Of Masks and Men – EMS Artifact

I laugh, derisively, at friends and relatives who try to lecture me on medical topics. I’m obviously not a doctor and never pretend to be. On the other hand, I spent a lot of time working with and learning from doctors. Those doctors included some men and women who were professors of medicine at a couple of pretty good medical schools.

It was a fringe benefit that I took for granted and thought was the norm in EMS. Boy, was I wrong. What I learned was far above what most paramedics learn in school or afterwards when they are out in the real world.

I point this out not to brag about how smart or well educated I am. Rather it’s just point out that I know some medicine.

Some people I know don’t let their lack of medical knowledge stop them from making sweeping pronouncements. My sister is one. She only stopped wearing a mask at the beginning of June because she believed everything that the CDC said, even if it was ridiculous on it’s face.

She still carries one of those masks that look like a surgical mask, but isn’t sterile and isn’t medical grade. Sometimes she wears the cloth masks that come in packages that clearly state that they are not medical and offer no protection.

It’s mask theater, nothing more.

Boiled down to their essentials, there are three kinds of masks that were in general use during the panicdemic.

The first is the National Institute for Occupational Safety and Health (NIOSH) approved N95 mask. NIOSH is part of the Centers for Disease Control and specifies standards for many medical devices. A properly fitted N95 mask will stop 95% of viruses and other small particles. They are used in medical and non medical settings such as construction.

For all of it’s faults, the Food and Drug Administration (FDA) does a good job describing various types of masks. Note the following,

N95s respirators regulated under product code MSH are class II medical devices exempt from 510(k) premarket notification, unless:

The respirator is intended to prevent specific diseases or infections, or

The respirator is labeled or otherwise represented as filtering surgical smoke or plumes, filtering specific amounts of viruses or bacteria, reducing the amount of and/or killing viruses, bacteria, or fungi, or affecting allergenicity, or

The respirator contains coating technologies unrelated to filtration (e.g., to reduce and or kill microorganisms).

They aren’t inexpensive and the aren’t comfortable to wear. Plus each individual needs to be fit tested to make sure that the mask seals properly. Quite frankly, they are a pain in the ass to wear for extended periods of time.

The function of N95 masks is to protect the person wearing it. If you want to avoid contracting Covid 19 or other virus or bacteria disease, this is what you wear. It’s actually what I wore early on before I realized that the virus didn’t pose the threat that was advertised. Which is a post for probably never, but definitely not today.

Note also, this from the FDA website,

General N95 Respirator Precautions

People with chronic respiratory, cardiac, or other medical conditions that make breathing difficult should check with their health care provider before using an N95 respirator because the N95 respirator can make it more difficult for the wearer to breathe.

Some models have exhalation valves that can make breathing out easier and help reduce heat build-up. Note that N95 respirators with exhalation valves should not be used when sterile conditions are needed.

All FDA-cleared N95 respirators are labeled as “single-use,” disposable devices. If your respirator is damaged or soiled, or if breathing becomes difficult, you should remove the respirator, discard it properly, and replace it with a new one. To safely discard your N95 respirator, place it in a plastic bag and put it in the trash. Wash your hands after handling the used respirator.

N95 respirators are not designed for children or people with facial hair. Because a proper fit cannot be achieved on children and people with facial hair, the N95 respirator may not provide full protection.

As I said, they are not very comfortable to wear for long periods of time.

Early on these masks disappeared because hospital central supply managers were ordering them as fast as they could find them.

Do not confuse them with KN95 masks which are good for dust and some fluids, but not virus and bacterial protection. If you’re sanding down some woodwork for painting, they’ll keep the dust out of your nostrils and thus your lungs, but that’s it.

Which brings us to real surgical masks. Those masks are designed to protect other people from the person wearing the surgical mask. Surgeons and others working in Operating Rooms wear them to protect the patient, not protect themselves from the patient. Before sterile technique was discovered, many surgical patients died from post operative infections. Maybe MORE people died from post operative infections. This of course was before the discovery of Penicillin and other anti biotics. What is a fairly simple to treat infection these days was a life threating event in those days.

From yet a different FDA website we get this,

Surgical masks: A mask that covers the user’s nose and mouth and provides a physical barrier to fluids and particulate materials. Surgical masks intended for medical purposes are considered medical devices. The mask meets certain fluid barrier protection standards and Class I or Class II flammability tests. Surgical masks are also tested for biocompatibility and are considered personal protective equipment (PPE). While surgical masks may be effective in blocking splashes and large-particle droplets, they do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the mask and your face. Surgical masks are not respiratory protective devices (unlike respirators).

So, surgical masks will NOT protect unmasked people from infected people who wear them. Nor will they protect the wearer from, well, anything. Note also that I have no idea what kind of masks hospitals are requiring visitors and patients to wear. Next time I happen to be near one, I’ll stop at an entrance and grab one to take a look. I have the sneaky suspicion that they too are mask theater.

If you don’t believe me, read this from the website linked above.

Q: Do face masks provide protection from coronavirus?

A: Masks may help prevent people who have COVID-19 from spreading the virus to others. The CDC has guidance for wearing masks. Wearing a face mask may limit exposure to respiratory droplets and large particles and may help prevent people who have COVID-19 from spreading the virus.

I wish my landscaper could do hedging like that.

Note also that if a mask is advertised as being “FDA registered” it does not mean that it is FDA approved. Here is what the FDA has to say about registration.

FDA Registration

Owners or operators of places of business (also called establishments or facilities) that are involved in the production and distribution of medical devices intended for use in the United States are generally required to register annually with the FDA.

It’s important to understand:

When a facility registers its establishment and lists its devices, the resulting entry in the FDA’s registration and listing database does not denote approval, clearance, or authorization of that facility or its medical devices.

So a mask marketed as “FDA Registered” may well not be approved and may well be useless.

Which brings us to the last class of face mask, which I call “fashion masks.”

The FDA addresses them with this comment,

Q: What does wearing a face mask for ‘source control’ mean?

A: Source control refers to use of cloth face coverings or face masks to cover a person’s mouth and nose when they are talking, sneezing, or coughing to reduce the likelihood of transmission of infection by preventing the spread of respiratory secretions. COVID-19 may be spread by individuals who may or may not have symptoms of COVID-19.

The use of cloth face coverings made from common, easily accessible materials are an additional public health approach to help slow the spread of COVID-19. The CDC has guidance for wearing masks.