Here is the transcript of this “debate” of ideas: I shouldn’t mislead you by saying that they are equal. One side is based on facts the other…I’m not sure. Over-reliance on others? I guess you could claim that I have the benefit of hindsight. However, I’m not a reporter. Nor am I a medical correspondent. The data I provide is not new. It’s old. It’s also common sense. It’s obvious to anyone who has reviewed the data on face masks that has been around for decades and studied since the SARS outbreak of 2002.
Dr. Michael Morgenstern: I’m Dr. Michael Morgenstern. Today I’m going to debate Dr. Jen Ashton on the importance of face masks. We’re going to let Dr. Jen Ashton start, and I think you’ll appreciate that this is a pseudo debate.
Dr. Jen Ashton: we put surgical masks on sick people to protect healthy people around them. They serve an emotional or psychological benefit for people because people feel more protected. The reality is. They don’t really provide us with protection.
Dr. Morgenstern: it may be true that surgical masks provide an emotional or psychological benefit to the individual who’s wearing the mask. The fact though is that it also serves to stop the spread of coronavirus because most of the spread of coronaviruses due to large Droplets that would get trapped if I were wearing a mask and if I was infected at the same time. We believe that it will also protect you from catching coronavirus and there are some good reasons for that.
Dr. Ashton: So, there are basically two types of masks. There’s surgical masks and their masks called respirators. Let’s start with the surgical masks in a hospital setting. I’m a surgeon. I do real surgery when I go into the operating room and I put a surgical mask on, it is not to protect. Um, myself from getting sick in an in a sterile environment, it is to protect the patient that I’m operating on in case I spit while I’m talking or cough or sneeze.
Dr. Morgenstern: It may be true that when you go into the operating room and put on a surgical mask, that you are just trying to protect others and are not concerned about whether or not you yourself will get infected. Number one, I would say that is one of the primary reasons why we would want anybody in this environment with coronavirus out there wearing surgical masks or another face mask or a face covering. And the reason is because they may be infected. They don’t know they’re infected, they spit onto somebody else, they sneeze onto somebody else, they cough onto somebody else or something else, and that ends up infecting other people. That primarily is the reason that you would wear a surgical mask in surgery. Others, according to the Institute of medicine, would wear a surgical mask during surgeries, prevent bodily fluids from getting into their mouth, and I think that’s the same reason why you would. Probably cover your face with some sort of shield, as I’m sure you do when you do surgery, and you may have seen other surgeons that do the same thing because they’re protecting their bodily fluids from blood or other splashes that could take place during surgery.
Dr. Ashton: surgical masks that you see all over television and video. They do not block out the tiny particle size of Corona viruses or influenza virus. They don’t. Those viruses can pretty much go right through those masks.
Dr. Morgenstern: The bottom line is that coronavirus is mostly spread through Droplet contamination. So, if somebody is coughing, they’re not likely to create aerosolized viral particles capable of infecting other people. So, wearing a surgical mask or any face covering should generally work to prevent you from getting infected by large Droplets. They may not filter out particles. Although the reality is that even penetration testing of Hanes t-shirts shows that they will filter out up to 55% of viral particles. So, it’s not accurate to be saying that they don’t filter out any viral particles because they do, but it’s also misleading because research shows that wearing surgical masks or face coverings works quite well to prevent individuals in hospitalized environments and caring for sick individuals with influenza from actually catching the virus. And we don’t have good enough data to support the fact that, N95 respirators would do a better job just because the disease theoretically could be aerosolized. I think that’s really important to point out to individuals.
Dr. Ashton: Now you would ask. Well then why? If you’re sick, we’d use those masks. Do anything simply as a barrier. It could be a plastic wall, it could be a, you know, a scarf. But masks are just convenient to give to a patient if they’re coughing or sneezing.
Dr. Morgenstern: I couldn’t agree more with Dr. Jen Ashton in this respect. Using any type of face covering, whether it be a plastic wall a plastic barrier a wall or a scarf, just covering your mouth with any face covering a DIY or homemade face mask. Those things are going to act as a barrier and they’re going to stop individuals from spreading this virus, and we need to do everything we can right now to make sure that this virus doesn’t spread to other people who are not sick.
Dr. Ashton: Then you go to the end 95 respirator. There are a bunch of different models. They come in different sizes, different shapes. Those are for health care providers. When they are taking care of a sick person with a high impact respiratory pathogen, they’re called because they block out 95% of viral particles. You have to be fit, tested for those masks, a specialized process. Um, if you’re not. They can actually also do more harm than good.
Dr. Morgenstern: I don’t see very much evidence, if any evidence to suggest that individuals will do more harm than good by wearing a face mask that doesn’t work for them. Let’s think about it. If the face mask doesn’t work, they’ll get infected. If they don’t wear a face mask, they’ll get infected. If the face mask does work. Then it will protect them, so I don’t see where it’s going to cause more harm than good. I’ve heard people say they’re going to touch their mask and then they’re going to fiddle around with it, but there’s so much more science that shows that the mass will help than any science showing that it would lead to [touching your face]. I’ve not seen any science that shows that people are going to touch their more masks more and that’s going to lead to more infection.
Dr. Ashton: I totally get that people feel more comfortable if they have a mask on, it’s talking about a distinction between concern for me. As an individual, me, myself, and I, and, and my role to protect those around me. So, it’s a difference of being selfish and selfless or thinking of the needs of others before the needs of oneself, however you want to describe it. That’s pretty much what the surgical mask issue comes down to.
Dr. Morgenstern: Just in case you need to hear this from somebody who is an infectious disease specialist. This is a clip from Dr. Colleen Kraft, who’s an infectious disease specialist at Emory university:
Dr. Colleen Kraft: The mask not only protects you against sort of that Droplet, but it protects you from bringing your hand. Which may have virus on it to your mucus membranes, such as your nose, your mouth. There’s an element of protection that it gives you as good as you know how to use it, good hand hygiene, you know, not coughing. in other people’s faces, not being in crowded area, watching what you’re touching, watching and how you touch your face. All of those things kind of go together. Not like a magic bullet, but it certainly is something that can help you protect your airway against things that you breathe in.
Dr. Morgenstern: I think this is really important given the amount of misinformation that’s out there. I think a lot of people didn’t know right up front what was going on, but the media has this role to play that is extremely important, especially health reporters. They need to make sure that those facts are right.