Zorro Returns

Zorro Returns

A recent issue of the New England Journal of Medicine had an editorial (not a research paper) titled “Strategic Masking to Protect Patients from all Respiratory Viral Infections”.   It was written by four Harvard physicians whose specialty is epidemiology and public health. 

The authors preamble alludes to the understandable mask wearing pushback/mask use fatigue in both the general population and in healthcare workers.  That’s very understandable.  We are all sick of constraints.  But the focus of the article is with the first word: “strategic”.  They make a rational argument for what they call strategic masking.  Myriads of studies during the Covid 19 pandemic came to diverse findings on mask benefit.  From “doesn’t seem to do much” to “has a major impact on transmission”.  The authors point out that the naysay findings are probably due to inappropriate mask type or improper use.  How many times have you seen people wearing a mask covering their mouth but not their nose.  Duh!  Collating all the data it seems that there is up to a 60 to 70% effectiveness of preventing viral transmission with masking.  This includes the SARS-COV-2 virus along with other pesky viruses: influenza, RSV, human metapneumovirus, parainfluenza and rhinovirus.  One fifth of patients hospitalized for pneumonia have a viral pathogen not a bacterial one.  Influenza alone accounts for 50 to 60 thousand deaths a year in the US.

The strategies they offer are several.  One is to consider mask use in public places and health care facilities during months of the year with high viral illness.  Another is to consider universal masking in health care settings when patients being attended to are at a higher risk due to age or underlying premorbid conditions.

My own personal experience does not constitute science.  But prior to Covid-19 and mask use this aging physician was catching two to three viral respiratory infections a year.  Since my mask use over the past 4 years, I have not been sick. 

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