Covid-19: important potential side effects of wearing face masks that we should bear in mind | The BMJ
https://www.bmj.com/content/369/bmj.m1435/rr-40

Dear Editor

In their editorial to the BMJ,[1] Greenhalgh et al. advise that surgical masks should be worn in public to prevent some transmission of covid-19, adding that we should sometimes act without definitive evidence, just in case, according to the precautionary principle. The Authors quote a definition of the precautionary principle found on Wikipedia, “a strategy for approaching issues of potential harm when extensive scientific knowledge on the matter is lacking.”

However, while no single formulation of that principle has been universally adopted,[2] the precautionary principle aims at preventing researchers and policy makers from neglecting potentially-harmful side effects of interventions. Before implementing clinical and public health interventions, one must actively hypothesise and describe potential side effects and only then decide whether they are worth being quantified on not.

Most scientific articles and guidelines in the context of the covid-19 pandemic highlight two potential side effects of wearing surgical face masks in the public, but we believe that there are other ones that are worth considering before any global public health policy is implemented involving billions of people.

The two potential side effects that have already been acknowledged are:

(1) Wearing a face mask may give a false sense of security and make people adopt a reduction in compliance with other infection control measures, including social distancing and hands washing.[3]

(2) Inappropriate use of face mask: people must not touch their masks, must change their single-use masks frequently or wash them regularly, dispose them correctly and adopt other management measures, otherwise their risks and those of others may increase.[3,4]

Other potential side effects that we must consider are:

(3) The quality and the volume of speech between two people wearing masks is considerably compromised and they may unconsciously come closer. While one may be trained to counteract side effect n.1, this side effect may be more difficult to tackle.

(4) Wearing a face mask makes the exhaled air go into the eyes. This generates an uncomfortable feeling and an impulse to touch your eyes. If your hands are contaminated, you are infecting yourself.

(5) Face masks make breathing more difficult. For people with COPD, face masks are in fact intolerable to wear as they worsen their breathlessness.[5] Moreover, a fraction of carbon dioxide previously exhaled is inhaled at each respiratory cycle. Those two phenomena increase breathing frequency and deepness, and hence they increase the amount of inhaled and exhaled air. This may worsen the burden of covid-19 if infected people wearing masks spread more contaminated air. This may also worsen the clinical condition of infected people if the enhanced breathing pushes the viral load down into their lungs.

...

In conclusion, as opposed to Greenhalgh et al., we believe that the context of the current covid-19 pandemic is very different from that of the “parachutes for jumping out of aeroplanes”,[7] in which the dynamics of harm and prevention are easy to define and even to quantify without the need of research studies. It is necessary to quantify the complex interactions that may well be operating between positive and negative effects of wearing surgical masks at population level. It is not time to act without evidence.


// Nevím, jaká je pravda v tomhle směru.. Rozhodně to ale není triviální problematika. Když uvažujeme o plošném opatření zasahující miliardy lidí, tak sebemenší negativní vliv, může mít dramatické dopady při tolika lidech. Vzhledem k tomu, že většina lidí nosí roušku špatně, tak v jejich případě výše a níže uvedené hovoří, že ten net benefit bude naopak záporný. Tedy horší než nic.

Nevím, jestli mi unikly nějaké informační trendy v posledních měsících a virus se najednou přes povrchy nešíří, jak se tvrdí na nyxu, ale rozhodně mi to nepřipadá jako non-téma, které by mělo být cenzurováno, pokud aktuální verze pravdy už tohle "dávno vyřešila". Mně tohle vrtá hlavou už x měsíců. Nedodržují to ani lidi, kteří roušky kážou.

Nebudu nikomu nadávat a ať si každej říká, co chce, ale myslím, že je naopak nebezpečný lidem tvrdit, že je v pohodě dotýkat se roušky.

Právě kvůli tomu WHO zpočátku měli stanovisko, že by zdraví lidé roušky nosit neměli. Nešlo totiž očekávat, že ji bude většina lidí nosit správně.

https://www.sacbee.com/news/nation-world/national/article240780786.html
The World Health Organization has not changed its position, which says marks are not needed in public for those who don’t already have coronavirus.

As coronavirus fears mount in the United States, experts warn that face masks won’t help most people avoid the virus — and they may actually increase the risk of getting it.

“The average healthy person does not need to have a mask, and they shouldn’t be wearing masks,” says Dr. Eli Perencevich, a professor of medicine and epidemiology at the University of Iowa’s College of Medicine, according to Forbes.

“Wearing a mask is tricky because it can create a false sense of security,” Perencevich said, according to the publication. “If you don’t wash your hands before you take off the mask and after you take off your mask, you could increase your risk.”
And fiddling with the mask may cause you to touch your face more often, also increasing your risk, Forbes reported. Improperly disposed surgical or respirator masks also can risk spreading coronavirus.


Are you wearing your face mask properly? Many people aren't, coronavirus experts say
https://medicalxpress.com/news/2020-04-mask-properly-people-coronavirus-experts.html

You've probably seen them at the supermarket or on the streets: People wearing surgical face masks pulled down under their noses, touching their face masks or dropping used face masks in public trash cans.

There's a right way and plenty of wrong ways to use face masks to help fight the spread of coronavirus, experts say. And a lot of people are on the wrong track.

On Friday, the U.S. Centers for Disease Control and Prevention recommended that people wear homemade cloth face masks in public, reversing its earlier advice, McClatchy News previously reported.

There's a catch, however. You have to wear the mask correctly and dispose of it properly, or you might actually increase the infection risk to yourself or others.

"That's what I see all the time," Griffin said, NPR reported. "That's why in the studies, masks fail—people don't use them (correctly). They touch the front of it. They adjust it. They push it down somehow to get their nose stuck out."

Tak vzhledem k tomu, že už mám ban do všech diskuzí o COVIDu, tak nezbývá to dávat sem.

Tak se podívejme na tuhle "konspirační teorii" a "nebezpečnou dezinformaci", o které když píšu, tak jsem "nebezpečnej ksindl" (diskuzní úroveň covidářů je v skutku neskutečná)

Tahle konspirační teorie, že by se lidé neměli dotýkat roušky, je oficiální pohled, který je velice snadno doložitelný.

Namátkou lze nalézt například článek prestižního TheConversation, což jsou akademické noviny, kde se do redakce mohou zaregistrovat pouze vědci.

https://theconversation.com/...ntial-consequences-of-wearing-face-masks-we-need-to-be-wary-of-140273

Third, masks may act as an extra transmission route or prompt other behaviour that transmits the virus, such as regular face touching. To stop masks being turned into alternative transmission routes, they need to be safely put on and taken off.

People touch their faces 15-23 times per hour on average – an itchy or poorly fitted mask may mean that people touch their eyes, nose and mouth even more regularly. After touching your mask, there’s a risk that your hands become contaminated, with the risk that you will then spread the virus to other surfaces, such as door handles, railings or tables.

Podobně můžeme slyšet od WHO v jejich instruktážním videu pro veřejnost

https://www.idnes.cz/onadnes/zdravi/rouska-maska-ustenka-koronavirus.A200318_123402_zdravi_jup

https://www.nature.com/articles/s41562-020-0887-9

The fomite route to transmission of the virus could be particularly important because the virus can survive on some surfaces for several days20. Therefore, not touching the T-zone (Box 6 in Fig. 1) may be an important behaviour to target. Although the above personal protective behaviours are included in government advice in a number of countries21,22,23, little guidance, training or support is given to promote adherence, even though failure to do so is critical to the transmission of the virus.

https://blogs.bmj.com/...t-touch-the-t-zone-how-to-block-a-key-pathway-to-infection-with-sars-cov-2/

It is not known precisely how much transmission occurs by each route, but the latter can be expected to play a substantial role.3 This is because, while the virus is typically only airborne for a matter of minutes, it can contaminate surfaces and objects, known as ‘fomites’,3 for many hours and even days, and we are constantly touching these surfaces and objects.

https://www.qeios.com/read/1SC5L4

SARS-CoV-2 is spread through airborne droplets, and possibly in some cases aerosol, containing virions (8). Face masks of various types (e.g. surgical masks) filter droplets containing virus. However, they may not reduce transmission of the virus in community settings if they are not used correctly and may even increase transmission if they act as fomites or prompt other behaviours that transmit the virus such as face touching. For example, a face mask that has been worn for several hours becomes moist and acts as a potential source of contamination. Studies show that people touch their faces 15-23 times per hour on average (9,10), and this may mean that eyes and contaminated face masks are touched, spreading the virus. Several reviews have been undertaken on whether wearing face masks confers net benefit or harm (11–19). This rapid review aims to draw together the key evidence to date to try to establish the most comprehensive picture available. Given that policy has to be made on the basis of the likelihood of benefits versus harms rather than necessarily a high degree of confidence that a given policy will have the desired effect, it is important to focus on this likelihood. Therefore, this review includes the use of a Bayesian analysis to calculate cumulative posterior odds of the benefit of face mask wearing.

Narazil jsem na víc článků o tomhle bizarním jevu, jak lidi z yoga/spiritual/psychedelic komunity čím dál tím víc podléhají konspiracím alá Qanon (satanistická hollywood a deep state elita žere děti. Což osobně nepovažuju za konspiraci, já bych bez kompotu z dětských jatýrek snad ráno ani nevylezl z postele, a to nejsem žádná elita), anti-covid atd. Tohle mi příjde jako zatím nejlogičtější vysvětlení:

Ecstatic globalism versus paranoid conspiracy

Let me add to this emerging discourse by suggesting that conspirituality theories are a form of mystical or ecstatic experience. I want to compare two forms of mystical experience.

The first is a sort of extroverted euphoric mystical experience: ‘Everything is connected. I am synchronicitously drawn to helpers and allies, the universe is carrying us forward to a wonderful climactic transformation (the Rapture, the Omega Point, the Paradigm Shift) , and we are the divine warriors of light appointed by God / the Universe to manifest this glorious new phase shift in human history.’

The second is a paranoid ‘bad’ trip version of the euphoric ‘good’ trip. ‘Everything is connected, there is a secret order being revealed to me, but I am not part of it. It is an evil demonic order, and it is trying to control me and everyone else. They have a Grand Plan and it is taking shape now. But perhaps I, and one or two others, can wake up to this Grand Plan, and expose it, and at least hide from it.’

The first trip is a euphoric ego-expansion (I am God! I am the Cosmic Universe evolving!) and the second is paranoid ego-persecution (The Universe is controlled by Evil Demons who are against me!)

In both, the individual awakens to this hidden reality. But in the first, they are a superpowered initiate in the hidden order and a catalyst for a Millennarian transformation, in the second they are a vulnerable and disempowered exposer of the powerful hidden order. (Millennarian, by the way, means that, like Robbie Williams, you believe in a coming Millennium, or Age of Love).

These are two sides of the same coin, two sides in the same game. Both are examples of mystical / schizotypal /magical / dream thinking. In both, the ego is part of a grand cosmic drama — in the first, they are the divine appointed catalyst for Phase Shift / humanity’s rebirth, in the second, they are the heroic exposer of the Hidden Order.

William James, father of American psychology, made this point in The Varieties of Religious Experience, where he writes that paranoia is a form of diabolical mysticism, a sort of religious mysticism turned upside down. The same sense of the ineffable importance of the smallest events, the same text and words coming with new meanings, the same voices and visions and leadings and missions, the same controlling by extraneous powers; only this time the emotion is pessimistic: instead of consolations we have desolations; the meanings are dreadful; and the powers are enemies to life.

Balancing the Socratic and the Ecstatic

In general (and in conclusion), there is a value in non-rational forms of knowing, such as dreams, intuitions, inspiration and mystical experiences. These can be important sources of wisdom and healing. Many great scientific discoveries and cultural creations have come from ecstatic or schizotypal inspiration, from Newton’s discovery of gravity to Milton’s Paradise Lost.

I am prone to this sort of ‘benign schizotypy’ myself, and on the whole it enriches my life and work. There is a reason schizotypal thinking has survived for millennia — sometimes it is highly adaptive. It has played an important role in our cultural evolution.

However, it is crucial to balance the capacity for ecstatic / magical / mythical thinking with the capacity for critical thinking. That’s what I’ve tried to do in my books: balance the Socratic and the ecstatic, or the left and right brain, if you’re into that sort of thing.

Too much Socratic thinking without any ecstasy, and you end up with a rather dry and uninspiring worldview. Too much ecstasy without critical thinking, and you may be prone to unhealthy delusions, which you then spread, harming others. You may be so sure you’re right, so hyped in your heroic crusade, you may block things that are really helpful and spread things that are really harmful.