- Fact #1: The Infection Fatality Rate for COVID-19 is somewhere between 0.07-0.20%, in line with seasonal flu
- Fact #2: The risk of dying from COVID-19 is much higher than the average IFR for older people and those with co-morbidities, and much lower than the average IFR for younger healthy people, and nearing zero for children
- Fact #3: People infected with COVID-19 who are asymptomatic (which is most people) do NOT spread COVID-19
- Fact #4: Emerging science shows no spread of COVID-19 in the community (shopping, restaurants, barbers, etc.)
- Fact #5: Published science shows COVID-19 is NOT spread outdoors
- Fact #6: Science shows masks are ineffective to halt the spread of COVID-19, and The WHO recommends they should only be worn by healthy people if treating or living with someone with a COVID-19 infection
- Fact #7: There’s no science to support the magic of a six-foot barrier
- Fact #8: The idea of locking down an entire society had never been done and has no supportable science, only theoretical modeling
- Fact #9: The epidemic models of COVID-19 have been disastrously wrong, and both the people and the practice of modeling has a terrible history
- Fact #10: The data shows that lockdowns have NOT had an impact on the course of the disease.
- Fact #11: Florida locked down late, opened early, and is doing fine, despite predictions of doom
- Fact #12: New York’s above average death rate appears to be driven by a fatal policy error combined with aggressive intubations.
- Fact #13: Public health officials and disease epidemiologists do NOT consider the other negative societal consequences of lockdowns
- Fact #14: There is a predictive model for the viral arc of COVID-19, it’s called Farr’s Law, and it was discovered over 100 years ago
- Fact #15: The lockdowns will cause more death and destruction than COVID-19 ever did
- Fact #16: All these phased re-openings are utter nonsense with no science to support them, but they will all be declared a success
Face Masks
There is no strong medical consensus on whether face masks help outside of health care settings. However, there does seem to be evidence that they can have negative health effects for the wearer.
According to Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, children could spread COVID-19 more if they wear masks.
HM Government guidance for restaurants, pubs, bars and takeaway services, 24 June 2020:
“The evidence suggests that wearing a face covering does not protect you…evidence of the benefit of using a face covering to protect others is weak.”
Browse the articles related to this topic below.
Join our community on Guilded.
The key findings are that <50% of participants were adherent with mask use and that the intention-to-treat analysis showed no difference between arms. Although our study suggests that community use of face masks is unlikely to be an effective control policy for seasonal respiratory diseases, adherent mask users had a significant reduction in the risk for clinical infection. Another recent study that examined the use of surgical masks and handwashing for the prevention of influenza transmission also found no significant difference between the intervention arms.
- Professor Karol Sikora says that COVID-19 behaves like pandemics in the past.
- Society is scarred all over the world.
- The virus will go but the fear will do the damage.
Note: YouTube has taken down the video. Please go directly to UnHerd’s site:
https://unherd.com/thepost/professor-karol-sikora-fear-is-more-dangerous-than-the-virus/
Professor Karol Sikora has become something of a celebrity in the UK over the past months for his expert commentary on the pandemic, and his unusual tendency for optimism rather than pessimism.
Virus ‘getting tired’
– In the past two weeks, the virus is showing signs of petering out
– It’s as though the virus is ‘getting tired’, almost ‘getting bored’
– It’s happening across the world at the same time
Existing herd immunity
– The serology results around the world (and forthcoming in Britain) don’t necessarily reveal the percentage of people who have had the disease
– He estimates 25-30% of the UK population has had Covid-19, and higher in the group that is most susceptible
– Pockets of herd immunity help *already* explain the downturn
– Sweden’s end result will not be different to ours – lockdown versus no lockdown
Fear more deadly than the virus
– When the history books are written, the fear will have killed many more people than the virus, including large numbers of cancer and cardiological patients not being treated
– We should have got the machinery of the NHS for non-corona patients back open earlier
Masks and schools
– Evidence on masks is just not there either way so it should be an ‘individual decision’
– We should move to 1m social distancing which means restaurants and bars could reopen
– More schools should reopen in June as ‘children are not the transmitters of this virus’
– We should be getting back to the ‘old normal’ not a ‘new normal’
Face masks in public spaces do not provide any greater protection to the population,” Johan Carlson from the Swedish Public Health Agency Folkhälsomyndigheten said at a press conference on May 13th.
Swedish health authorities argue that keeping a distance, washing your hands, not touching your face, and staying at home if you experience any symptoms are still the best ways to halt the spread of the coronavirus. There is a concern that wearing face masks would make people follow these guidelines less strictly.
- There is a risk of a false sense of security.
- The virus can gather in the mask and when you take it off, the virus can be transferred to your hands and thereby spread further.
- Worn properly, masks might reduce the spread of infection if worn by those with asymptomatic infections, even if they might not protect the wearer themselves.
https://www.thelocal.se/20200514/explained-why-is-sweden-not-recommending-face-masks-to-the-public
As for the scientific support for the use of face mask, a recent careful examination of the literature, in which 17 of the best studies were analyzed, concluded that, “ None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”1
When a person is infected with a respiratory virus, they will expel some of the virus with each breath. If they are wearing a mask, especially an N95 mask or other tightly fitting mask, they will be constantly rebreathing the viruses, raising the concentration of the virus in the lungs and the nasal passages. We know that people who have the worst reactions to the coronavirus have the highest concentrations of the virus early on. And this leads to the deadly cytokine storm in a selected number.
Surgical masks and N95 respirators are not effective at preventing the flu. Of the 446 nurses who took part in this study, nearly one in four (24%) in the surgical mask group still got the flu as did 23% of those who wore the N95 respirator.
Influenza infection occurred in 50 nurses (23.6%) in the surgical mask group and in 48 (22.9%) in the N95 respirator group (absolute risk difference, −0.73%; 95% CI, −8.8% to 7.3%; P = .86), the lower confidence limit being inside the noninferiority limit of −9%.
We found that closure of education facilities, prohibiting mass gatherings and closure of some non-essential businesses were associated with reduced incidence whereas stay at home orders, closure of all non-businesses and requiring the wearing of facemasks or coverings in public was not associated with any independent additional impact.
“Surprisingly, stay-home measures showed a positive association with cases”
“These results would suggest that the widespread use of face masks or coverings in the community do not provide any benefit”
https://www.medrxiv.org/content/10.1101/2020.05.01.20088260v1
Relaxing stay-at-home orders and allowing some types of non-essential businesses such as shops to reopen are the lowest risk measures to get the UK and other European countries out of lockdown – according to research from the University of East Anglia.
- Stay-home policies were not associated with a decline in incidence, and actually showed a positive association with cases. As the number of lock-down days increased, so did the number of cases.
- Face coverings may even be associated with increased risk, but the data quality for this is very uncertain.
https://www.uea.ac.uk/about/-/new-study-reveals-blueprint-for-getting-out-of-covid-19-lockdown
Background
Surgical site infection (SSI) continues to be one of the most common postoperative complications. In our previous study, surgical mask (SM) bioburden was identified to be a potential source of SSI. In the present study, we investigated the factors involved in SM bioburden.
Methods
Bioburdens of the disposable SM (A: medical mask; B: medical surgical mask) and newly laundered cloth SM (C) were tested by immediately making an impression of the external surface of the mask on sterile culture media. SM microstructure was observed using a scanning electron microscope (SEM). Filtering efficiency and airflow resistance were evaluated with TSI Automated Filter Tester 8130 (TSI Incorporated) according to GB/19083-2010. Whether speaking during operation and washing the face pre-operatively affect SM bioburdens was also evaluated. Surgical procedures were performed in a dynamic operation room. Fifty cases of mask use were enrolled in this study.
Results
The bioburden of mask A was the highest. The bioburden of mask B was the lowest. Mask C possessed the lowest filtering efficiency and the highest airflow resistance. SM bioburden was higher in the speaking group. SM bioburden showed no significant difference after washing the face, despite the finding that washing could significantly reduce facial bioburden.
Conclusions
Multiple factors influence SM bioburdens. Mask B showed the lowest bioburden and best protection effects. Mask C is not recommended to be used, especially considering that surgeons do not wash the cloth masks daily. Unnecessary talking during operation is not recommended, and washing the face before surgery is not strictly necessary.
Penetration of cloth masks by particles was almost 97% and medical masks 44%.
This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated.
Background
Surgical masks (SMs) are used to reduce bacterial shedding from the mouth, nose and face. This study aimed to investigate whether SMs may be a potential source of bacterial shedding leading to an increased risk of surgical site infection.Methods
Bacterial contamination of the SMs was tested by making an impression of the external surface of the mask on sterile culture media immediately. We investigated the difference in bacterial counts between the SMs worn by surgeons and those placed unused in the operating room (OR), and the bacterial count variation with indicated wearing time. Moreover, the difference in bacterial counts on the external surface between the first and second layers of double-layered SMs was also assessed.Results
The bacterial count on the surface of SMs increased with extended operating times; significant difference was found between the 4- to 6-hour and 0-hour groups (p < 0.05). When we analysed the bacterial counts from the same surgeon, a significant increase was noted in the 2-hours group. Moreover, the bacterial counts were significantly higher among the surgeons than the OR. Additionally, the bacterial count of the external surface of the second mask was significantly higher than that of the first one.
Conclusions
The source of bacterial contamination in SMs was the body surface of the surgeons rather than the OR environment. Moreover, we recommend that surgeons should change the mask after each operation, especially those beyond 2 hours. Double-layered SMs or those with excellent filtration function may also be a better alternative. The translational potential of this article This study provides strong evidence for the identification that SMs as source of bacterial contamination during operative procedures, which should be a cause for alarm and attention in the prevention of surgical site infection in clinical practice.
Abstract
Introduction: Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care.
Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.
Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.
Conclusions: Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.
Results
Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI −33.5 % to −10.5 %, p < 0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI −34.2 % to −15.8 %, p < 0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI −24.2 % to −3 %, p = 0.013) and VCO2 by 17.7 %, (95 % CI −28.1 % to −8.6 %, p = 0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: −4.1 % to −2.2 %, p < 0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated.
Conclusions
Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage.
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-015-0086-z
Results: Distance was not modified by the mask (P=0.99). Dyspnea variation was significantly higher with surgical mask (+5.6 vs. +4.6; P<0.001) and the difference was clinically relevant. No difference was found for the variation of other parameters.
Conclusion: Wearing a surgical mask modifies significantly and clinically dyspnea without influencing walked distance.
Results: Thirty nine patients (23 men; mean age, 57.2 years) were recruited for participation in the study. Seventy percent of the patients showed a reduction in partial pressure of oxygen (PaO2), and 19% developed various degrees of hypoxemia. Wearing an N95 mask significantly reduced the PaO2 level (101.7 +/- 12.6 to 92.7 +/- 15.8 mm Hg, p = 0.006), increased the respiratory rate (16.8 +/- 2.8 to 18.8 +/- 2.7/min, p < 0.001), and increased the occurrence of chest discomfort (3 to 11 patients, p = 0.014) and respiratory distress (1 to 17 patients, p < 0.001). Baseline PaO2 level was the only significant predictor of the magnitude of PaO2 reduction (p < 0.001).
Conclusion: Wearing an N95 mask for 4 hours during HD significantly reduced PaO2 and increased respiratory adverse effects in ESRD patients.
We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. We identified no new trials for this latest update.
From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002929.pub3/full
- If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.
- Wear a mask if you are coughing or sneezing.
- Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
- If you wear a mask, then you must know how to use it and dispose of it properly.
In conclusion, as opposed to Greenhalgh et al., we believe that the context of the current covid-19 pandemic is very different from that of the “parachutes for jumping out of aeroplanes”,[7] in which the dynamics of harm and prevention are easy to define and even to quantify without the need of research studies. It is necessary to quantify the complex interactions that may well be operating between positive and negative effects of wearing surgical masks at population level. It is not time to act without evidence.
[D]oes any of what is out there add up to a watertight case for compelling people to wear masks in public or at work (outside a healthcare setting)? The threshold for compulsion must surely be higher than ‘maybe’ and ‘perhaps’. But if it really is the case that the threshold for regulatory compulsion is being approached, it should be a simple matter for our scientific advisors to present it to us and allow time for it to be critically discussed in relation to a real-world setting, before government imposes measures upon us all.
https://www.spectator.co.uk/article/face-masks-should-there-be-a-cover-up-
Speaking may be a primary mode of transmission of SARS-CoV-2. Considering that reports of asymptomatic transmission account for 50-80% of COVID-19 cases and that saliva has peak viral loads at time of patient presentation, droplet emission while speaking could be a significant factor driving transmission and warrants further study. We used a planar beam of laser light passing through a dust-free enclosure to detect saliva droplets emitted while speaking. We found that saying the words ‘Stay Healthy’ generates thousands of droplets that are otherwise invisible to the naked eye. A damp homemade cloth face mask dramatically reduced droplet excretion, with none of the spoken words causing a droplet rise above the background. Our preliminary findings have important implications for pandemic mitigation efforts.
https://www.medrxiv.org/content/10.1101/2020.04.02.20051177v1