Reports of Boris Johnson’s consideration of a mandatory face mask order broke on Friday 11th July, for the first time over the course of the pandemic.
Many, myself included, have been pushing for this for months. A non-peer reviewed Oxford study suggests as little as 25% of the UK’s population regularly wore masks in late April- easy to see when you do your weekly shop in your local superstore.
A lot of this is due to mixed messaging. It wasn’t long ago that masks were in short supply and we were told to save them for those on the front lines; this isn’t the case anymore, so why not wear a mask?
Over my next few articles, I’ll cut through the bull and clearly label why yes, you should be wearing a face mask indoors, methods to encourage your loved ones to also wear masks and ways of making your own for cheap.
Is the Coronavirus like the flu?
The short answer: no.
SARS-CoV-2, the virus that causes COVID-19, is actually a type of coronavirus- a subfamily of viruses, including SARS and the common cold. Usually they impact the respiratory system, causing about ~15% of colds in temperate climates.
Viruses generally infect by using proteins on their surface to open up your cells and ‘trick’ your body into making more of them. Coronaviruses do this with spike proteins, using them to attach onto your cells and open them up, like a skeleton key. Your cells then let them in and replicate the virus’s DNA. SARS-CoV-2 is most effective against the cells that line your organs and your lungs- hence why it seems to be a respiratory illness.
COVID-19 attacks the lungs (causing the cough), can infect the brainstem (causing respiratory failure), infects the kidneys (causing kidney failure) and can cause your immune system to go into overdrive, causing blood clots that can kill you.
The most dangerous part of COVID-19 seems to be the long-lasting damage it can do to your body. When you have the flu, most of the damage comes directly from the virus hurting cells, but that’s not the case for COVID.
“What you find in the lungs of people who have stayed with the disease for more than a month before dying is something completely different from normal pneumonia, influenza or the Sars virus,” Prof Mauro Giacca of King’s College London told the Lords Science and Technology Committee.
“You see massive thrombosis. There is a complete disruption of the lung architecture – in some lights you can’t even distinguish that it used to be a lung.”
There are many accounts of lung function not returning to normal months after recovery. In a study published in March, 66 out of 70 recovered COVID-19 patients hadn’t regained their lung function fully.
It’s about more than just lung damage too; new evidence suggests that even mild cases of COVID-19 can cause brain damage. Scientists don’t fully know why- it may be caused by the lack of oxygen typically found in COVID patients, or maybe by the cytokine byproducts of your body’s immune response. Autopsies have even suggested the virus can enter the brain. Either way, as many as 50% of hospitalised COVID patients experience neurological symptoms during their stay- encephalitis (or brain swelling), seizures and potentially even bleeding on the brain.
This is terrifying. The flu is unlikely to cause these same neurological reactions; with COVID patients, it’s up to 50%.
On almost every front, SARS-CoV-19 affects the body more severely than the flu. That’s why it’s so important to protect yourself and your community.
Should I wear a face mask?
The short answer: yes.
We’ve known they work since at least 1919. In the aftermath of the influenza pandemic, scientists were interested in how we could really reduce diseases that are transmitted by coughing.
“…Over one-half of diphtheria patients emitted diphtheria [bacteria] in talking and coughing,” George H. Weaver noted in his 1919 paper studying how many droplets of magenta Fushin dye made it through progressively finer-mesh gauze.
We knew back then that bacteria and viruses were in the tiny droplets we exude when we cough, sneeze or even breathe; we just didn’t have the technology to visualise them. We know now that most of these droplets are miniscule, in the range of 1–500 µm, but usually are 10µm in diameter- around half the width of a human hair.
You breathe those droplets in when you stand close to someone. If they have a disease, the droplets will contain all those bacteria or viruses- and you’ll breathe those in too. From there, they can attack your body and do plenty of damage.
Siddhartha Verma, Manhar Dhanak, and John Frankenfield used a smoke machine to simulate those clouds of droplets in a paper published in June. The plumes of droplets travel up to 12 feet without a mask- twice the recommended social distancing recommendations of the WHO. With a simple handmade cloth mask, these plumes barely travelled further than the cotton.
Weaver further noted in 1919 that “Gauze masks appear from clinical data to prevent infection via mouth droplets”. In other words, yes; masks work.
The most important takeaway from this study is not that masks protect the wearer. Yes, there are masks that do protect the wearer completely- called N95 masks because they filter out 95% of airborne particles- but most of us don’t need such an intense filter.
Instead, face masks are about protecting those around you. It’s unlikely to prevent other peoples’ droplets making it through, instead preventing you from breathing out those plumes yourself.
This is why it’s so important for every able person to wear a mask- and why people that aren’t at high risk should save the N95 masks for those that are vulnerable.
I made my own mask out of this t-shirt’s sleeves. Took me half an hour, and I wear it many times a week!
Shouldn’t only sick people wear masks?
In short: no.
Evidence of asymptomatic transmission has been around since the early stages of the pandemic. It’s thought many people have had the virus and just not known about it, and even more thought they just had a mild cough.
The guidance for symptomatic carriers of COVID-19 has been clear: stay at home, quarantine for at least two weeks and get tested. But what about people without the cough and the temperature we all know to look for?
If you don’t show symptoms, you probably won’t put yourself in quarantine. Carriers without symptoms still leave the house, still go on holiday, still go to church. These people can end up as superspreaders if they take no precautions.
Things may have been different if they wore face masks. You never know for sure if you’ve got an asymptomatic case of COVID-19, so why not wear a mask just in case? Besides, evidence also suggests that these asymptomatic superspreader events are part of the reason this became a pandemic at all.
Look to countries like Japan, where mask use was a common sight in densely-populated cities before the pandemic. Japan was lifted out of a state of emergency on May 25th and has only had 972 deaths as of 12/07/20- similar to daily figures in the UK during the peak of the crisis.
If we had implemented a mandatory face mask order earlier in the pandemic, would we have fared better? Chances are, yes. Cases are falling across the UK and people are recovering worldwide, but that doesn’t mean we should ignore the mountain of evidence that face masks save lives.
Basic measures, like wearing face masks in indoors spaces and regularly washing your hands, could prevent another wave. Why take the risk?