits” Dr. Lewis shared:

Misinformation and Talking Points

  1. Efficacy. It is true that masks are not 100% effective however there is little in medicine that is. The best analogy is the seat belt. It does not protect you, unfortunately, from being harmed or even killed in a car accident. But we know that it does offer some protection and hence, most of us will buckle up every time we get in the car.
  2. Mixed messages. There have been mixed messages during the pandemic. Back in March there was a real concern that we as healthcare professionals would suffer from a dearth of personal protective equipment (PPE) and we didn’t want the public “hoarding” PPE in the same way that we saw panic-buying of toilet paper. Our messaging has now swung to where we believe that everybody, when out in public, should wear a face covering if possible.
  3. Behavioral aspects of mask wearing. At some point we were concerned that mask wearers were likely to be more cavalier in their behavior and less likely to socially distance. Now we have seen that wearing a mask in public is more advantageous than not.
  4. “Schrodinger’s mask.” Critics of the mask can’t have it both ways. It can’t be both porous enough to let the virus in but impermeable enough to keep oxygen out. As a physical barrier, I think we need to make the point that largely what it’s doing for the wearer is catching droplets that we expel when we breathe but especially when we cough or sneeze. Yes, the virus itself is so tiny that it can potentially pass through the pores in a mask. We also have to remember that the particles are not traveling in a straight line, they experience Brownian motion. They also might be affected by the electrostatic charge of some masks, particularly N95s.
  5. Portals of entry. Again, it is a two-way street. You’re protecting others around you by wearing the mask and you are also lowering the chances that you would receive droplets from another person. As Dr. Anthony Fauci recently pointed out, there are three main portals of entry in the face in terms of mucosa: the mouth, nose and eyes. Wearing a mask usually covers two out of the three.
  6. Gas exchange. We need to reassure our patients and the public that while there is a certain discomfort to the mask, in a sense that gas exchange is being impaired, there is really more psychology to that than physiology. We have practiced knowing germ theory and medicine now for over a century and a half. We know that our surgical colleagues wear these masks for hours on end in the operating room with no appreciable drop in oxygen or elevation of carbon dioxide.

In closing, Dr. Lewis stated that he thinks it is so important that we continue to message to the public that these very simple things like wearing a mask, washing hands, social distancing, are the best preventive measures and are not just personal protection but increasingly a civic responsibility.

Mark A. Lewis, MD, is director of gastrointestinal oncology at Intermountain Healthcare in Salt Lake City, Utah. He has an interest in neuroendocrine tumors, hereditary cancer syndromes and patient-physician communication.

Unmasking Mask Misinformation and Myths – Medscape – August 19, 2020