Masks helped less, harmed more

Among other things, the state of Maharashtra lifted its mask mandate on April 02, 2022. Was there any scientific evidence in the first place behind universal usage of masks by everyone everywhere? Did masks aid in preventing Covid spread, as was the stated aim? Was there any harm due to such universal mask usage? It is important to examine these, as it could affect future decisions.

Masks have been promoted under several assumptions: (A) droplet transmission; (B) asymptomatic transmission; (C) everyone is at threat from Covid-19; (D) immunity from natural exposure does not exist; and finally (E) there are no costs to everyone wearing masks everywhere. Let us examine these assumptions one by one.

Airborne aerosol transmission, not droplet transmission: In the early months of 2020, it was thought that Covid spread mainly through droplets, that is, coughing and sneezing, and large particles of saliva which can come out of the mouth while talking. This was also the basis behind the 6-feet distancing guideline.

However, it has been known for a long time that respiratory viruses are airborne: they are present in “aerosols”. These are 1 μm (micron= one millionth of a metre) in size or even smaller. A study of influenza respiratory viruses, published in 2008 says: “Over 87% of particles exhaled were under 1 μm in diameter”. In a study of the SARS-CoV-2 virus itself, published as early as July 2020 says “mucus/surfactant aerosols (size range between 0.2 and 0.6μm) can transport viruses out of the lungs of patients and be present in the room air for hours”.

What does this imply with respect to masks? The pores in masks, especially cloth masks are far greater in size compared to the above virus particles. And certainly the few milli-metres of gap which invariably comes in practice, between the mask and the wearer’s face, are millions of times greater in size. It defies scientific reality to think that such masks can filter the aerosols carrying virus particles.

Asymptomatic transmission negligible: Another claim which gained quick worldwide acceptance in early 2020, even without solid evidence, was that of asymptomatic transmission: “even people without any symptoms can be silent transmitters”. This claim was based on weak evidence: just a few case study reports. Later, a more methodical study published in Dec 2020 revealed that such transmission is very rare indeed (0.7%), statistically indistinguishable from zero. If transmission from healthy people without symptoms is negligible, the case for universal masking is weak indeed.

Is everyone at threat from Covid-19?: Another implicit reason behind universal masking is the claim that Covid is a great threat for all. But for most healthy adults of working age (under 60), the risk of Covid is comparable to other risks we are already used to. A study pegs the IFR (Infection Fatality Rate) in the 50-59 agegroup as 0.14%, which is in the range of the seasonal flu; and the risk for lower age groups goes down exponentially.

Indeed, how many children or even those under-40 do we know, who have been severely affected by Covid? Data shows that the risk of Covid for those under 25 years is about ten times less than that of traffic accident, and also about ten times lower than death by suicide! Given these, why should everyone put on masks everywhere? Why should even children in schools wear a mask?

Immunity from natural exposure: How strong is immunity after natural exposure to SARS-CoV-2? While known biology says that such immunity is strong, doubts have been cast on this aspect in the media, without any basis. Various studies have indeed affirmed the known biology. A cohort study of 17,000 healthcare workers in UK, published in Dec 2020, showed not a single instance of symptomatic reinfection. Later studies have also affirmed the same basic biology known for thousands of years!

After the second wave, sero-surveys have shown high levels of natural exposure among Indians: as high as 80-90% in cities like Mumbai and Delhi, as of Aug 2021 itself. And these cities did not have a noticeable third wave. Likewise, the slums of Mumbai had high levels of exposure in the first wave itself: as of Aug 2020, and they did not even have a second wave.

Strong immunity after natural exposure further weakens the case for universal masking.

The costs of universal masking: Is there no cost to insisting on masks for everyone everywhere? Those who have promoted masks must be humble enough to admit that it has been a global mass experiment. We simply do not know the long-term effects of such masking. Some of the early results of this experiment are not great. A study of children born in 2020 showed a staggering drop of 22% in average IQ, as measured by standard verbal, motor and cognitive ability.

Doctors in the city of Bengaluru in India reported that among children under the age of 5, there has been over a 10-fold increase in those with speech disorders, due to lack of social stimulation. How much of these was because of universal masking, covering one of the primary inputs to infants: adults’ facial expressions? Will these children ever make-up for the IQ loss?

Also unknown are the health effects of possible inhaling of micro-plastics over a long period of time. Furthermore, in India’s hot and humid climate, wet, sweat-soaked masks can be a breeding ground for other germs. This is of particular concern especially in children.

What about the societal costs of universal masking? These are there for everyone to see. Masks have served to promote anxiety, conveying to everyone that they are at constant danger. What does this constant anxiety do to their mental well-being?

With universal masking, everyone sees everyone else as a disease agent rather than a human being. What does this do to society’s well-being? And of course, there has been virtue signalling, shaming and blaming people for virus spread.

In conclusion, although masks have been far less harmful compared to other harsh measures like lockdown or school closure, they have been equally unscientific and based on weak evidence. Evidence-based measures, rather than wishbased measures are always a must. Hopefully we will learn our lessons for the future.

(Bhaskaran Raman is a Professor at IIT-Bombay. Views are personal).

(This was first published in National Herald on Sunday)