The mask mess

 

Parents of Gainesville, Fla. elementary school students forced to wear face coverings for large parts of the day sent a half-dozen of the masks in to be tested for pathogens earlier this month. As was to be expected, scientists at the University of Florida found all sorts of contaminants on the masks.

There were those that were predictable – the bacteria involved with acne, gingivitis and e. coli – and others less so, including several strains of the bacteria that can cause deadly meningitis.

“Half of the masks were contaminated with one or more strains of pneumonia-causing bacteria. One-third were contaminated with one or more strains of meningitis-causing bacteria,” reported the Alachua (County) Chronicle, a local news site. “One-third were contaminated with dangerous, antibiotic-resistant bacterial pathogens. In addition, less dangerous pathogens were identified, including pathogens that can cause fever, ulcers, acne, yeast infections, strep throat, periodontal disease, Rocky Mountain Spotted Fever, and more.”

None of this was surprising. The contamination problems of wearing masks for extended periods of time have been known for some time. They were so well known that Chinese doctors in 2018 conducted a study of masks in hospital surgeries to try to come up with guidelines on how to minimize the problem.

“…We recommend that surgeons should change the mask after each operation, especially those beyond 2 hours,” they eventually wrote in a study published in the Journal of Orthopaedics. 

The source of the contamination in the masks, they said, “was the body surface of the surgeons rather than the operating room environment,” and their study, they argued, “provides strong evidence for the identification that surgical masks 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.”

That wearing masks for long periods of time – say for a whole school day or an eight-hour work shift – might cause bacterial or viral contamination of concern, if not alarm, is something one might have thought would attract some attention during the pandemic as well, but it hasn’t.

Mask contamination has gone largely unstudied. When Korean scientists found SARS-CoV-2 all over the outside of the masks of COVID-19 patients and reported on this in the Annals of Internal Medicine, the methodology they used in the study was criticized as uninterpretable. They agreed there was a problem.

“We proposed correcting the reported data with new experimental data from additional patients, but the editors requested retraction,” they added.

The U.S. Occupational Health and Safety Administration never studied the issue, never set standards for how long masks should be worn in the workplace, and left the sanitation of masks up to employees who were simply advised to follow the washing advice of the Centers for Disease Control and Prevention (CDC).

Shifting standards

Regulation of masks, which were viewed as necessary for safety, in some ways parallels the regulation of asbestos, which was once also considered necessary for safety.

“Asbestos was an inexpensive additive used to create a range of affordable, fire-resistant products, including building materials such as roofing shingles, wallboard, concrete, insulation and coating,” notes The Mesothelioma Center. “It was woven into textiles to make fire-resistant fabrics and cloth used by firefighters and industrial workers, and it was added into consumer goods such as ironing board covers and appliances.”

The U.S. military used a lot of it.

“The U.S. Navy covered its ships from bow to stern with asbestos products, utilizing their effective fireproofing qualities but effectively exposing everyone on board to the toxic material in the process. Navy veterans today are paying the price for those manufacturing decisions,” according to the Center.

“Nearly one-third of people who file mesothelioma lawsuits are veterans, and a majority of those have a Navy service record.”

Mesothelioma is a form of lung cancer primarily linked to the inhalation of asbestos particles.

“If the dust is inhaled or swallowed, the asbestos fibers will settle in the lungs or in the stomach, where they can cause irritation that may lead to mesothelioma. Exactly how this happens isn’t understood. It can take 20 to 60 years or more for mesothelioma to develop after asbestos exposure,” according to the Mayo Clinic.

The health dangers of asbestos were known as early as the 1930s, but it wasn’t phased out of residential construction in the U.S. until the 1980s as the good intentions of the safety gang gave way to the reality of mesothelioma.

Masks are not asbestos, but they share something in common with some of the asbestos products of old: unknown long-term effects. It is impossible to predict medical problems that might take decades to develop.

Clean air

Nobody knows what changes in the still-developing immune systems of children might result from them sucking air through a mask for extended periods of time each day. What is known is that homo sapiens evolved over the course of some 200,000 to 300,000 years to breathe unfiltered air.

That air is full of pathogens.

Korean scientists who examined the air in Korea in 2012 reported finding 1.6 million to 40 million viruses and 860,000 to 11 million bacteria in each cubic meter. The amount varied depending on where, and notably when, the air was sampled.

“Viral abundance exhibited a seasonal fluctuation…which increased from autumn to winter and decreased toward spring,” they noted in their study published in the Journal of Virology.  This, they wrote, might help explain the so-called winter flu “season” in the northern hemisphere.

The researchers also reported discovering massive numbers of unknown viruses and plant-associated viruses in the air. All of this led them to the conclusion that precious little is known about the invisible ecosystem that exists in the air we breathe.

“Further studies of the broad range of airborne viral diversity will be required to address growing concerns regarding human health risks and crop productivity,” they concluded.

If little is known about that viral ecosystem, even less is known about how it interacts with the developing immune systems of children. Some of the viruses they inhale with every breathe might in some way be good for them.

Most are likely benign. And some of the commonly called germs they inhale only to quickly exhale are clearly bad and might become more so if trapped in a mask and rebreathed again and again.

Though the masks of those Florida children were found to contain bacteria that cause diphtheria, pneumonia, and meningitis none of the children were suffering from those diseases.

Resesarchers studying Saudi Arabaian women who wear veils, however, in 2001 speculated that the use of those face-covering garments “can probably be one of the reasons of higher prevalence of fibromyalgia and cervicobrachialgia among Saudi females.”

Could wearing masks for extended periods of time make children more susceptitible to these or other diseases? Nobody knows. Could vulnerability depend on how much time the child spends behind a mask?

Nobody knows the answer to that either, but many diseases and illnesses have been linked to length of exposure or dosing.

A 2020 meta-analysis of the connection between secondhand cigarette smoke and cardiovascular disease found a “risk plateau” on exposure to “15 cigarettes per day.”  The dose-related connection between liver cancer and exposure to the pesticide DDT has long been known. There have even been studies suggesting that the dose, ie. “viral load” of SARS-CoV-2 to which people are exposed plays a big part in determining whether they come down with the COVID-19 disease.

The argument for masks is that they could help reduce the loads of SARS-CoV-2 to which people are exposed. The argument against masks could be much the same; they reduce the amount of natural air inhaled and replace part of it with rebreathed air full of contaminants the lungs were trying to remove from the body.

Dogoodism

The drive to mask children has been fed in large part by good old American dogoodism aimed either at protecting the children – who are at little threat of death from COVID-19, according to all studies – or their teachers and parents, who are or might be at greater risk from the disease.

This might explain why the mainstream media ignored the University of Florida report and the mainstream pushback became such that the University itself was forced to put out a statement saying that its “Mass Spectrometry Research and Education Center routinely conducts lab tests for members of the public as requested, as it did for Ms. (Amanda) Donoho.

“However, it is important to note that we had no way of establishing the chain of custody for these masks and to what conditions they were exposed prior to the lab test. To draw any conclusions is premature, and a more controlled, peer-reviewed research is warranted. It is also important to note that Centers for Disease Control and Prevention studies indicate wearing a mask is among the most effective measures for preventing and mitigating the spread of COVID-19.”

The “chain of custody” statement is a suggestion the masks might have in some way – intentionally or unintentionally – been exposed to dangerous pathogens to which the children were never exposed.

Masks would appear to have become so significant as a form of virtue signaling that the University didn’t want to be associated with the possibility it had found evidence that might discourage parents from masking their children, though the unmainstream media quickly picked up on that theme.

The iOTW.report, a Florida-based blog, should get an award for the best headline: “Your face diaper is just that.”

The right-leaning (according to the independent AllSides website) Epoch Times – which the New York Times (NYT) sees as a “Giant Influence Machine” and which the mainstream media-linked Nieman Lab calls “A vehicle for pro-Trump conspiracy theories, and the culmination of all that Facebook has encouraged – was somewhat more restrained.

“University of Florida Lab Finds Dangerous Pathogens on Children’s Face Masks,” reported what appears to be one of the few growing newspapers (maybe the only one) in the country.

(Opinions on what the news organization founded by Chinese dissidents is or isn’t are all over the place. Though the NYT labeled it a propaganda organ, Betsy Morais at Politico observed that “if The Epoch Times has a political agenda…it seems to be a narrow one” except when “focused on the perceived excesses of the Chinese government.”)

Whatever the case, it appears to be the largest publications to pick up on the Florida findings, which may or may not mean anything.

Masks might be protective. They might be harmful. And they might be neither.

Other countries

Both Sweden and Norways, outliers in a masked up world, sent kids to school without masks during the pandemic and reported few serious cases of COVID-19 as result.

According to the research, as summarized by the respected Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, about 2 million Swedish children “children aged 1 to 16 years in Sweden as of Dec 31, 2019, 65 died in the pre-pandemic period of November 2019 to February 2020, compared with 69 in the pandemic period of March through June 2020. None of the deaths were caused by COVID-19.”

Fifteen children ended up very ill but recovered.

The Norwegians studied children only in the country’s two counties with the highest coronavirus spread and found “that transmission of SARS-CoV-2 from children under 14 years of age was minimal in primary schools in Oslo and Viken,” CIDRAP reported.

Norway’s conclusion was that the results obtained “during low to medium community transmission demonstrate the limited role of children in transmission of SARS-CoV-2 in school settings.”

The level of infection might have played a role in the Norwegians results. In a setting with “modest infection rates,” Danish researchers who completed the only random-controlled trial (RCT) of masks during the pandemic said they could find no evidence masks did anything to reduce infections.

RCTs are considered the gold standard of medical research. The anti-maskers had a field day with the Danish study.

“New Danish Study: Face Masks Don’t Protect Against Covid,” headlined Technocracy News & Trends. “Landmark Danish study finds no significant effect for facemask wearers,” The Spectator proclaimed.

“We’re constantly being told to ‘mask up’ to protect against COVID, but a recent Danish study showed there’s no statistical advantage to wearing a mask or not wearing a mask in public,” Newsradio KTRH in Texas reported.

“New Study on Masks Shows…That NO ONE Knows What They’re Talking About…NO ONE,” Townhall headlined. “Told you,” Laura Ingraham Tweeted atop a link to a report that “the largest randomized controlled trial of masks ever (n=6,000) from Denmark fails to show a statistically significant difference in infection rates.”

The mainstream took a different tack even before beginning the “fact checking” leading to the conclusion “Danish Study Doesn’t Prove Masks Don’t Work Against the Coronavirus.”

Before that, Reuters headlined “Danish study finds face masks provide limited protection to wearer,” in a story that quoted a Copenhagen University Hospital media release saying “the results could indicate a more moderate degree of protection of 15-20 percent, however, the study could not rule out that face masks do not provide any protection.”

A “fact check” of that story could only have concluded the Danish study was mischaracterized by Reuters.

The reality was the study found no statistical evidence to prove masks did anything but suggested the possibility that it might be possible to find such evidence if more data was collected.

From this, “Reuters staff” concluded the study was “consistent with previous research. Health experts have long said a mask provides only limited protection for the person wearing it, but can dramatically reduce the risk to others if the wearer is infected, even when showing no symptoms. Preventing the spread to others is known as source control.”

The big shift

There has never been an RCT completed specifically on “source control” in the general public setting, and previous research along those lines largely concluded masks were meaningless.

“…Three large, randomized controlled trials were conducted in the 1980s to determine once and for all if surgical masks actually did prevent surgical wound infection,” MedPage Today senior staff writer Crystal Phend wrote in a story a decade before the politics of research were contaminated with the fears of COVID-19.

“Here, where bacteria were the major concern in wound infection, the enemy targets were larger and might not require the fine filtration necessary to keep a respiratory virus away, researchers theorized. But the trials ‘showed absolutely no efficacy’ for that original purpose,” researcher C. Raina MacIntyre of the University of New South Wales in Sydney, Australia told MedPage.

The University had just completed new research suggesting N95 respirators might work better. In the wake of that study, Phend wrote, “the case against old-fashioned surgical masks seemed clear.

“‘To me it would not seem justifiable to ask healthcare workers to wear surgical masks,’ MacIntyre said in an interview.

“Then another shocker. A second head-to-head study appeared, this time in the Journal of the American Medical Association. It’s conclusion: surgical masks were just as good as N95 respirators.”

The latter study concluded that 20 to 25 percent of nurses dealing with flu patients caught the flu whether wearing N95 respirators or surgical masks. The study did not control for nurses who worked with no mask at all.

This is the great gray area in which the issue of masking lived before the COVID-19 pandemic drove fears that something must be done, and it was decided by most of the experts that even if masks weren’t proven to help, they might.

The claims of mask efficacy then grew to make them vital safety equipment sans any real evidence they did anything.

When Texas months ago lifted its mask mandate, the Fort Worth Star-Telegram observed that the state was predicted to become “the epicenter of a coronavirus surge.” It didn’t happen.

The infection rate actually tilted downward. The experts are still trying to figure out exactly why. The Worldometer tracker now shows the seven-day average down to 1,207 infections,  about a sixth of 7,105 at the time the mask mandate was lifted in March.

As of this writing, the death rate in Sweden – which went through the pandemic largely unmasked – is 143 per 100,000 compared to the 185 per 100,000 in the fully masked up U.S., according to that tracker.

Swedish epidemiologist Anders Tegnell is of the view it’s dangerous to rely on masks as a tool to battle the pandemic. 

This is not to say that masks do nothing because there is no more evidence to support that conclusion than there is evidence to support the idea they actually stop the spread of SARS-CoV-2.

A study conducted by the University of Vermont concluded that what stops the spread is a reduction in close contacts between people and warned that masks tended to increase the number of close contacts.

The science on masks at this time can only be described as foggy, and anyone who tells you otherwise simply doesn’t understand science.

Despite all of the people screaming “listen to the scientists,” as if scientists were the oracles of the 21st century, every responsible scientist knows that science often doesn’t have the answer. As a rule, it takes science a long time to reach definitive conclusions about anything.

This is the nature of science. It travels a road of contradictions, reversals and dead ends. A scientist friend the other day messaged that he was in the process of finishing a new paper disproving what he thought he had proven a decade ago.

That is science at work.

Long unmasked

And it is against this backdrop one should consider whether children – who have for generations gone without masks and have driven the global population from something under 15 million people in the ancient world to 7.8 billion today – need to be masked to save the species from extinction.

This is an especially pertinent discussion given the low risk of death from COVID-19 in children. Unintentional injuries – motor vehicle accidents, drownings, falls, poisoning and more – are far greater threats,  according to CDC data.

Unintentional injuries kill about 12,000 people per year under age 19, according to the CDC. As of June, the Statista website reports, 314 Americans age 17 or under have died of COVID-19 since the pandemic was officially declared on March 11, 2020. The total for COVID-19 deaths among those 29 and younger – 2,637 – is still four and a half times less than the total for the number of under 19 years old dead in unintentional accidents.

The number of children under the age of 14 who died of suicide in 2019 – 514, according to the data from the National Institute of Mental Health, is 64 percent greater than the number of children under age 17 who have been killed by COVID-19 since the pandemic started more than a year ago.

These are real world numbers on risks to children. More kids under the age of 15 drowned in pools and hot tubs – 389 – in 2016, WebMD reported, than were in the under 17 cohort killed by COVID-19 since the pandemic began. But as of this writing, there has been no effort to require the owners of pools and hot tubs to “mask,” ie. cover, those threats to children when not in use by adults or with adult supervision.

This is the sort of context in which the masking of children really needs to be discussed. But that is unlikely to happen because, like everything else in the country these days, masks have become hugely politicized.

And fear – be it about what is in the masks or what happens if children aren’t masked – is the tool most often used to try influence the discussion because political interests want it that way.