Why Face Masks Don’t Work: A Revealing Review

Introduction
The above quotation is ascribed to Justice Archie Campbell author of Canada’s SARS Commission Final Report. 1 It is a stark reminder that scientific knowledge is constantly changing as new discoveries contradict established beliefs. For at least three decades a face mask has been deemed an essential component of the personal protective equipment worn by dental personnel. A current article, “Face Mask Performance: Are You Protected” gives the impression that masks are capable of providing an acceptable level of protection from airborne pathogens. 2 Studies of recent diseases such as Severe Acute Respiratory Syndrome (SARS), Middle Eastern Respiratory Syndrome (MERS) and the Ebola Crisis combined with those of seasonal influenza and drug resistant tuberculosis have promoted a better understanding of how respiratory diseases are transmitted. Concurrently, with this appreciation, there have been a number of clinical investigations into the efficacy of protective devices such as face masks. This article will describe how the findings of such studies lead to a rethinking of the benefits of wearing a mask during the practice of dentistry. It will begin by describing new concepts relating to infection control especially personal protective equipment (PPE).

Trends in Infection Control
For the past three decades there has been minimal opposition to what have become seemingly established and accepted infection control recommendations. In 2009, infection control specialist Dr. D. Diekema questioned the validity of these by asking what actual, front-line hospital-based infection control experiences were available to such authoritative organization as the Centers for Disease Control and Prevention (CDC), the Occupational Safety and Health Association (OSHA) and the National Institute for Occupational Safety and Health (NIOSH). 3 In the same year, while commenting on guidelines for face masks, Dr. M. Rupp of the Society for Healthcare Epidemiology of America noted that some of the practices relating to infection control that have been in place for decades, ”haven’t been subjected to the same strenuous investigation that, for instance, a new medicine might be subjected.” 4 He opined that perhaps it is the relative cheapness and apparent safety of face masks that has prevented them from undergoing the extensive studies that should be required for any quality improvement device. 4 More recently, Dr. R. MacIntyre, a prolific investigator of face masks, has forcefully stated that the historical reliance on theoretical assumptions for recommending PPEs should be replaced by rigorously acquired clinical data. 5 She noted that most studies on face masks have been based on laboratory simulated tests which quite simply have limited clinical applicability as they cannot account for such human factors as compliance, coughing and talking. 5

Covering the nose and mouth for infection control started in the early 1900s when the German physician Carl Flugge discovered that exhaled droplets could transmit tuberculosis. 4 The science regarding the aerosol transmission of infectious diseases has, for years, been based on what is now appreciated to be “very outmoded research and an overly simplistic interpretation of the data.” 6 Modern studies are employing sensitive instruments and interpretative techniques to better understand the size and distribution of potentially infectious aerosol particles. 6 Such knowledge is paramount to appreciating the limitations of face masks. Nevertheless, it is the historical understanding of droplet and airborne transmission that has driven the longstanding and continuing tradition of mask wearing among health professionals. In 2014, the nursing profession was implored to “stop using practice interventions that are based on tradition” but instead adopt protocols that are based on critical evaluations of the available evidence. 7

A December 2015 article in the National Post seems to ascribe to Dr. Gardam, Director of Infection Prevention and Control, Toronto University Health Network the quote, “I need to choose which stupid, arbitrary infection control rules I’m going to push.” 8 In a communication with the author, Dr. Gardam explained that this was not a personal belief but that it did reflect the views of some infection control practitioners. In her 2014 article, “Germs and the Pseudoscience of Quality Improvement”, Dr. K Sibert, an anaesthetist with an interest in infection control, is of the opinion that many infection control rules are indeed arbitrary, not justified by the available evidence or subjected to controlled follow-up studies, but are devised, often under pressure, to give the appearance of doing something. 9

The above illustrate the developing concerns that many infection control measures have been adopted with minimal supporting evidence. To address this fault, the authors of a 2007 New England Journal of Medicine (NEJM) article eloquently argue that all safety and quality improvement recommendations must be subjected to the same rigorous testing as would any new clinical intervention. 10 Dr. R. MacIntyre, a proponent of this trend in infection control, has used her research findings to boldly state that, “it would not seem justifiable to ask healthcare workers to wear surgical masks.” 4 To understand this conclusion it is necessary to appreciate the current concepts relating to airborne transmissions.

It is actually dangerous to your health to wear face masks. The following is a report of an ad hoc experiment performed on average citizens donning face masks following a public meeting, using a blood oximeter to test for blood oxygen with and without face masks.

On Tuesday, June 9, 2020, Orange County (California) residents turned out en masse to the Board of Supervisors meeting to protest the mandatory mask order. At the meeting the health officer provided zero medical-scientific data that mandatory mask-wearing was safe, particularly during summertime high temperatures, or in the context of young children - nor could he provide any study showing mask-wearing is effective at containing viral transmission in order to combat the myriad studies showing it is NOT effective at viral containment.
At the meeting numerous doctors, attorneys, educators, psychologists, parents, and concerned residents cited medical studies on the harms from mask-wearing. So upset were these residents by the failure of the health officer to rescind the medically-unsubstantiated mandatory mask order - which intransigent position also drew hours of heavy fire from the Supervisors - or even to provide any studies showing efficacy of mask-wearing, that the residents proceeded to go outside onto the steps of the County Hall, at noon, in the 100 degree heat, and put on the "mandated masks" while using a Pulse Oximeter to measure their oxygen levels and heart rate.
The results were nothing short of horrifying:
ALL of the individuals had their oxygen rate drop from a healthy 98 or 99% (without the mask) - a total of five, ten, and sometimes twenty full points - within a few minutes of mask-wearing. Medically, below 92% is considered "dangerous" - while below 90% oxygen merits a denomination of "hypoxemic" The AVERAGE drop of these OC residents in oxygenation was more than 12 points, into the hypoxemic range.
Two of the participants, one a very fit daily runner, and one a very fit nurse, had their oxygen rates drop into the 70s - where organ damage, systems failure, and death can occur. ALL participants suffered dangerous drops in oxygen: 43% fell into the "dangerous" zone, 29% in the hypoxemic zone, and 29% fell into the extremely dangerous hypoxemic zone (where cardiac arrest, organ failure and death occur.) Even those who just stood around in the masks doing absolutely nothing had frightening drops in oxygen levels. As context, most of the participants were in decently good health, and not overweight. I'm sure I don't need to extrapolate for the reader what could happen if this test were performed with an average cross section of citizens, i.e., with the nearly 40% of OC residents who suffer from at least one chronic health condition, and with the more than 20% of OC residents who are obese. It is a striking juxtaposition to note that Medicare and most insurance companies will pay for people with oxygen rates of less than 88% to get supplemental oxygen and all carriers and health experts advise you to seek immediate medical intervention below 88% - and the average oxygen rate was two points less than that at 86% after only a few minutes of mask-wearing.
Given the data from yesterday, let me underscore once more in no uncertain terms, and in language that is absolutely unmistakable: the liability that an OC School District or Board will be facing if it mandates mask-wearing for students or teachers is truly incalculable, in the event the mask-wearing causes a drop in oxygen (which we now know it likely will), which then leads to a medical complication or death. We have no idea what will happen to children who are made to wear masks in the triple digit weather of mid-August, but my guess is that their systems, being less developed and often more sensitive -- compounded by the fact that children are notoriously poor at self-regulation and are traditionally MUCH more active than adults -- will fare very badly indeed. Recent headlines have made quite clear that death of children and losses of consciousness can and do occur: https://nypost.com/2020/05/06/two-boys-drop-dead-in-china-while-wearing-masks-during-gym-class/
https://7news.com.au/lifestyle/health-wellbeing/two-schoolboys-collapse-and-die-just-six-days-apart-in-china-while-wearing-face-masks-c-1017871t659l
https://nypost.com/2020/04/24/driver-crashes-car-after-passing-out-from-wearing-n95-mask/
. Let me now turn to the original reason for writing this email, which was to provide you a Summary of Medical Data (June 2020) from Switzerland, which further throws into serious question why educational agencies would make any changes to school protocols - if we are not similarly prepared to make massive overhauls based on the flu season each year (which seasonal flu actually affects children more than COVID does):

"According to the latest immunological and serological studies, the overall lethality of Covid-19 (IFR) is at most 0.1% and thus in the range of a strong seasonal influenza (flu)."
"Even in the global “hotspots”, the risk of death for the general population of school and working age is typically in the range of a daily car ride to work."
"The median or average age of the deceased in most countries (including Italy) is over 80 years and only about 4% of the deceased had no serious preconditions. The age and risk profile of deaths thus essentially corresponds to normal mortality. https://swprs.org/a-swiss-doctor-on-covid-19/?fbclid=IwAR1HebavrIpzi2bkq7Djm86JOyh5hTeIRw8QbjhPaSkI_eUOzpUItrWKtj8

Also, New England Journal of Medicine notes that masking is ineffective in community settings, and that even in healthcare arenas, it's highest and best use is not to reduce viral transmission but people's anxiety:

"The chance of catching Covid-19 from a passing interaction in a public space is minimal. In many cases, the desire for widespread masking is a REFLEXIVE REACTION TO ANXIETY over the pandemic.... Expanded masking protocols’ greatest contribution may be to reduce the transmission of anxiety, over and above whatever role they may play in reducing transmission of Covid-19." New England Journal of Medicine (May, 21, 2020). https://www.nejm.org/doi/full/10.1056/NEJMp2006372?fbclid=IwAR2XUtZJCUW-fGrayqv481-PmqTaAlaYU2V6w0YBcB9fi5KDC-iv5xhy-cE

Finally, the World Health Organization came out yesterday (June 8, 2020), concluding in NO UNCERTAIN TERMS that asymptomatic patients are NOT spreaders of the virus, which simply confirmed what earlier studies in May had found. Accordingly, we should NOT be worried that Little Johnny is going to catch the virus and bring Covid home to kill Grandma. Put simply: masking and social distancing are unnecessary, will create more medical and psychological damage than benefit, and are unneeded as healthy people and asymptomatic positive people DO NOT SPREAD THE VIRUS (so just keep the sneezy-coughers out of class -- which is standard -- and we will be just fine):

"Coronavirus patients without symptoms aren’t driving the spread of the virus, World Health Organization officials said Monday, casting doubt on concerns by some researchers that the disease could be difficult to contain due to asymptomatic infections. 'We have a number of reports from countries who are doing very detailed contact tracing,' she said. 'They’re following asymptomatic cases. They’re following contacts. And they’re not finding secondary transmission onward. It’s very rare. https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html

Sincerely,
Leigh Dundas, Esq.

The masks study video: https://youtu.be/WqhwwLbNZqo

The history of social distancing and the harm of using it in schools: https://youtu.be/NWh99sSF2Zs

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