"Arguments Against Wearing A Face Mask" by Ventura County CA Health Officer
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Coronavirus: Ventura County health officer says he won't issue countywide mask order
Go to minute 5 of this video where Dr. Robert Levin explains why he will not issue a facemask order.
This is a very helpful, must-see PDF dated April 27, 2020. Dr. Levin deserves credit for refusing to issue a facemask order in Ventura County. Unlike all the bureaucrats who issue these orders with no medical evidence, Dr. Levin actually posted 14 medical studies backing up his rationale. The 14 excerpts listed are very easily understood and digested. I highly suggest everyone read this short list because it includes several negative health effects of cloth masks which are not well known and are rarely if ever discussed, even among the 'anti-mask' crowd.
Ventura County Public Health: COVID-19 and the Use of Cloth Face Masks
Summary of Findings
Here are excerpts from that report and studies which Dr. Levin cited:
Arguments Against Wearing a Mask
With near universal use of cloth and medical masks worn in public in Wuhan, China during the 2019-2020 flu season leading up to the COVID-19 outbreak, the outbreak spread virtually unchecked.
With no masking order in place, Ventura County residents have successfully “flattened the curve” by using social distancing.
In a study involving 1607 health care workers across 14 hospitals, the rate of infection outcomes were 13 times higher in the cloth mask group compared with the medical mask group. Penetration of cloth masks by particles was almost 97% and medical masks 44%. The conclusions of this study “caution against the use of cloth masks”.
“Available evidence shows that (cloth masks)… may even increase the risk of infection due to moisture, liquid diffusion and retention of the virus. Penetration of particles through cloth is reported to be high.” “Altogether, common fabric cloth masks are not considered protective against respiratory viruses and their use should not be encouraged.”
“Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection.” The virus may survive on the surface of the facemasks.” “Self-contamination through repeated use and improper doffing is possible.”
Textile materials (that can be used for cloth masks) can contain harmful chemicals and dyes (i.e. formaldehyde). There is no research available regarding the safety of breathing through such materials but formaldehyde is a gas that can irritate a person’s eyes, nose, throat and lungs, or trigger an asthma attack, even at low concentrations. Prolonged exposure to formaldehyde can cause cancer.
According to the World Health Organization, the use of a medical mask by healthy people to protect themselves from COVID-19 in community settings is not supported by current evidence. The following potential risks should be carefully taken into account in deciding to wear a medical mask in the community setting: • self-contamination that can occur by touching and reusing a contaminated mask • depending on type of mask used, potential breathing difficulties • diversion of mask supplies and consequent shortage of masks for health care workers • diversion of resources from effective public health measures, such as hand hygiene
Wearing cloth masks in public can create a false sense of security and complacency in which people may neglect other hygiene practices.
Frequent washing and drying of a cloth mask can decrease the filtration capacity of the mask. https://www.ncbi.nlm.nih.gov/pmc/articles/P MC6599448/
Failing to wash a cloth mask daily increases the risk of self-contamination for the person wearing the mask due to contaminants found on the outer surface of the mask after use. The risk increases with longer duration of use. https://bmcinfectdis.biomedcentral.com/track /pdf/10.1186/s12879-019-4109-x
Buying pre-manufactured masks such as N95 and medical masks can create shortages of PPE for health care providers. https://www.who.int/news-room/detail/03- 03-2020-shortage-of-personal-protective- equipment-endangering-health-workers- worldwide
Virus-contaminated aerosols can pass through cloth and medical masks with coughing and sneezing. https://annals.org/aim/fullarticle/2764367
“The evidence is not sufficiently strong to support widespread use of facemasks as a protective measure against COVID-19.” https://www.medrxiv.org/content/10.1101/20 20.04.01.20049528v1
“Neither surgical nor cotton masks effectively filtered SARS–CoV-2 during coughs by infected patients… the size and concentrations of SARS– CoV-2 in aerosols generated during coughing are unknown. Oberg and Brousseau demonstrated that surgical masks did not exhibit adequate filter performance against aerosols measuring 0.9, 2.0, and 3.1 μm in diameter. Lee and colleagues showed that particles 0.04 to 0.2 μm can penetrate surgical masks. The size of the SARS–CoV particle from the 2002–2004 outbreak was estimated as 0.08 to 0.14 μm; assuming that SARS-CoV-2 has a similar size, surgical masks are unlikely to effectively filter this virus.” https://annals.org/aim/fullarticle/2764367
“The CDC does not mandate that face coverings be worn statewide.” https://www.cdph.ca.gov/Programs/CID/DCDC /Pages/Face-Coverings-Guidance.aspx
There is no evidence that cloth masks or medical masks worn in public plus practicing social distancing is any better than social distancing alone.
The outer surface of a mask in a patient with COVID-19 is almost always positive for virus, even more often than the inside surface. Coughing and speaking have been documented to disperse the virus out into the air.
"With these published and observed findings in mind, Public Health will not mandate that cloth face masks be worn in all public places in Ventura County at this time. Were the prevalence in our community to increase or with the advent of more convincing evidence in favor of this strategy, this guidance may change.
All community members should respect the desires of individual establishments or cities that have elected to require face masks. I endorse their doing so without reservation but based on the evidence, do not feel I can require it at this time. This review is in no way intended to lead to the conclusion that one should use medical masks over cloth masks; medical masks are for health care providers. This review will leave the reader with the two valid choices of using either a cloth mask in a community setting or no mask at all.
The fact that there are more comments listed in the “Against” column is not a reflection of bias on behalf of this reviewer but rather that there seem to be more researchers performing studies that produced those results. More plentiful results do not mean more meaningful results.
The reason that this document is lengthy and does not point to a clear-cut conclusion is because there is no conclusive evidence on either side of the issue. One might say that the obvious choice then is to choose the more conservative masking side of the issue. This might be the clear approach were it not for concerns raised about the safety of wearing cloth masks and their effectiveness. If unable to accept the complexity of the issue, then rely on your beliefs.
Statements of endorsement and concern are expressed about the use of cloth masks by reputable organizations on both sides of the issue.
In an effort to better understand usage patterns in Ventura County, a survey was conducted of mask choices worn by individuals exiting selected places of business....
Note: Dr. Levin also listed a much shorter "Arguments in Favor of Wearing a Mask, you can read those items in the full report, by downloading the PDF referred to above.
Ventura County Public Health: COVID-19 and the Use of Cloth Face Masks Summary of Findings
Should cloth masks be worn during this COVID-19 pandemic in either the community setting or in places of business where food is sold?
1. There is no incontrovertible, compelling or even a preponderance of evidence to support an Order to wear a cloth mask in the community setting at this time.
2. I am supportive of cashiers and customers wearing cloth masks inside a grocery store or any essential business where social distancing is difficult to maintain. Supporting evidence is not strong enough to issue an Order to mandate the use of cloth masks at this time; consumer preference is already accomplishing this in most parts of the County.
Ventura Co. health officer says he won't issue countywide mask order 4/29/20. Excerpt:
"As a doctor I help my patient make choices, as the health officer, my patient is the county, so I have to look at this from a whole different perspective," Dr. Robert Levin said during a news briefing. "I could not find that it was appropriate for me to recommend countywide that people wear cloth masks."