Mask on, please

Six months after the first case of COVID-19 was reported in Wuhan, China, more countries have started relaxing restrictions. People are going out again, businesses have resumed, limited travel is being allowed, and social gatherings are back. But, with no vaccine yet in sight, how safe is it out there, and what can people do to keep themselves from getting the virus? Novak Djokovic’s doomed Adria Tour, the charity exhibition tournament organized by the world’s top-ranked male tennis player, now serves as a sobering reminder for the rest of the world rushing to return to normal about the folly of abandoning precautions such as maintaining physical distance, washing hands frequently—and wearing face masks.

The tour, planned across four Balkan nations, was canceled after player Grigor Dimitrov tested positive for COVID-19; he played in Serbia, the first leg of the tour, and complained of fatigue after a match in Croatia, the tour’s second stop. Last week, Djokovic, his wife, and two more players also tested positive, prompting Djokovic to apologize and declare that “Unfortunately, the virus is still present, and it is a new reality that we are still learning to cope and live with.”

The tournament was heavily criticized for its lack of social distancing and health restrictions amid a pandemic that has killed almost 500,000 worldwide. “Players were seen hugging and huddling together for photos, and were filmed playing basketball together on off days,” according to ABC News. “Videos also emerged of parties in which players joined each other on stage, dancing together with their shirts off in front of crowds of people. Players and staff did not wear masks throughout the event.”

That oversight appears to be crucial. Several studies have suggested that wearing face masks is particularly effective in containing the spread of COVID-19, combined with physical distancing and handwashing.

A modeling study from the universities of Cambridge and Greenwich showed that face masks—even crude, homemade ones consisting of facial tissue and paper towels as inner layers—when “worn all the time, by a high proportion of the population,” have a high efficiency rate in preventing the virus’ spread. Another study led by Dr. Christopher T. Leffler of the Virginia Commonwealth University in Richmond supports the observation that places like Thailand, Japan, South Korea, Hong Kong, Vietnam, and Taiwan saw lower COVID-19 mortality rates because wearing face masks was already common, or was made mandatory early into the pandemic. “[…] Societal norms and government policies supporting mask-wearing by the public were independently associated with lower per-capita mortality from COVID-19. The use of masks in public is an important and readily modifiable public health measure,” said the study. A Reuters report, meanwhile, highlighted the main finding of another study published in PNAS, the Proceedings of the National Academy of Sciences of the United States of America: that “mask-wearing is even more important for preventing the virus’ spread and the sometimes deadly COVID-19 illness it causes than social distancing and stay-at-home orders.”

But are face masks harmful to health, as some claim? Cebu Gov. Gwen Garcia was recently photographed coming out of a meeting without a face mask on, violating government regulations. Police have routinely pounced on ordinary people without face masks in the last three months of harsh quarantine. When called out on social media, however, Garcia retorted: “Para nako [for me], INHALING back the CARBON DIOXIDE that I EXHALE while WEARING A MASK will CAUSE overall EXHAUSTION, LOWER my IMMUNE SYSTEM and AFFECT my brain.”

That is dubious science at best. The claim that face masks could cause hypercapnia (a condition of abnormally elevated carbon dioxide or CO2 levels in the blood) or hypoxia (a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level) is scientifically unsupported. The World Health Organization-philippines said there is no evidence that using face masks for a prolonged period could affect the brain or the heart. And, as noted by a USA Today report, “Neither the Centers for Disease Control and Prevention nor the WHO has issued warnings suggesting the use of surgical face masks would result in dangerous oxygen level depletion within the general public.”

The use of face masks as an affordable, accessible, and effective first line of defense against COVID-19 cannot be overemphasized: South Korea’s so-called superspreader was a 61-year-old woman who attended a religious event where participants were asked to remove protective masks to pray. The recent clusters of infection in the United States were not from the massive anti-racism demonstrations where majority of the protesters wore masks, but from social events and gatherings where people did not.