NEW THOUGHTS ON THE SURGICAL MASK
Previous essays I have published take the WHO ( World Health Organization) viewpoint that regular masks are not effective and do not need to be worn by the general public. A surgeon friend of mine brought up a point that I had not considered. He has a broader vision that all people ought to wear the regular surgical mask because it would be a social equalizer. Now, if you see people in the street with a mask on, you have this gut reaction, they must be infectious, and you ought to distance yourself from them. If everyone wore a mask, regardless of what type, we would all be equal and would be reminded that distance is essential, along with coughing and sneezing.
As pointed out by many previously, the N95 mask is the only mask that protects the wearer as it filters out particles the size of the virus. These masks are not all that easy to wear. Firstly, they must be fitted for each individual. They are tight, uncomfortable, and can actually bruise the delicate skin on the face. Because they filter out very small particles, it is hard to draw air through them, and it makes breathing a real chore. The common surgical type mask, on the other hand, is easy to wear and easy to breathe through and does prevent larger droplets from contaminating the environment even though it does not filter out incoming air well, especially aerosolized particles. The standard surgical mask, therefore, may protect the environment from broadcasting the larger droplet spray, but to a lesser extent, the wearer of the mask. It is the large droplets that are presumed to be the primary mode of transmission.
The history of that mask goes back to Paul Berger, a French surgeon, who in 1899 published a paper where he said, “For several years I have been worried as to the part that drops of liquid project from the mouth of the operator, and may cause infections (in the patient on whom the operation is performed)…”. He started to wear the cloth mask and insisted that his assistants would do likewise. The response from his fellow surgeons was one of ridicule, just like they ridiculed Ignaz Semmelweis, who suggested we ought to wash our hands after performing an autopsy. Ignaz postulated that “little plants” from the dead body could get on the hands, and whatever killed that person would then be transmitted to the hands and then to a new victim. Berger suffered the same kind of insults regarding his new idea of wearing a facemask. Semmelweis, in the interim, became so convinced that handwashing was actually saving lives that he started attacking his surgeon colleagues in the local newspaper, calling them murderers. They responded by incarcerating him in an insane asylum where he died, knowing he was right.
Berger seemed headed for the same fate, had it not been for the famous surgeon, Jan Mikulicz. Jan also chimed in with an article that mirrored Berger’s ideas about spraying droplets while talking, coughing, and sneezing. Jan was the protégé of another famous surgeon, Theodor Billroth. With those names as character references, the mask became the standard for all surgeons in short order.
Just recently, an interesting experiment proved that talking/singing can spread disease. A minister in Mount Vernon, Washington, who refused to follow the social distancing order, held choir practice, and 60 members of his choir showed up. None of them were ill, none of them coughed or sneezed. They just sang for two hours. Within a few weeks, 45 of them were sick with COVID-19, and several had died, proving that just talking (or in this case singing) was sufficient to spread the virus. It is thought that the majority of transmission is by larger droplets rather than finer particle spread. Had these singers all worn masks, it is likely that none, or at least fewer, would have been infected. Of course, that experiment has not yet been done, but it would be interesting if it were. I would suggest the next minister who wants to break the law, that the choir participants should all wear masks, and perhaps he would kill fewer of them.
I do understand the science behind the difference between the regular face mask and the N-95 mask. Still, I will have to change my opinion and go against the recommendation of the WHO (World Health Organization) and start wearing my homemade double layer mask my wife sewed from old (washed x 3) underwear (I am serious!).