COVID-19 – do masks help?

Executive summary

* The official positions from the World Health Organisation (WHO), the US Centres for Disease Control (CDC), the US Surgeon General and the UK Deputy Chief Medical officer are similar – you don’t need a mask. Some go even further and suggest that wearing a mask may do more harm than good. Others caution that masks should be saved for caregivers.

* A campaign called #Masks4All has been gathering momentum in the past few days. The campaign message is that masks do help, and we should make our own.

* I searched the academic database for any articles about masks and the current virus of concern, COVID-19. One article in The Lancet noted the different advice in different countries and called for more research to clarify a definitive position.

* The search for masks and viruses generally produced so many academic papers that it was possible to focus on the best evidence available – systematic reviews and meta-analyses.

* Since 2007, the Cochrane Collaboration has been reviewing and updating evidence on interventions to reduce the spread of respiratory viruses. The interventions examined include hand washing, wearing masks, wearing gloves and more.

* The main Cochrane paper (2011) has quantified the value of these interventions. Mask wearing was found to have significant value, as did the other interventions. The most recent Cochrane review (2020) supported the findings, although adding some caution about the strength of the evidence available.

* A systematic review and meta-analysis, which examined the effectiveness of masks against transmission of respiratory infections in healthcare workers, also found that masks were of benefit. I am not aware of any debate about the value of masks among healthcare workers – only among the general public. Yet why would masks protect them and not us?

* The need to save masks for healthcare workers appears to have been a key driver of the advice that the general public doesn’t need them.

* The evidence shows that wearing a mask protects against virus transmission. We can avoid any claimed harms by making our own masks (protect supplies for healthcare workers) and caring for them carefully (protect against contamination).

* The official advice might change soon – it needs to.


The simplest definition of culture is “The way we do things around here.” If you’ve ever had the privilege of visiting the far east – China, Japan, Hong Kong etc – you will have noticed that they do some things differently to western countries i.e. our cultures are different. One of our cultural differences, which has been starkly apparent during the COVID-19 outbreak, has been the wearing, or not, of masks.

Blowing one’s nose, or using a tissue, in public is considered the height of rudeness in the far east. Anyone showing the first sign of a cold (let alone flu, or something nastier) will don a face mask out of respect for other people. They are saying – I have some germs right now and I want to protect you. We don’t do this in the west. We are more likely to stare at someone wearing a mask thinking that it looks odd and then sneeze down a train carriage.

Dr Eric Westman dropped me an email with some very interesting videos on masks and virus protection and he asked if I could review the research on this topic. After spending an hour looking at the videos, I wanted to do exactly that…

The official positions on masks

The official positions from the World Health Organisation (WHO), the US Centres for Disease Control (CDC), the US Surgeon General and the UK Deputy Chief Medical officer are similar – you don’t need a mask. Some go even further and suggest that wearing a mask may do more harm than good. Others caution that masks should be saved for caregivers.

WHO: “If you do not have any physical symptoms, such as fever, cough or runny nose, you do not need to wear a medical mask. Masks alone can give you a false feeling of protection and can even be a source of infection when not used properly.” Dr April Baller WHO Health Emergencies Programme (Ref 1).

CDC: “If you are NOT sick: You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). Facemasks may be in short supply and they should be saved for caregivers” (Ref 2).

US Surgeon General: “Seriously people – STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!” (Ref 3).

UK Deputy Chief Medical Officer (Dr Jenny Harries): “If a healthcare professional hasn’t advised you to wear a face mask, it’s usually quite a bad idea. People tend to leave them on, they contaminate the face mask and then wipe it over something. So it’s really not a good idea and doesn’t help” (Ref 4).

The videos

Eric sent me three videos:

1) A video posted on March 25th by Rachel Thomas and Jeremy Howard (Ref 5). The video is 35 minutes long. Much of it translates a video posted on March 14th by Petr Ludwig, a Czech speaker, writer and social media influencer. Both videos explain the campaign #Masks4All and some of the science behind it. The campaign #Masks4All can be seen here (Ref 6). Petr’s original video (with subtitles) can be seen here (Ref 7). The message from both videos is that masks do help, and we should make our own.

2) A video posted on March 28th by Petr Ludwig, featuring Adam Vojtech, the Minister of Health for the Czech Republic. This video is fewer than four minutes long and it is the one to watch (Ref 8). The message is simple and powerful. The Czech Republic has mandated that everyone who has to leave home must wear a mask. The adopted slogan is, by everyone wearing a mask, “I protect you and you protect me.”

3) The third video was one that Eric has done, showing how surgical room training can be helpful to everyone right now (Ref 9). It is so vital to avoid infection transmission in surgery that staff have standard methods for handling items. They know if something has been contaminated and they know how to identify and avoid such an item. We can learn from this.

The videos were powerful and contained scientific references, but they weren’t systematic reviews of the evidence, so let’s do a top-level one… (Note 10).

A systematic search of the evidence

Every time I review a topic, I use an academic database to search for all relevant articles on that subject. Sometimes a topic search will only elicit a handful of returns and you need to make do with what you can get. Other topics return hundreds, or thousands, of papers and you then need to be more selective.

The first search was to see if anything has been written on COVID-19 particularly. Searching COVID-19 and mask(s) returned two potentially relevant articles:

– Feng et al. Rational use of face masks in the COVID-19 pandemic. The Lancet. 2020 (Ref 11).

– Leung et al. Mask masking in the COVID-19 epidemic: people need guidance. The Lancet. 2020 (Ref 12).

The first article is relevant to our research question. The second article might be useful if we find that masks can help the general public.

The first article was just two pages long. It contained a useful table summarizing global positions on masks. It reported the WHO, US and UK positions, as I did above. It also summarized the recommendations on masks in China, Hong Kong, Singapore, Japan and Germany. Interestingly, Hong Kong was the only country strongly recommending masks for the general public (if symptomatic, or if on public transport, or if in crowded spaces). China graded people by risk of infection and advised accordingly. Japan thought that the effectiveness of wearing a face mask to protect from contracting viruses was limited. Germany quoted the WHO position verbatim.

The paper authors noted that recommendations varied across countries and called for more research to clarify a definitive position. They observed that “there is an essential distinction between absence of evidence and evidence of absence.” The article reported that “increase in use of face masks by the general public exacerbates the global supply shortage of face masks, with prices soaring, and risks supply constraints to frontline healthcare professionals.” This doesn’t answer our research question – we need to know if masks will help the general public. The consequences of the answer are a separate issue.

The second search didn’t limit articles to those written about COVID-19. It looked for any papers about masks and protection against viruses in general. Searching for “mask(s)” and “virus” returned 922 papers. Ticking “humans” brought this down to 686 – still too many to review. Ticking “systematic review” and/or “meta-analysis” brought the search down to 20 papers. Far more manageable and focusing on the best evidence available. i.e. not a trial here and there – but collations of all trials available.

Even with such a specific search, a number of papers always turn out to be irrelevant to the research question (e.g. the 20 included a number of papers on bronchiolitis in high-risk children). Additionally 5 out of the 20 papers were by Jefferson et al and were revisions of one of the papers focused on below.

Among the few remaining systematic reviews and meta-analyses, there were two Cochrane reports. Notwithstanding recent events within the Cochrane Foundation, the articles emanating from this organisation are considered to be the most independent and valuable evidence available.

There are two key papers to examine, therefore:

1) Jefferson et al. “Physical interventions to interrupt or reduce the spread of respiratory viruses. 2011” (Ref 13). (This was the most recent of the Jefferson papers).

2) Burch & Bunt. Can physical interventions help reduce the spread of respiratory viruses? 2020 (Ref 14).

Let us look at these two studies…

The Cochrane reviews

1) The 2011 Cochrane paper reviewed 67 studies (including randomised controlled trials, population studies, case control studies, and time series studies, in many different countries). The conclusion was that the following interventions can help – frequent handwashing and barriers to transmission such as isolation and wearing protective clothing (masks, gloves and gowns). The review found “no evidence that the more expensive, irritating and uncomfortable N95 respirators were superior to simple surgical masks.”

The key output of meta-analysis is a pooled odds ratio (or risk ratio or hazard ratio). This number tells us – looking at all the evidence that we can find, from all the studies available – what does the intervention do to the odds/risk of something happening compared with not doing the intervention? This measure tells us relative risk, not absolute risk, and so caution should be applied (Note 15).

This paper reported that only the case control studies were sufficiently homogenous (similar) to be used in meta-analysis. There were nine of these. Interestingly, all nine assessed the impact of public health measures to curb the spread of SARS (severe acute respiratory syndrome – another coronavirus) during February to June 2003 in China, Singapore and Vietnam. They are, therefore, very relevant to the examination of data for the current coronavirus, COVID-19. The nine studies included some specifically involving health care workers, as opposed to the general population, but the efficacy of each intervention can still be assessed.

The key diagram (replicated below) is on p127 of the 162-page Cochrane report. The following diagram reports the odds ratio/effect size for each of nine interventions. The number of studies and the number of participants contributing to each finding is also shown. The numbers in brackets after the effect size denote the 95% confidence interval. If the confidence interval does not include 1.0, the result is said to be significant and not a chance occurrence. All of the interventions achieved a significant result.

The paper reported that, using data from 7 studies and 3,216 participants, “simple mask wearing was highly effective (OR 0.32).” That means that those wearing a mask were about two thirds less likely to contract SARS as those not wearing a mask. That’s relative risk. Analysis 1.3 on p129 allows us to calculate absolute risk. Among those wearing a mask there were 268 cases (of virus) in 681 people. Among those not wearing a mask there were 1,573 cases in 2,535 people. That was an absolute difference of 39 cases in 100 vs 62 cases in 100 (23 cases in 100). That’s well worth the intervention.

While wearing an N95 respirator appeared to be even more effective (OR 0.17), this was based on just 3 studies, involving 817 people, and the upper limit of the confidence interval was above that of just mask wearing. Those washing hands frequently (defined in the paper as a minimum of 11 times daily) were approximately half as likely to contract SARS than those not doing this (OR 0.54). Wearing masks was more effective than frequent handwashing – both using relative risk (OR 0.32 vs 0.54) and absolute risk (39 cases in 100 vs 57 cases in 100 i.e. 18 cases in 100).

This Cochrane review supported wearing masks, along with many other measures, for reducing the risk of virus transmission.

2) The Burch and Bunt study was a revision of the Jefferson et al 2011 Cochrane review. It reiterated that most of the evidence came from case control studies and that findings suggested that “handwashing; wearing of masks, gowns, and/or gloves; and use of eye protection may reduce the spread of respiratory viruses.” The paper added that results were inconsistent across studies and that the evidence overall was seen as very low certainty. The best evidence (moderate certainty) was for handwashing plus masks. None of the meta-analysis numbers from Jefferson were updated and so the figures remained the same.

This Cochrane review thus also supported wearing masks, along with many other measures, for reducing the risk of virus transmission.

One other paper was worthy of review from this second search. A paper from 2017 was called “Effectiveness of masks and respirators against respiratory infections in healthcare workers: A Systematic Review and Meta-Analysis” (Ref 16). As the title states, this paper undertook a systematic review and meta-analysis of the benefit of masks and respirators against respiratory infections in healthcare workers. Meta-analysis of randomised controlled trials found evidence for a protective effect of masks and respirators against respiratory illness. Meta-analysis of observational studies found evidence for a protective effect of masks and respirators against SARS specifically.

Despite the fact that our research question is about masks and the general public, I reviewed this paper because I am not aware of any debate questioning the value of masks among healthcare workers. This makes me think that I should have openly challenged the official mask advice sooner, as it has never made sense that masks help healthcare workers, but no one else.

The proposal

The campaign #Masks4All is encouraging people to make and use cloth masks and to make the cloth masks look very different to health care worker masks, so there can be no accusations about the general public having taken masks needed for front line staff.

Eric has been researching in parallel and he helpfully found an article from 2015, which has been cited 23 times (a measure of impact) (Ref 17). This study, published in the BMJ, involved 1,607 hospital health care workers, working in high risk wards. The wards were randomized to medical masks, cloth masks or a control group (usual practice, which included mask wearing). Participants used the mask on every shift for 4 consecutive weeks.

The paper abstract (summary) claimed that the rates of all infection outcomes were highest in the cloth mask group. The relative risk was given as a huge 13 (CI 1.69-100.07) for Influenza Like Illness (ILI). What the abstract didn’t say was that ILI was self-reported. When laboratory confirmed viruses were compared, there were no significant differences between actual viruses in the medical or cloth mask groups.

Putting this all together

The official advice from the WHO, US, UK and many other authorities is that masks don’t help and might possibly harm. Masks are claimed to be of possible harm in three ways i) by giving a false sense of security, ii) by transmitting infection if not used properly, and iii) by reducing masks available to health care workers.

i) This review does not find evidence to support (i) – any security afforded seems valid, not false.

ii) The BMJ article on cloth masks appeared to offer evidence for (ii), but this was found to be invalid and frankly disingenuous. If there are risks of repeat-use cloth masks, as opposed to throw-away surgical masks, these risks can be alleviated by making sufficiently robust masks, washing them appropriately (Ref 18) and avoiding the chance of the masks contaminating surfaces – as shown in Eric’s video. (Plus – if infection did get on the mask, that was almost certainly an infection that would have got in the nose or mouth indicating that the mask helped. If the person cares for their mask properly, it can help them again, and again.)

iii) This review dismisses (iii) – save masks for care workers – as being irrelevant to the research question – can masks help? (iii) might be a public health strategy to protect limited supplies for health care workers. That would be understandable, but it doesn’t provide evidence that masks don’t work. On the contrary, it emphasizes their value. Health care prioritization can also be supported by the helpful online campaigns to encourage people to make their own masks.

As I was finishing this article and wondering why the official advice is as it is, there were signs that this might be about to change. Eric alerted me to a Wall Street Journal article reporting that the US is reconsidering its position following revised guidelines in some parts of Europe (Ref 19). Trust is vital at the current time and we need to be able to trust official advice. There are many things that we don’t know and for which we don’t have evidence, but on this topic we do and have had for some time. Clearly ‘saving masks for the frontline’ has been a factor and this was explicit in the Surgeon General’s tweet and in The Lancet paper “Rational use of face masks in the COVID-19 pandemic.” But that doesn’t excuse not following the evidence and not providing alternatives for the masses.

The bottom line is that there is evidence that wearing a mask reduces the risk of virus transmission. It looks like the west needs to embrace the culture of the east from this point on. We need to make mask wearing (and making) “the way we do things around here!”


Ref 1:
Ref 2:
Ref 3:
Ref 4: Dr Jenny Harries with the Prime Minister, Boris Johnson, at 10 Downing Street, March 11th, 2020.
Ref 5:
Ref 6:
Ref 7:
Ref 8:
Ref 9:
Note 10: My PhD was an application of systematic review and meta-analysis to the dietary fat guidelines and so I am very familiar with (and trained in) this technique. A full systematic review adheres to established methodology (PRISMA) and can take weeks/months, but a top-level systematic search can provide a good starting point to answer a research question.
Ref 11: Feng et al. Rational use of face masks in the COVID-19 pandemic. The Lancet. 2020
Ref 12: Leung et al. Mask masking in the COVID-19 epidemic: people need guidance. The Lancet. 2020.
Ref 13: Jefferson et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2011.
Ref 14: Burch & Bunt. Can physical interventions help reduce the spread of respiratory viruses? 2020
Note 15: If 1 in 1million people taking a drug have an event and 1.3 in 1 million people taking the placebo have an event, the relative risk difference is 30% (1.3-1.0). The absolute risk difference is 0.3 in 1 million. Big difference!
Ref 16: Offeddu et al. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. 2017.
Ref 17: MacIntyre et al. A cluster randomised trial of cloth masks compared with medical masks in healthcare workers. BMJ Open. 2015.
Ref 18: A quick search didn’t produce academic references on this, but a trusted consumer site suggests that using detergent and washing at 60’c or even 90’c will kill germs
Ref 19:

22 thoughts on “COVID-19 – do masks help?

  • avatar
    August 11, 2020 at 11:01 pm

    Hi Zoe,

    Curious how your thoughts on wearing masks may have evolved over the recent months. Assuming you have been following the trends for the virus to have its similar course with or without lockdown and mandatory masks. I differ with Dr Westman and others who remain steadfast on their benefit exceeding their costs. I’ve even left my Democrat party (45 years devoted) recently because of what I perceive alongside Ivor as a travesty in authoritarian mismanagement.

    As always, thanks for your diligence and candor.


    • avatar
      August 12, 2020 at 7:29 am

      Hi Paul
      It’s been really interesting looking back at COVID stuff written at the time and I really wouldn’t change much – if anything.

      The research question here was do masks help and the evidence at the time (mostly from Cochrane) suggested that there was some evidence of impact. This was counter to the government advice at the time – the Jenny Harries (UK medical officer) words shared.

      I’ve seen stuff since on the size of the SARS CoV-2 particle and what masks can keep out which I haven’t researched fully to verify or otherwise, but – if true – it would require the research question to be specific to different viruses and there’s little enough general info, let alone virus specific info. The issue of whether or not they are of any use when people are already (by law in Wales incredibly!) 2m apart and/or when people walk past each other in a shop/on a street is another matter and other aspects of wearing them (comfort, heat, elderly/unstable people not being able to see feet, civil liberties etc) is another matter again.

      But this post summarised what evidence was available as of the end of March 2020.

      Best wishes – Zoe

      • avatar
        August 12, 2020 at 3:21 pm

        Thanks, Zoe.

        Yes, questions re particle size and masking, along with false confidence, handling/reuse of masks, etc., are important to the discussion.

        And the larger question of how this virus acts in the world is on everyone’s mind. (When we see people walking alone in the woods or by the ocean, wearing a mask, we MUST ask ourselves whether the idea of masks ascribing extra safety is going to far.)

        Your article is cited by Dr. Weston as proof we should all be masking up—after all, it can’t hurt, right? I find that unfortunate.



      • avatar
        August 12, 2020 at 7:28 pm

        Have you read this from the CDC in May?

        “Evidence from 14 randomized controlled trials of these measures did not support a substantial effect [of face masks] on transmission of laboratory-confirmed influenza.”

        Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures. (

        Your article came on the heels of the WHO suggesting people should NOT wear masks. I saw this as an attempt to retain a hold on a limited supply of masks for health care workers rather than a statement on their efficacy. However, my views have changed based on further study, and I believe that it is a valid criticism leveled at their use (or at least the level of their efficacy).

        I would invite you to reassess your review of (i), that a sense of security surrounding the use of masks (many, including the fashionable vented type easily transmit viruses FROM the wearer). Regarding (ii), “If there are risks of repeat-use cloth masks, as opposed to throw-away surgical masks, these risks can be alleviated…” does not reflect your typical, rigorous review. Rather, it points to an assumption that questioning the safety is, in itself, “disingenuous.” (Am I misreading this?0

        I don’t mean to be simply critical, but because I place so much stock in your findings, Zoe, I feel compelled to bring my questions forward.

        Thanks, as always, and with respect,


        • avatar
          August 13, 2020 at 10:37 am

          Hi Paul
          As I closed with before – this reflected the evidence available at the end of March and it was what it was.

          The reason I described the BMJ cloth mask paper as disingenuous was explained in the article: “The paper abstract (summary) claimed that the rates of all infection outcomes were highest in the cloth mask group. The relative risk was given as a huge 13 (CI 1.69-100.07) for Influenza Like Illness (ILI). What the abstract didn’t say was that ILI was self-reported. When laboratory confirmed viruses were compared, there were no significant differences between actual viruses in the medical or cloth mask groups.”

          IF I reviewed masks today the conclusions would be different – you shared a more recent article above. A number of others have been written since. This is one of the most definitive (
          “We know that wearing a mask outside health care facilities offers little, if any, protection from infection. Public health authorities define a significant exposure to Covid-19 as face-to-face contact within 6 feet with a patient with symptomatic Covid-19 that is sustained for at least a few minutes (and some say more than 10 minutes or even 30 minutes). The chance of catching Covid-19 from a passing interaction in a public space is therefore minimal. In many cases, the desire for widespread masking is a reflexive reaction to anxiety over the pandemic.”

          Compulsion has been introduced since I wrote the end of March review (not a policy I support). People wearing them because they have to rather than because they choose to should be the subject of a study in itself. Those who wear them because they have to tend to keep the same mask and not bother with changing it or cleaning it. They take it off and stick it in a dirty pocket or handbag in between outlets where they have to wear it. They tuck it under their chin and then slide it up when they need to. They constantly touch it and breach all guidelines for using a mask effectively. Those who wear one out of choice treat it very differently.

          I hope this helps! And never worry about constructive challenge – that’s how we all progress!

          Best wishes – Zoe

  • avatar
    July 10, 2020 at 12:57 am

    Lots of good, pragmatic information summarized here. The hashing of “NO mask wearing!” then “MUST wear masks!” with no real reasoning for the change made me not trust the people making these edicts (the same with “you can go to the beach but avoid wet sand and you cannot swim”). People need reasons for why policies change and a LOT of government rules implemented had no scientific reason.
    My question is a big one regarding the use of all remediation methods (masks, 6′ distancing, strict area sanitizing and hand washing):
    When do the rules begin to be needed and when do they have little effect so they can be dispensed with?
    The data shown proves remediation methods help stem the spread (masks especially containing spew from ill individuals) but most Western nations have not mandated these remediation methods until SARS-COV2. There are other diseases that have killed similar or higher numbers and we have not, in general, been mandated to use these methods. When (non-SARS-COV2) flu season hits, will all the remediation methods be reinstated? Will we EVER get away from masks/distancing/sanitizing/etc.?

    • avatar
      July 10, 2020 at 8:12 am

      Hi Harry
      Good point! The best single paper on all this is the 2011 Cochrane paper that looked at hand washing, masks, physical distancing etc. But that’s just for evidence for protection once there’s something to be protected from. I don’t think anyone is looking at what you’re talking about – when should this stuff start and when should it end. Living in Wales (still in full lockdown pretty much), I’m very interested in the latter!

      I am refusing to accept any talk of ‘new normal.’ As you say – we get viruses every year – check out how many each year in fact! ( This just happens to be the first one that the so-called developed world has reacted to. Which will we react to in future? Who knows. I’m hoping once the net deaths have been worked out for this one, we never lock down ever again.

      Best wishes – Zoe

  • avatar
    June 18, 2020 at 2:45 pm

    I wonder if there has been anything new on the effectiveness of face masks since this article on 1st April? My elderly mother is in a care home (she has dementia) and I learned today that the care home group (one of the largest in UK) are hoping to introduce visiting. They tell me the visits will only take place outside and we must be 2m apart – this is fine. But they add that I will have to wear a face mask, which (in my opinion) hugely negates satisfaction and enjoyment of the visit. Mum will not be able to see me smile (or any other facial expression) and may have trouble hearing me speak. I am inclined to think the rule of having to wear a face mask at this occasion is overkill and under these conditions (outside and 2m apart). Am I missing something?

    • avatar
      June 18, 2020 at 3:33 pm

      Hi Linda
      All of your points are very valid. It will be wonderful for your mother and you to see each other again but you’re right that this won’t feel comforting for her (or you).

      The most recent evidence on this was included in The Lancet paper that looked at social distancing ( That post might be of interest for you too as it looked at the transmission of viruses and concluded that pretty much only spouses/carers and people sharing a bed room were likely to catch the virus from someone infected.

      I think even the gov says it’s OK for people to meet sitting 2m apart outdoors and they don’t add mask wearing. However, if it’s home policy, you’ll need to follow it.

      Best wishes – Zoe

  • avatar
    April 12, 2020 at 1:41 pm

    I’m not a fan of masks when it comes to stopping people from becoming infected. They are great for stopping yourself from infecting others. There are just too many ways that wearing a mask can harm the wearer. If I was to go out when I had possible symptoms then I would wear a mask but, if we have the symptoms then we shouldn’t go out. Personally I would like to become infected with COVID-19 as quickly as possible so that I will have immunity in the future. As a long-distance runner, I would probably kill myself trying to run with a mask. Being outside in the fresh air is beneficial to most people right now and if we were forced to wear masks then I feel more people would not go out. I know some folk who refuse to go out because people keep shouting at them that they are supposed to stay indoors. The message seems to be getting scrambled and I feel face masks would make things worse as in “I can’t go out because I haven’t got a mask to wear. I know that the last bit is silly by the way.

    • avatar
      April 12, 2020 at 1:49 pm

      Hi John
      All good points.

      My goal was to look at the evidence and the evidence does support the fact that masks reduce transmission.

      Notwithstanding that I’m pretty confident that hubby and I have had this – like you – I would be wanting to get it if I hadn’t already. The ‘masks work’ issue does not address the other big issue of herd immunity – which we will need until/unless a vaccine arrives if the vulnerable are ever to get out of lockdown – which has its own harms. Unless SARS-CoV-2 dies out as as SARS-CoV did.

      Reducing the spread and herd immunity among the healthy (which is essentially the vaccine principle) are not compatible!

      Best wishes – Zoe

      • avatar
        April 12, 2020 at 7:04 pm

        Thank you Zoe, I am with you as far as herd immunity. We are currently looking at whether insulin resistance is playing a part in the number of deaths. I have heard nothing from the NHS regarding the use of high dose vitamin C, vitamin D, vitamin A, vitamin B1, zinc and magnesium. I’ve sent the information and links to trials to as many GP’s as I know but with no response so far. I’ve also been telling people that quercetin and liquorice root are excellent when used as an antiviral and preventative. Even New York hospitals have started taking up parts of this and New York is normally staunchly pro Big Pharma. I have lost all faith in the advice being given to the health minister. I have been sanctioned by both Google and Facebook for my “fake news” so I have had to become creative. I wish you more luck than I have had.

  • avatar
    April 2, 2020 at 3:41 pm

    Would steam-ironing a cloth mask be adequate to kill any coronavirus on them?

    Might be an awful lot quicker and easier than washing every time – so long as what they are made from can take it.

    • avatar
      April 2, 2020 at 3:46 pm

      Hi there
      Top thought. This is what Dr Eric Westman thinks will be a good plan too. He suggested 10 secs of steam ironing. We’ll all have super tidy masks eh?!
      Many thanks for this
      Best wishes – Zoe

  • avatar
    April 2, 2020 at 2:18 pm

    Hi Zoe, great article, as usual. I’ve been wondering why we’ve been told here in the UK that generally masks don’t help, yet care givers need them. The entire Far East can’t be wrong! So, I’ve decided to order some cloth ones. They may not be as good as the ones the NHS use but at least if I have it but have no symptoms, it lowers the risk of transmission. Plus, because I do find I touch my face a lot (which I’ve really started to notice) a mask will be a deterrent. I don’t agree that it makes people less careful with hand washing and social distancing, I think it will act as a constant reminder. I like the slogan “I protect you and you protect me”. The government want our cooperation and trust, perhaps they need to be honest when they either don’t know or get it wrong. Those in the Far East must think we’re crazy!

      • avatar
        April 3, 2020 at 5:56 pm

        Hi, well I’m now watching today’s update from the government and Jonathan Van-Tam has reiterated what the WHO are saying, that masks don’t help. My faith in our esteemed leaders and the ‘experts’ they call on is diminishing. I thought the government’s stance on our diet was perhaps a one-off failing…perhaps not. Maybe our health secretary should have at least a background in medicine or social care, instead of being a number-cruncher. I am planning to still wear mine when I go out. I despair.

  • avatar
    April 1, 2020 at 6:08 pm

    Thanks for going over these studies so carefully, Zoe. My question is, where are a few hundred million masks supposed to come from? I know people say “make your own,” but 1) most people don’t sew anymore and 2) people don’t necessarily do as they told. They’ve been told not to hoard groceries, for instance, but they’re still doing it. There’s already been an indication that thousands of masks are going out the back door at a hospital in New York.

    • avatar
      April 1, 2020 at 7:04 pm

      Hi Lori
      Fair point and that does seem to have been the driver for telling us that they won’t help. But they will – is it fair for people, trying to protect high risk loved ones, to go out without reducing their risk as much as possible? We can use scarfs, sleep eye masks, copy Czech where people have been making them and leaving them for people to take. The on line videos do have some great ideas.

      It’s a difficult balance because the care workers should have priority, but this could also reduce the number of people needing care workers.

      The NY thing is really disappointing to hear. Some people are being brilliant right now and others are staggering. Folk eh?!
      Best wishes – Zoe

  • avatar
    April 1, 2020 at 2:45 pm

    Of course, PPE is protective; that’s why it is called Personal Protection Equipment.

    Medical staff, in general, is not suicidal enough to choose a profession where you are in serious danger of getting infected with something that can lead to your death when there is no means to protect yourself.

    But even though, we should talk about a cultural change towards covering your own face to protect others from infections in the future – or, you know having a diet that doesn’t make you susceptible to general infections in the first place, right now, we have a serious shortage on PPE worldwide.

    Since social distancing along with proper hygiene and common sense politeness (like sneezing and coughing in your elbow and not in the direction of another person) and not touching your face works well in a normal setting, if you make it a routine (which of course requires self-discipline until it’s second nature), those surgical masks should go to people, who can’t obey those rules by nature of their profession.

    If you’re a nurse or a doctor you simply can’t do your job from 6 feet away, because those jobs require you to be in nearly constant physical contact with your patients.
    And I’m not just talking COVID 19 here. There are patients with HIV and AIDS with whose bodily fluids we have to work. More dangerous are HCV and of course the plethora of nosocomial infections from MRSA to 4 MRGN, that we also need PPE for. And these few examples are not even beginning to cover it. Those patients still exist and need help too.

    So please, if you read that article o NOT go on a website and buy surgical masks if you don’t need them for caring for somebody at home and otherwise work in a normal job or currently not at all.
    Especially in light of the fact that a lot of the stuff currently available at eBay is probably stolen from hospitals and deliveries meant for them.
    Sew your own protection masks, they usually reduce your risk to get infected about 30 % and for everyone else about 90 %. (
    But wear them correctly (meaning tight and not when they are wet from your exhales, so make more than one for a day), make sure you can wash them at least 60 °C and do NOT use them as an excuse to not practice social distancing, because then you will do more harm than good.

    Because in all honesty: for now I can still justify using less equipment than usually required even though I’m more afraid than ever to become infected.
    But like I said: I am not suicidal.
    If I have to work without, I will quit my job.

  • avatar
    April 1, 2020 at 12:46 pm

    Before you published this, I had searched Amazon UK for “face mask”.
    There are lots of them available!

    I want a mask, or perhaps a set of disposable masks, both to avoid spreading COVID-19 if I have it, and to reduce my risk of catching it.
    (I don’t think I have COVID-19, but I would like both an antigen test and an antibody test to find out).

    Now I don’t know what to buy! The ones at Amazon UK are not expensive. But are they effective?
    (I suspect most will reduce the likelihood that I will spread COVID-19).

    • avatar
      April 1, 2020 at 5:38 pm

      Hi Barry
      I did look at some on amazon for a worried friend but the reviews were terrible – paper thin, flimsy, sent from China said some (which would impact delivery time) and they looked like surgical masks, which makes you wonder if they could have been diverted from healthcare. The Masks4All campaign is trying to get people to make clearly non surgical masks to avoid any harassment.
      If you have a sleep eye mask, they’re pretty good for mouth and nose coverage! If you look at the chart in this note, you can see that glasses also help, but I guess you’ll be trying not to go out. Hope friends, family and neighbours are looking after you – not least because the gov food parcel doesn’t look like what you’d eat!
      Best wishes – Zoe


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