The discussion about face masks is widely held. In the Netherlands and abroad. Not entirely strange, because under the guise of unity, European countries often sheepishly followed each other in all kinds of measures during the pandemic.
Afraid if politicians are to be told afterwards that they had made a wrong assessment. ‘One hundred percent certainty’ and ‘it must never go wrong’ are statements made by people, including ministers, who either play politics with statements against their own better judgement, or have insufficient knowledge of epidemiology and statistics.
And so the discussion is repeatedly being held whether we should again be obliged to wear face masks everywhere, so that we again see people with face masks everywhere in public life and on the street. The tragicomic aspect of the entire discussion is that it ignores how, for what purpose and when face masks should be used.
‘The tragicomic thing is that it ignores how, for what purpose and when mouth masks should be used’
A mouth (nose) mask requires proper use, such as fitting properly when placed, covering the nose and mouth, but also removing it correctly. What you don’t read anywhere is that mouth masks also help very well not to put your fingers in your nose. So you cannot place droplets with virus directly in your nose.
Face masks also make us aware of the fact that something is going on. When used properly (empty artis, according to the rules of the art), the right masks (for example FFP2) protect the user well when he comes close to a patient who has the virus. The question that is often not asked and that should concern the minister is: does the mask help to prevent the spread of the virus in the population when everyone wears mouth masks in public spaces and on the street?
And unfortunately, the population does not wear those masks empty artis at all. You don’t need a peer-reviewed publication in the highest scientific journal for that; you see that in the supermarket, the train, the bus and on the street. Most people don’t wear the mouth mask properly and they certainly don’t take the mouth mask off correctly.
‘Making everyone wear a mouth mask by law does not help prevent the spread of the virus in an epidemiological sense’
Well, that’s just real life and then it helps – if you think logically – nothing. Admittedly, it can help the single person who wears the good mouth mask properly and takes it off again to reduce the risk of contamination. But introducing a legal obligation to have everyone wear a mouth mask does not help prevent the spread of the virus in an epidemiological sense. This follows very easily from logical reasoning.
Again, I would definitely advise vulnerable people to wear an empty artis mask after very good instruction when there is an increased risk of getting COVID-19 or influenza in certain situations. As a government I would also first provide good information and communication. But putting face masks in public spaces for everyone in order to prevent the spread of the virus is – neatly said – not rational.
Having said this, I of course risk being qualified as a wappie professor. Fortunately, a figurehead of evidence-based medicine, the Cochrane library, has presented a comprehensive overview that you can find here. It should be noted that the quality of scientific studies on this subject is of mediocre quality. But it doesn’t want to get much better either, given what I explained above.
‘The research into mouth masks in our western world will not get much better’
The conclusion of the Cochrane review is simple: face masks for the population in public places and spaces do not help prevent the spread of the virus. With all due care because of the mediocre quality of the research. But I predict you, the research in our western world will not get much better. In a dictatorship where people are deprived of all fundamental freedoms, it could perhaps be properly investigated.
Well, now it is becoming difficult for governments to continue to threaten with a restriction of freedom of the population that is not based on reason or evidence. However, reason is not the strongest feature of ‘politics’ and I’m afraid not all of us.