COVID-19: the case for ongoing masking

Do you want us to return to the earlier, deadlier waves of the COVID-19 pandemic that saw more than half a million Americans die from infection? If we stop face covering, we must be ready to pay the price of increased mortality and economic devastation as new waves of illness arise. The COVID-19 masking mandate should continue because it is effective. It will ensure the economy does not collapse under another wave of acute infection. Moreover, it is the least restrictive and encumbering of all preventative measures against this disease. Face masking is an effective measure in tackling COVID-19 infection. There is evidence that mask-wearing prevents COVID-19 transmission and encourages the development of herd immunity by causing asymptomatic and mild illness in the general populace.1,2 This qualitative survey also demonstrates the efficacy of masking.3 Researchers showed “a near-perfect correlation between early universal masking and successful suppression of daily case growth rates and/or reduction from peak daily case growth rates” of COVID-19 infection. More importantly, they showed that the benefits of masking still existed even with poor facial masking technique. Read: Wearing masks: how neuroscience can help us The world is dealing with a viral respiratory pandemic. One of the essential properties of viruses is their ability to mutate. COVID- SARS-2 virus, which causes COVID-19 infection, is not an exception. It has had up to six mutations since it appeared in Wuhan, China, in December 2019. The virus could either mutate to a more virulent form or a less virulent one. The delta variant was the deadliest mutation. After this came the omicron variant, though not as fatal but certainly more easily transmissible. The morbid implication of the delta variant ensured that COVID-19 mandates were generally adhered to all over the world, including the wearing face masks. I hear cynics decry the mask mandate and other measures, insinuating that the actions impinge on their freedom and saying the omicron variant is not as deadly. However, one must remember that it is a virus and can mutate back to a more lethal form. Therefore, it is imperative that masking continues until the virus becomes dormant, as did the earlier severe acute respiratory syndrome (SARS) coronavirus infection of 2003. Let's not miss the point that any universally effective measure carries with it a productive economic force that transmits benefits to individuals, governments and the public. Continuing face covering during the COVID-19 infection is a prudent economic tactic ensuring the economy stays afloat. The world has so far avoided a global financial meltdown as a result. The main reason for this is the universal adoption of COVID-19 economic supporting measures such as soft loans for businesses and individuals, and the near-zero interest rate. These measures helped the world stave off economic recession while mandating now-proven COVID-19 preventative measures such as face mask mandates.4,5 I hear naysayers bemoan the COVID-19 measures (including mask and vaccine mandates, the need for quarantine and social distancing) without mentioning the catastrophic economic consequences that would occur if current preventative measures had not succeeded. A second occurrence of infections from the delta variant will undoubtedly take the world into a global recession the likes of which has not been seen since the 1929 economic collapse. Read: What to tell patients about wearing homemade masks Every rational person agrees that the gradual easing of lockdown measures (i.e. social distancing and vaccine mandates), while still maintaining masking mandates in the face of declining COVID numbers, has been a great success. However, we also know that that rules have been most lax in places where severe COVID-19 infections and mortality are highest. We understand that the recrudescent waves of COVID-19 disease occurred after the government lifted preventative measures. Renewed waves of infection happened from wave one to wave two, and now in wave six since the lifting of face masking rules. Therefore, continuing masking is the prudent thing to do, especially as it is the least restrictive of measures. Read: Most Canadian support wearing masks during COVID-19, oppose protests Many of us wear bodily accoutrements without a sense of external imposition, such as headgears and hats, earrings, watches, tattoos, etc. The wearing of face masks, which are massively cheaper than any of the above accoutrements, should be encouraged and continued without a sense of imposition. As the COVID-19 infection decreases and becomes less virulent, the least restrictive measure (face masks) should be continued. The more stringent and economically impactful requirements are sidelined with the acceptance of face masks. Other measures, including physical distancing, compulsory quarantining, expensive COVID-19 testing, etc., further impact the economy and mental health of the public. The ease of using face masks should be reassuring as it is but one armament in the fight against those who oppose continued masking. Most people support mask mandates. Only a minority (about 10%) do not keep wearing masks following an analysis of public tweets.6 Anti-maskers note discomfort, face-covering perceived as not helpful, etc., however they do not cite any research to support their view of why masks are not needed. People have argued against any mandates, be it vaccines or masks. However, we now live in perilous and unique times and the need to mitigate any dangers should take precedence. This will allow us to use all measures quickly while taking advantage of lessons learned in practical public health preventative measures used in the past. Some of the steps accepted by even the mask mandate refuseniks include the wearing of seatbelts in cars, the acceptance of early childhood vaccinations, etc. One may argue that most sceptics would have expressed the same arguments they are using today were they present during the initiation of mandatory seat belts. Yes, some argue that wearing masks makes people take more risks regarding COVID-19 exposure. But I see this as a fallacy based on fundamental principles. Firstly, masking is a simplistic and tolerable measure. For those arguing discomfort, a simple change of mask type can be the solution. Secondly, individuals with the conscience to wear masks are unlikely to violate other health measures such as social distancing or overcrowding. This criticism is analogous to the argument that people who wear car seatbelts expose themselves to more dangerous driving by relying on their seatbelts. News on the conservative political spectrum—mainly belonging to the Republican Party in the United States of America—perceive less risk and take fewer preventative measures regarding COVID-19 infection.7 Mask-refusers need not politicize their use as doing so will cause severe health consequences, including death. Finally, mask mandate skeptics argue that it is nice to see the faces of their loved ones. However, do we not see the fallacy of this point? By not covering our face, we could infect the same loved ones and cost them their lives. Preventable mortality is an ideal to be pursued. The benefit of continued facial masking is preventable mortality. Without equivocation, the continuing use of facial coverings to prevent COVID-19 infection is a noble endeavour. Furthermore, its effectiveness contributes to economic benefits resulting from its universal ease of deployment. With such a preponderance of advantages, there is no need to fight against the use of face masks. I encourage the further exploration of means to educate the public so that the concept of continued masking is more culturally acceptable. Dr. Daniel Okoro, is clinical assistant professor in the Department of Psychiatry at the University of Calgary. References: Gandhi M and Rutherford GW. Facial masking for COVID-19- Potential for “variolation” as we Await a Vaccine. The N Engl J. Med.2020;383;18 Seidelman JL, Lewis SS, Advani SD, Akinboyo IC, Epling C, DO MC, et al. Universal masking is an effective strategy to flatten the severe acute respiratory coronavirus 2 (SARS-COV-2) healthcare worker epidemiologic curve. Infection Control and Hospital Epidemiology. 2020;41(12):1466-1467 Kai D, Goldstein GP, Morgunov A, Nangalia V, Rotkirch A. Universal Masking is urgent in the COVID-19 pandemic: SEIR and Agent Based models, Empirical validation, Policy recommendations. arXiv preprintarXiv:2020Apr22:2004.13553 Leonard A, Boutilier K. The impact of mask mandate on the trade-off between GDP and COVID-19 mortality. Covid Economics. 2021Jun9;155 Cathey PM. The impact of COVID-19 mask mandates on consumer spending. Centre for Open Science. 2021 Mar 12. He L, He C, Reynolds TL, Bai Q, Huang Y, Li C et al. Why do people oppose mask wearing? A comprehensive analysis of U.S. tweets during the COVID-19 pandemic. J Amer Med Infor Asso. 2021. 28(7):1567-1573 Caputo M. Poll: Majorities support vaccine, mask mandates — but not Republicans [Internet]. POLITICO. 2022 [cited 13 April 2022]. Available from: https://www.politico.com/news/2021/08/11/majorities-support-vaccine-mask-mandates-republicans-503506

COVID-19: the case for ongoing masking

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