Masks still save lives

Masks still save lives

The covid pandemic situation has improved greatly from what it was in Spring 2020, when synagogue death notices came on an almost daily basis.

A recent Massachusetts study reported in the Journal of the American Medical Association, however, indicates that after a drop in mortality for older adults during the delta surge in 2021 (mortality rates 7% higher than expected), people over 65 are dying from covid at higher rates once again (mortality rates 23% higher than expected). This is likely due to the recent omicron strains being more contagious, and vaccine protection waning over time. Yet in many synagogues and other public gatherings almost no one is wearing masks. Is this a good idea? Masks can still provide great benefit to us and should still be worn.

A million Americans have died, and shamefully, many of those deaths were avoidable. At the beginning of the pandemic experts knew of the risks of covid-19 but did not advise that we all mask up. That was partly because an inadequate supply of personal protective equipment for healthcare workers. Government officials did not encourage the public to use medical-grade masks; they tried to conserve the supply for frontline hospital personnel.

Masks also became a political hot potato, with some politicians and other public figures refusing to don them. If the public had been immediately informed that masks reduce the risk of transmission of covid, and had been encouraged to wear them, hundreds of thousands of lives could have been saved.

In light of the disastrous beginning of the pandemic, we need to consider the role of masks as the pandemic moves into new phases — where many are vaccinated, a significant proportion of the population has had the disease, and we are closing in on herd immunity. Many covid policies have been loosened, mask mandates suspended, and social distancing a thing of the past. While all of this is good news, it is not yet time to throw the masks away.

Scientific studies show that proper and consistent use of effective masks did, and will, continue to protect us and the people around us from covid-19 and other infectious diseases that spread through the air. One review article, by Jeremy Howard and 18 collaborators from 19 institutions in six countries, published in the highly prestigious journal Proceedings of the National Academy of Sciences, cites dozens of articles that support the use of masks, even in asymptomatic people, explaining that “…people are most infectious in the initial period post-infection, where it is common to have few or no symptoms.”

Appropriate wearing of N95 and KN95 masks dramatically reduces the risk of transmission of covid-19, as well as influenza, the common cold, and myriad other infectious diseases. For close to 100 years it has been recognized that some infectious disease germs spread through the air, and that wearing a mask can reduce the rate of transmission. Research shows that bacteria and viruses can be propelled from person to person in aerosols and droplets released when people cough, sneeze, speak — or simply breathe. Surgeons wear masks to protect their patients from their germs, and to protect themselves from diseases carried by infected patients.

But some might argue, “covid is over!” Unfortunately, that is not the case. Infection rates are lower for now, but they still are significant. While some reports indicate that the omicron variants are milder than previous strains, many people still are getting sick, some for the second or third time. Hospitalizations have dropped, but some patients still end up in ICUs, fighting for their lives. And there are significant numbers of patients who do not recover completely, suffering from “long covid,” where symptoms can continue on from the original bout, or can reappear after recovery. Patients with long covid can suffer months of fatigue, malaise, and multi-organ affects. Cardiac symptoms, respiratory, gastrointestinal, skin, and kidney disorders related to the covid infection have been reported. Patients can be incapacitated for many months, or indefinitely.

And covid patients still are dying. In February 2022, about 2,500 Americans were dying every day. Now there is a lull, with decreased mortality, perhaps for good, or perhaps it is just a trough. Currently, only about 300 people in the United States die of covid every day — but of course you don’t say “only” if it’s someone you love — or even someone you know — who is lost to the virus.

We do have many reasons to be hopeful (thank you, science). Effective new antiviral medications that can keep most covid patients out of the hospital are available. The highly effective vaccines and boosters reduce the severity of the disease, and vaccinated people are much less likely to be hospitalized and 50% less likely to develop long covid. But one third of Americans are still not fully vaccinated. (While some Americans continue to scoff at the vaccines, there are countries where vaccines are not so easily available, and people would do anything to get the shots. But that’s a topic for another day.)

Immunity fades over time for those who are vaccinated or who have had covid. Even people who are boosted have diminished immunity as time goes by. And vaccines developed for one strain are not as effective against newer strains.

Vaccines do, indeed, wane in effectiveness. But masks do not! European scientists Harald Brussow and Sophie Zuber reviewed close to 100 studies on vaccination and face mask wearing and reported a “significant reduction in covid-19 incidence with mask wearing.” They point out that masks are physical barriers against all viruses, regardless of the variant, or even the disease. (Note that rates of influenza have also been greatly reduced in the past two years, thanks to masks and social distancing.)

Masks are still an important part of our armaments against covid. It is true that covid is less severe in vaccinated people, but vaccine effectiveness wanes, so masks still are needed to reduce the risk of getting sick, or of needing medication, of being hospitalized, or of being sidelined by the unpredictable and possibly long-term effects of a serious, life-threatening viral infection.

In money matters, we consider profit and cost when investing. In healthcare decisions, we measure benefits and risks of medications, treatments, procedures, and behaviors. In the past 2 ½ years we were forced to make daily decisions about risks and benefits for routine activities. We calculated whether to participate or forgo simple activities, weighing, for instance, if a trip to the store, or a visit with family and friends, was worth the risk, compared with the corresponding benefits.

When we are presented with a way to reduce the risk — either by being vaccinated, or by judicious use of masks — it is possible to change the risk/benefit equation. You can attend a grandchild’s graduation with lower risk if you wear an N95 or KN95 or equivalent mask properly and consistently. It is not as risky to travel on public transportation — plane, train, bus, or ship — if you wear that mask in public spaces. Masks can reduce the risk of infection, giving people more options and possibilities for beneficial activities.

So don’t throw away those masks. Viruses and other pathogens are part and parcel of our planet, and we will always be challenged by new variants of covid, influenza, and other infectious diseases.

Oh, and don’t forget to wash your hands.

Miryam Z. Wahrman, Ph.D., is professor of biology at William Paterson University, and author of “The Hand Book: Surviving in a Germ-Filled World.” She and her husband live in Teaneck.

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