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What difference are Facemasks making?

Here’s a statement of fact, with which readers will be familiar: Despite the ubiquitous use of facemasks in public spaces, workplaces, supermarkets, and lots of other places, Ireland presently has some of the highest covid case numbers on the planet.

We are all familiar with how facemasks are supposed to work to reduce the spread of infection: Covid 19 is an airborne virus. When an infected person exhales, they spread the virus across the room in which they are breathing. The facemask captures viral particles, and, as a secondary benefit, limits the circulation of the air from a person’s mouth, or nose, meaning that the viral particles will not reach others in the same room. Meanwhile, the uninfected person in the room benefits from their own mask, which – in theory – captures some viral particles and prevents them from being inhaled.

Despite this, Ireland has – it bears repeating – some of the highest case numbers in the world.

At the beginning of the pandemic, the medical authorities were, readers will recall, united in their opposition to the wearing of facemasks. Indeed, the arguments were compelling. Here is the Irish Times, in April 2020:

As the number of people wearing protective face masks in Ireland soars one of the State’s leading virologists has warned that the equipment may actually be doing more harm than good .

Dr Kim Roberts of the Trinity College virology department told The Irish Times that while there was some evidence suggesting face masks when worn correctly can have “a modest effect” on reducing transmission of Covid-19, “if not worn correctly, masks can pose as a hazard and can potentially increase the risk of transmission of the virus”.

Here is the Irish Times, again, in March 2020:

There is no evidence to support the wearing of surgical masks by healthcare workers for close patient encounters and staff meetings, according to new official guidance.

The guidance was issued by Health Service Executive clinical lead on infection control Prof Martin Cormican in response to moves towards routine wearing of face masks by a number of hospitals.

One Dublin hospital last week advised staff they should wear surgical masks for all patient encounters and meetings between staff where social distancing of at two metres cannot be maintained.

Now, it’s fair to say that there was, subsequent to these stories, what the Times itself described as “a big shift in medical thinking around masks”. Coincidentally, that shift in thinking took place shortly after the worry about mask supplies became less urgent, though nobody in their right mind, obviously, would ever suggest that scientific advice might be politicised, least of all in Ireland.

Nonetheless, we are now in a very different place. Universal mask wearing. Record cases.

Is it not, then, fair to ask this question: What if the original advice was correct?

Remember what the warnings were: That people would not wear their masks correctly. Does that sound familiar? That people would not take proper care of them. Does that sound familiar? How many people, reading this article, have a facemask in their car that has not been washed in weeks? How many have one stuffed in their pocket? How many of you have children who have one in their schoolbag and stuff it in and out of that bag five times a day?

These are questions that seem almost verboten, in polite company. To be an “anti-masker” is second only to being an “anti-vaxxer” in the grand scheme of holding socially undesirable views. And yet, here we have, from the beginning of the pandemic, scientists warning that masks actually might make things worse if they were used incorrectly. Which, we all know, they widely are.

Is it not possible, then, that the mask itself has become more a cultural garment than a medical one? That we wear them not to be safe, but to feel safe, and to make others feel safe? In my own case, that is certainly true: I wear one not because I think it works, but because the law says I must. It lives on the passenger seat of my car, beside the dog’s collar, and lead. Sometimes, on busy weeks, it might be buried under some paperwork, or an empty crisp packet. As a supposedly sanitising medical implement, it fails some very basic tests.

The point here is that these are not my views: It is reality. And it is a reality that scientists actually warned about, and said that it might actually exacerbate the spread of the virus, rather than contain it.

The problem, of course, is that hardly anybody who wears a mask – at least, in my experience – really wears it for protection at all. They wear it for a range of other reasons – cultural, political, convenience, the sense of safety it provides. They do not actually treat their masks as they would any other piece of medical equipment.

And so, isn’t it fair to ask: What if the science at the start of the pandemic was actually right, and we’ve been getting it wrong ever since? After all, it’s not as if the masks have stopped us having the highest case rates in the world.

So why are we still wearing them, exactly?

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