I’m a surgeon. The main reason I have worn masks for the last 25 years is to protect you from my germs, not to protect me from yours.  

Masks save lives.  But masks do a better job of protecting others from your germs — rather than protecting you from theirs. 

COVID-19 spreads so easily through a population because it replicates in your throat.  That means that it can reproduce and make hundreds of millions of copies of itself in your throat, and you aren’t aware of it. Then, when you go outside, you spread those viral particles to people around you. 

Just talking or breathing spreads virus particles. You do not need to be coughing to disperse them.  Masks work by significantly decreasing the spread of these particles to others you pass in the store or on the street.  You don’t need to block 100% of virus particles. That’s not how infections occur.  You need a particular “viral load” to cause disease. One viral particle isn’t going to do it.  So the more particles you block from getting away from your face, the less chance those around you have of catching the virus.   

But mask-wearing in the US is far from ubiquitous.   Is it because people do not understand how important it is? Is it because the messaging early on was unclear?  I’ve heard many reasons. Very little surprises me these days. 

What should be a clear cut case of objective public-health practice has simply become another hugely polarizing issue across the American landscape.  

How did we get here?  How did a mask become such a polarizing issue in America?  

As Dr. Bob Wachter recently pointed out in a thread on twitter, “mask-wearing has exposed many fault lines in American life:”

  • facts vs. emotion: facts have a hard time in our society now. Beliefs and emotions reign supreme in many circles.  
  • Protecting self vs. others: Masks protect others from you.  They may protect you too, but many people are looking out for #1. 
  • state power vs. individual liberty

And the mask issue ratchets up the volume by adding yet another variable, vanity. 

Our politicians aren’t helping.  

Have you seen the videos of the senate hearings?  Many Democrats are wearing masks, and Republicans aren’t. Some politicians who face a tough election wear a mask at times, and at other times they don’t.  It’s silly. It sends a dangerous message. Where are the adults in the room?  Voters, even republicans, think that the president should be wearing a mask.  

 

The CDC now recommends a face covering or mask in public.

But, but the CDC and Dr. Fauci said masks weren’t necessary???

Get over it.  Things change when we are dealing with a novel deadly virus.  Both the CDC and Dr. Fauci both recommend using a mask or face covering when distancing cannot be maintained.  Here is the link to the CDC page on guidance for masks or face coverings. 

The recent science is also a lot more clear … masks and facial coverings should be worn in public.  

Masks prevent the spread of COVID19
Click on the image to view the article.

 

What type of mask should I wear? 

There are three different considerations.  The first is an N95 mask. If properly fit and adequately used, and N95 mask should block 95% of virus particles from reaching our face.  These are useful for frontline personnel who are dealing with COVID-19 positive patients all day long. As I mentioned earlier, you do not need to block 100% of virus particles to prevent infections.  

A surgical mask will prevent anywhere from 60-80% of particles from reaching your face.  A cloth mask can block a smaller amount, and that will vary based on the fabric used, its thickness, etc. 

But all of those mentioned above will block a significant number of particles from leaving your mouth and entering the airspace of those people you will casually come into contact with when you are out and about.   Just talking alone allows droplets to leave your mouth and linger in the air in front of you. They may linger for 10 minutes or so. A lot of variables will determine how long those droplets hang around.  

Droplets and COVID 19 spread and why you need to wear a mask
Click on the image to read the article.

 

How do masks prevent the spread of COVID-19? 

This is an interesting video that models how we would limit infections in the US if different percentages of people wearing masks.  The concept is simple.  If you are infected, and without symptoms, you will spread the virus to many other people.  Some of those will get sick. Some of those will die. If this video doesn’t help convince you why you should wear a mask, then you do not need to read any further.  

 

Masks are awkward 

After living in Japan for a long while, I became very accustomed to watching people wear masks.  It took a while, but we weren’t facing a pandemic. Perhaps I would have been more understanding earlier on if we did face such a threat.  Some Americans perceive mask-wearing to be a sign of weakness.  There was a dramatic take-down on Twitter the other day when members of the armed services proudly showed their masks and boldly hinted that anyone who doubted their toughness or hinted that they were cowards were welcome to have an in-person chat :-).  

Would people think you were a coward because you wore a parachute, seatbelt or bicycle helmet?  I doubt it. 

When should I wear a mask? 

If you are out and about and cannot maintain a six-foot distance from people around you, then you should wear a mask.  Anytime you are indoors, you should wear a mask. If you are sick, then you should be wearing a mask at all times in your home as well. Again, you are protecting others from your germs.  

 

Save a life today.  Safe the life of someone you may never meet.  Do the right thing. Wear a mask.  

Disclaimer:  this information is for your education and should not be considered medical advice regarding diagnosis or treatment recommendations. Some links on this page may be affiliate links. Read the full disclaimer.

About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

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