Garth A. Rattray | Barefaced ignorance – Part 2

The initial ambivalence displayed by major internationally recognised health authorities is partly to blame for the unenthusiastic acceptance of wearing masks to reduce and slow the spread of COVID-19. First, we were told that wearing masks in public was not necessary.

Then they said that we could wear masks, and then they said that we should. Now that we are told that masks are required, not many people are taking this seriously, and it certainly is not being enforced.

COVID-19 is spread by fomites, sneezing and coughing, but asymptomatic persons also expel innumerable infected droplets and aerosols during regular speech. Some of the expelled material can float around and even remain suspended in the air, especially indoors, for a variable time.

Masks worn by the general public made from heavyweight or multilayered cotton are pretty good at trapping expelled material. Handkerchiefs, scarves and bandanas are less effective, but they are still very useful.

Someone online mocked masks because he could smell someone’s flatulent expulsion through his mask and questioned how protective they are against a tiny virus. However, the gas that gives fart its distinctive pungent odour is hydrogen sulphide; it has a diameter of around 133.6 picometres (a picometre is one-trillionth of a metre). On the other hand, the SARS-CoV2 virus has a diameter of around 100 nanometres (a nanometre is a billionth of a metre). A nanometre is 1,000 times bigger than a picometre. In other words, a virus is humongous compared to gas.

Jamaica has been doing exceptionally well at keeping our numbers low; however, if widespread random testing were done, more cases would certainly be discovered. We really do not know precisely how many infected but asymptomatic and infectious people are walking around.

SPREAD WILL BE MINIMAL

If everyone wears a mask, the spread will be minimal. Unfortunately, most persons in Jamaica do not wear masks; and many people wear them on their chins or under their noses. Because of the possible disastrous consequences of going around in public without a mask, I consider that to be inconsiderate and dangerous, barefaced ignorance.

Most citizens are not even practising proper physical distancing and good hand hygiene. Those shortcomings, along with refusing to wear masks, constitute a recipe for disaster. Countries and jurisdictions that make masks mandatory, along with physical distancing and good hygiene, have slowed the spread of the virus considerably.

During a pandemic, medical ethics forbids experimenting on people by telling them not to wear masks and monitor them for infection, so the epidemiological evidence for the benefits of masks comes by way of “experiments of nature”.

In at least two documented instances, COVID-19-infected individuals with coughs who wore masks did not infect those in close contact with them.

Masks are pretty good as ‘source control’ – preventing expelled droplets from getting far. Surgeons operate on all sorts of exposed organs and other body parts all day and their masks prevent them from infecting their patients. We can’t totally negate our risk of catching COVID-19, but we can significantly reduce it if everyone wears a mask in public … it’s that simple.

Wearing the most sophisticated mask does not fully protect the wearer from catching COVID-19 because it can be caught through the membranes in our eyes. It’s strongly believed that, if even 80 per cent of the population wears masks (any type of mask that covers the mouth and nose), that will be more effective than a total lockdown.

COVID-19 is here to stay, and vaccination may be the best solution. Herd immunity kicks in when about 75 per cent of the population develops immunity (by infection or injection) but, so far, some places are only reporting single-digit (possible) immunity rates per capita. This is why I consider people in public without masks to be barefaced ignoramuses.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.