Thank you for continuing to be such a voice of reason and such an advocate for the children, Dr. Prasad. I have noticed that several of my kids friends (ages 7 -- 10) who were recently Covid vaccinated last month all now have Covid. Thankfully their symptoms are not serious -- mostly cold-like. But it's still rather staggering for me to observe this. I have not given my kids this shot (they had been exposed to Covid back in March 2020 with very minimal symptoms) and they have been in close contact with their friends who have Covid now, and they did not test positive or have symptoms. I am so troubled by the lack of transparency around this issue when it comes to young children...Especially ones who have already acquired immunity! I live in San Francisco, so as you can imagine, my peers think I'm insane for waiting on this shot for my kids...But I will withstand all of their judgement for what I see with my own eyes, and thankfully, what I've learned from you and other brave truth tellers. Thank you and Happy 2022!
I got a lease violation for not wearing a cloth mask in my apartment building in LA. I feel so conflicted now every time I step out of my apartment because I know wearing masks is unnecessary, it feels intrusive but I don't want to be evicted. What a world!
One thing you're wrong about: Some of us are actually over 40, unvaxxed, haven't had covid (laptop class, represent), and still interested in the value of masking in certain situations. Just because the political messaging over the last 2 years has sent someone into a full-fledged tizzy about vaccine safety and efficacy doesn't mean they're against other mitigation measures when warranted.
I happened to be off work today and tuned into the Today show. I was shocked that there was an entire segment on how to properly double mask your child. They recommended a kids size surgical mask and then a cloth mask over it. Have these people ever met kids? We have lost our minds 🤦♀️
No "mask" is scientifically warranted against aerosols. The fact that people still push this nonsense is the reason others push it on kids. It must all stop.
Dr. Prasad, all this information seems to be falling on deaf ears. How do we persuade people to listen or even think differently?
I will likely be fired in March for refusing the booster (already vaxxed). I brought up natural immunity, as I am in the Health and Wellness committee and was overruled by "we're following the CDC guidelines".
To begin with, Korean certified masks are KF94 masks not KN94 masks. Plus the KF94 masks I wear in certain siutations are not "uncomfortable". And finally, I defy your stereotype, you've made.
I had a mild symptomatic case of covid, so I have natural immunity, but I have also been waiting for a more conventional vaccine (e.g. protein sub-unit vaccine). I have a number of issues and concerns regarding a new mRNA platform as well as a vaccine reliant on just a few epitopes of the spike protein (so I still have some issues with protein sub-unit vaccines that only use spike proteins for the antigen). While I understand that natural immunity is better than vaccinated immunity, I'm still not convinced that natural immunity protects one against reinfection especially with newer variants. I also understand that omicron may ultimately function like a live attenuated vaccine. But models of prevalence of omicron aren't very accurate, and since there is so little sequencing done in the US, we really don't know what variants are dominant, and some forms of Delta Plus may also evade b and t cells.
With that noted, regardless, I still wear a mask in certain situations, not only because I have to, but also to reduce viral loads I'm exposed to. That type of mask is a KF94. I've been wearing KF94 masks since November of 2020. I purposely wear masks where I am indoors in confined areas with other people like waiting rooms at doctors's offices. I concur with you that mask wearing and not wearing in restaurants or bars is incredibly ridiculous. Wearing masks outdoors is just plain silly and signify that people don't understand that respiratory viral transmission is primarily via airborne aerosols not fomites or larger droplets.
Furthermore as I note in these blog posts,
-Viral transmission and more adventures in mask wearing
what's really needed is an emphasis on improving air quality through improved ventilation, filtration, uv lighting and CO2 monitoring. That's what's really needed in classrooms, offices and especially in other locations where masks are removed to eat or drink.
I think the biggest problem with masking is that it's just mindless without any real understanding as to the basics of respiratory viral transmission. Without that understanding, most mask wearing is just theater that actually gives people a false sense of security. So mindless masking may actually increase risk of exposure and infection rather than reduce those risks.
The viral load reduction is a nice concept and may even be true. But it has never made a difference in any clinical study of aerosolized respiratory virus transmission. Mask wearers and non-mask wearers have the same disease uptakes/transmission rates virtually irrespective of the mask except for the few minutes after a professionally fitted N95 mask is donned...and even that is hard to show with clinical data as Vinay underscores. This has been studied for decades with other respiratory viruses. If it makes you feel good/superior (or, as in your case you have to, so we have convenient confirmation bias) that is great, but the data that it makes any difference is just not there.
I'm going to add one more thing ....and that is my situation is obviously very different than your situation. I am only in confined indoor spaces infrequently for very short periods of time....say a visit to a doctor's office or my dentist. You obviously are in such environments frequently for long periods of time. So thinking about this more, I can understand how constantly wearing N95 or KF94 quality masks would be uncomfortable and a pain in the ass.
That's again why I think the emphasis should be more on air quality like I noted in my initial reply. Air quality can be improved in a number of ways to reduce stagnant air full of airborne aerosolized virions. Open windows, ceiling or floor fans work. So do more air exchanges and using hood exhausts to draw out air in restaurants. Hepta filters on HVAC units or portable air filters are another way to filter out airborne aerosols. UV lighting helps too. CO2 monitoring is something else hat can be done.
All or some of these methods would also make a lot more sense in classroom environments.
I completely agree about the filtration; the airline presidents were completely correct in their testimony.
I have some depressing (for the purposes of this conversation) video showing leakage on N95 masks from my lab using Schlieren imaging. You will be astonished at the leakage, especially around the nose, of a professionally fitted, fresh N95 mask. But I have no idea how to post it. I can reduce it to one PowerPoint slide with two embedded videos that will give you pause. If you want to create a one-use email address (or post one you do not mind posting) I will send you the slide (assuming you have PowerPoint).
Well it turns out it is too big to attach to an email...surprised even me. But Adobe gave me a link (who knew I had this option?...lol) so here it is. You will have to download it to play the two videos -- the link displays a pdf but has a download icon to get the powerpoint. Let me know if you can pull it off.
Yeah, got it. Though not entirely sure what I'm looking at . But you're right, there still is significant flow....but no where near as much as with the surgical mask.
Curious as to what you think of nasal sprays. Seems to be better RCT trial research data (see link below) using very dilute povidine iodine nasal sprays as a virucide than any research data supporting the use of masks.
The emphasis needs to be GETTING AWAY FROM COVID ZERO. We will all catch this, and immunity pursuant to catching it is broader than as you say the mRNA spike shot.
The way viruses work is to evolve to a state more contagion and less lethality. The viral wet dream.
Everyone needs to stop masking. It is entirely Medieval.
Really has nothing to do with "feeling superior"....just has more to do with understanding that the main means of transmission is airborne aerosols not larger droplets or fomites. So, electrostatic fabric that fit tight to one's face can filter virions. Though most people don't wear fitted or even tight fitting masks.
Now I sort of mis- or overstated my argument about respiratory loads. So I do concur that in the context of being exposed to droplets, what you're noting about the research is 100% correct. Most public health policy is based on droplet theory which isn't really based on any solid evidence. All fear induced mask wearing is based on being splashed by droplets full of virions......and most of this behavior is downright silly especially outdoor mask wearing. The six foot rule is also silly. Plastic barriers are also dumb.
But when you're sitting in a small poorly ventilated or poorly filtrated room for a long period of time (over 20 minutes) say in a waiting room (of for example the cardiologist I saw to get some diagnostics done) with old and obese people (who tend to be super spreaders), it's the airborne aerosilized virions that are the real concern. So if you can filter 94% or 95% of these virions out with a mask that fits tightly to one's face for those 20 plus minutes, you're expose...then you're less likely to get infected as Osterholm explains in the video clip I provided above. Cloth masks, plastic guards, and loose fitting surgical masks are basically useless in such a scenario,
Now I haven't seen any RCT's or even any good studies specifically n masking corroborating any of this. The two mask RCT's were very flawed ...the Danish one was particularly silly. The 1% aRR of the Bangladesh study wasn't terribly compelling either. All the observational studies are pretty useless as well. So I also agree with you that clinical and observational research doesn't support masking.....The research doesn't exist one way or the other.
But a review of related studies on aerosol transmission (in regards to the atmospheric chemistry) does support high quality mask wearing in interior enclosed non-well ventilated spaces like I've described above. So, again, I support situational mask wearing that actually requires most people to be able to think beyond "anti" or "pro" dialectics. Though, unfortunately it seems, people are no longer able to do any such critical thinking of any kind any more...or so it seems (pardon my cynicism).
No to all mandates of "masking". Medical personnel know that surgical masks are useful for surgeries only, and that this virus is by no means a world ending pandemic. All other masking should end.
How can it be that this perpetual mask-mania continues, let alone how it even started.
It is interesting to read the CDC guidance on masks from the H1N1 pandemic combined with the knowledge that there has been nothing that scientifically changed regarding mask effectiveness.
Could you present some data comparing covid risk to other risks we accept (including flu, but isn’t it more contagious than flu)? I wish this was more clearly laid out in messaging.
I’d also love to see the longer post on recommendations for immunocompromised people. This is a lingering conflict I have, about how responsible we as a society should be to protect vulnerable and disabled folks. Though I understand that if we say we should do things to protect them from covid, then we also have to say we should have been doing them for flu.
“Children are a vulnerable group that would face the longest and, thus, most profound consequences of a potentially risky mask use. Basic research at the cellular level regarding mask-induced triggering of the transcription factor HIF with potential promotion of immunosuppression and carcinogenicity also appears to be useful under this circumstance. Our scoping review shows the need for a systematic review.
The described mask-related changes in respiratory physiology can have an adverse effect on the wearer’s blood gases sub-clinically and in some cases also clinically manifest and, therefore, have a negative effect on the basis of all aerobic life, external and internal respiration, with an influence on a wide variety of organ systems and metabolic processes with physical, psychological and social consequences for the individual human being.”
We need to make sure it is actually worth all of the potential downsides—even those not studied (no longer seeing people smile at you) before recommending or requiring masks. Dr. Prasad argues that has yet to be proven.
Thank you for continuing to be such a voice of reason and such an advocate for the children, Dr. Prasad. I have noticed that several of my kids friends (ages 7 -- 10) who were recently Covid vaccinated last month all now have Covid. Thankfully their symptoms are not serious -- mostly cold-like. But it's still rather staggering for me to observe this. I have not given my kids this shot (they had been exposed to Covid back in March 2020 with very minimal symptoms) and they have been in close contact with their friends who have Covid now, and they did not test positive or have symptoms. I am so troubled by the lack of transparency around this issue when it comes to young children...Especially ones who have already acquired immunity! I live in San Francisco, so as you can imagine, my peers think I'm insane for waiting on this shot for my kids...But I will withstand all of their judgement for what I see with my own eyes, and thankfully, what I've learned from you and other brave truth tellers. Thank you and Happy 2022!
I got a lease violation for not wearing a cloth mask in my apartment building in LA. I feel so conflicted now every time I step out of my apartment because I know wearing masks is unnecessary, it feels intrusive but I don't want to be evicted. What a world!
Fight it!
Unfortunately, you have to choose your battles. I'm in Chicago dealing with similar restrictions in my apt complex.
One thing you're wrong about: Some of us are actually over 40, unvaxxed, haven't had covid (laptop class, represent), and still interested in the value of masking in certain situations. Just because the political messaging over the last 2 years has sent someone into a full-fledged tizzy about vaccine safety and efficacy doesn't mean they're against other mitigation measures when warranted.
Masking is not a science-based mitigation measure. Health, metabolic health, is.
I happened to be off work today and tuned into the Today show. I was shocked that there was an entire segment on how to properly double mask your child. They recommended a kids size surgical mask and then a cloth mask over it. Have these people ever met kids? We have lost our minds 🤦♀️
No "mask" is scientifically warranted against aerosols. The fact that people still push this nonsense is the reason others push it on kids. It must all stop.
Dr. Prasad, all this information seems to be falling on deaf ears. How do we persuade people to listen or even think differently?
I will likely be fired in March for refusing the booster (already vaxxed). I brought up natural immunity, as I am in the Health and Wellness committee and was overruled by "we're following the CDC guidelines".
You mean Prozac? Not Prosac?
Thanks for all your work. Love the part about kids/covid/masks.
To begin with, Korean certified masks are KF94 masks not KN94 masks. Plus the KF94 masks I wear in certain siutations are not "uncomfortable". And finally, I defy your stereotype, you've made.
I had a mild symptomatic case of covid, so I have natural immunity, but I have also been waiting for a more conventional vaccine (e.g. protein sub-unit vaccine). I have a number of issues and concerns regarding a new mRNA platform as well as a vaccine reliant on just a few epitopes of the spike protein (so I still have some issues with protein sub-unit vaccines that only use spike proteins for the antigen). While I understand that natural immunity is better than vaccinated immunity, I'm still not convinced that natural immunity protects one against reinfection especially with newer variants. I also understand that omicron may ultimately function like a live attenuated vaccine. But models of prevalence of omicron aren't very accurate, and since there is so little sequencing done in the US, we really don't know what variants are dominant, and some forms of Delta Plus may also evade b and t cells.
With that noted, regardless, I still wear a mask in certain situations, not only because I have to, but also to reduce viral loads I'm exposed to. That type of mask is a KF94. I've been wearing KF94 masks since November of 2020. I purposely wear masks where I am indoors in confined areas with other people like waiting rooms at doctors's offices. I concur with you that mask wearing and not wearing in restaurants or bars is incredibly ridiculous. Wearing masks outdoors is just plain silly and signify that people don't understand that respiratory viral transmission is primarily via airborne aerosols not fomites or larger droplets.
Furthermore as I note in these blog posts,
-Viral transmission and more adventures in mask wearing
https://beyondspin.wordpress.com/2021/10/16/viral-transmission-and-more-adventures-in-mask-wearing/
-The psychology of masking
https://beyondspin.wordpress.com/2021/06/22/the-psychology-of-masking/
- Why Mandates don't work
https://beyondspin.wordpress.com/2021/12/28/why-mandates-are-pointless/
what's really needed is an emphasis on improving air quality through improved ventilation, filtration, uv lighting and CO2 monitoring. That's what's really needed in classrooms, offices and especially in other locations where masks are removed to eat or drink.
I think the biggest problem with masking is that it's just mindless without any real understanding as to the basics of respiratory viral transmission. Without that understanding, most mask wearing is just theater that actually gives people a false sense of security. So mindless masking may actually increase risk of exposure and infection rather than reduce those risks.
###
The viral load reduction is a nice concept and may even be true. But it has never made a difference in any clinical study of aerosolized respiratory virus transmission. Mask wearers and non-mask wearers have the same disease uptakes/transmission rates virtually irrespective of the mask except for the few minutes after a professionally fitted N95 mask is donned...and even that is hard to show with clinical data as Vinay underscores. This has been studied for decades with other respiratory viruses. If it makes you feel good/superior (or, as in your case you have to, so we have convenient confirmation bias) that is great, but the data that it makes any difference is just not there.
I'm going to add one more thing ....and that is my situation is obviously very different than your situation. I am only in confined indoor spaces infrequently for very short periods of time....say a visit to a doctor's office or my dentist. You obviously are in such environments frequently for long periods of time. So thinking about this more, I can understand how constantly wearing N95 or KF94 quality masks would be uncomfortable and a pain in the ass.
That's again why I think the emphasis should be more on air quality like I noted in my initial reply. Air quality can be improved in a number of ways to reduce stagnant air full of airborne aerosolized virions. Open windows, ceiling or floor fans work. So do more air exchanges and using hood exhausts to draw out air in restaurants. Hepta filters on HVAC units or portable air filters are another way to filter out airborne aerosols. UV lighting helps too. CO2 monitoring is something else hat can be done.
All or some of these methods would also make a lot more sense in classroom environments.
I completely agree about the filtration; the airline presidents were completely correct in their testimony.
I have some depressing (for the purposes of this conversation) video showing leakage on N95 masks from my lab using Schlieren imaging. You will be astonished at the leakage, especially around the nose, of a professionally fitted, fresh N95 mask. But I have no idea how to post it. I can reduce it to one PowerPoint slide with two embedded videos that will give you pause. If you want to create a one-use email address (or post one you do not mind posting) I will send you the slide (assuming you have PowerPoint).
Well it turns out it is too big to attach to an email...surprised even me. But Adobe gave me a link (who knew I had this option?...lol) so here it is. You will have to download it to play the two videos -- the link displays a pdf but has a download icon to get the powerpoint. Let me know if you can pull it off.
https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:eced91c5-a2b4-4b04-bbcb-d4ca3fa32de9
Yeah, got it. Though not entirely sure what I'm looking at . But you're right, there still is significant flow....but no where near as much as with the surgical mask.
Curious as to what you think of nasal sprays. Seems to be better RCT trial research data (see link below) using very dilute povidine iodine nasal sprays as a virucide than any research data supporting the use of masks.
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=chowdhury%20covid%20povidone&btnG&fbclid=IwAR3KFNuzy-ACOe7jtLON6_i6A6zXn5VRY-JUIDTYnPGdNWzRq_U36YL2YvU
The emphasis needs to be GETTING AWAY FROM COVID ZERO. We will all catch this, and immunity pursuant to catching it is broader than as you say the mRNA spike shot.
The way viruses work is to evolve to a state more contagion and less lethality. The viral wet dream.
Everyone needs to stop masking. It is entirely Medieval.
Really has nothing to do with "feeling superior"....just has more to do with understanding that the main means of transmission is airborne aerosols not larger droplets or fomites. So, electrostatic fabric that fit tight to one's face can filter virions. Though most people don't wear fitted or even tight fitting masks.
Now I don't agree with Dr. Osterholm on many items pertaining to this endemic, but I found this comment https://youtu.be/sBTYi8-o8gk that I clipped from one of his podcasts makes sense since it jibes with these two recent papers on indoor transmission https://www.pnas.org/content/118/17/e2018995118 and respiratory viral transmission https://www.science.org/doi/10.1126/science.abd9149
Now I sort of mis- or overstated my argument about respiratory loads. So I do concur that in the context of being exposed to droplets, what you're noting about the research is 100% correct. Most public health policy is based on droplet theory which isn't really based on any solid evidence. All fear induced mask wearing is based on being splashed by droplets full of virions......and most of this behavior is downright silly especially outdoor mask wearing. The six foot rule is also silly. Plastic barriers are also dumb.
But when you're sitting in a small poorly ventilated or poorly filtrated room for a long period of time (over 20 minutes) say in a waiting room (of for example the cardiologist I saw to get some diagnostics done) with old and obese people (who tend to be super spreaders), it's the airborne aerosilized virions that are the real concern. So if you can filter 94% or 95% of these virions out with a mask that fits tightly to one's face for those 20 plus minutes, you're expose...then you're less likely to get infected as Osterholm explains in the video clip I provided above. Cloth masks, plastic guards, and loose fitting surgical masks are basically useless in such a scenario,
Now I haven't seen any RCT's or even any good studies specifically n masking corroborating any of this. The two mask RCT's were very flawed ...the Danish one was particularly silly. The 1% aRR of the Bangladesh study wasn't terribly compelling either. All the observational studies are pretty useless as well. So I also agree with you that clinical and observational research doesn't support masking.....The research doesn't exist one way or the other.
But a review of related studies on aerosol transmission (in regards to the atmospheric chemistry) does support high quality mask wearing in interior enclosed non-well ventilated spaces like I've described above. So, again, I support situational mask wearing that actually requires most people to be able to think beyond "anti" or "pro" dialectics. Though, unfortunately it seems, people are no longer able to do any such critical thinking of any kind any more...or so it seems (pardon my cynicism).
Regardless, here's an interesting article in Wired of all places on this subject of airborne aerosol research that you might have missed https://www.wired.com/story/the-teeny-tiny-scientific-screwup-that-helped-covid-kill/
Thanks for your reply and engagement.
###
No to all mandates of "masking". Medical personnel know that surgical masks are useful for surgeries only, and that this virus is by no means a world ending pandemic. All other masking should end.
Vinay - love your stuff, but I think you need to pull this and repost after some copy editing. Or you posted the first draft by accident.
How can it be that this perpetual mask-mania continues, let alone how it even started.
It is interesting to read the CDC guidance on masks from the H1N1 pandemic combined with the knowledge that there has been nothing that scientifically changed regarding mask effectiveness.
https://www.cdc.gov/h1n1flu/masks.htm
Thanks for laying this out so clearly.
Could you present some data comparing covid risk to other risks we accept (including flu, but isn’t it more contagious than flu)? I wish this was more clearly laid out in messaging.
I’d also love to see the longer post on recommendations for immunocompromised people. This is a lingering conflict I have, about how responsible we as a society should be to protect vulnerable and disabled folks. Though I understand that if we say we should do things to protect them from covid, then we also have to say we should have been doing them for flu.
Please consider…
Masks need to be changed every two hours at a minimum due to bacteria in the mask:
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6037910/.
https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8072811/
“Children are a vulnerable group that would face the longest and, thus, most profound consequences of a potentially risky mask use. Basic research at the cellular level regarding mask-induced triggering of the transcription factor HIF with potential promotion of immunosuppression and carcinogenicity also appears to be useful under this circumstance. Our scoping review shows the need for a systematic review.
The described mask-related changes in respiratory physiology can have an adverse effect on the wearer’s blood gases sub-clinically and in some cases also clinically manifest and, therefore, have a negative effect on the basis of all aerobic life, external and internal respiration, with an influence on a wide variety of organ systems and metabolic processes with physical, psychological and social consequences for the individual human being.”
Heart rate and oxygen levels are affected:
https://pubmed.ncbi.nlm.nih.gov/33670983/
Heart rate, microclimate (temperature, humidity) and subjective ratings are significantly influenced by wearing facemasks:
Heart rate, microclimate (temperature, humidity) and subjective ratings were significantly influenced by the wearing of different kinds of facemasks.
Surgical mask induced deoxygenation should be studied in kids before recommending or requiring it of kids:
https://pubmed.ncbi.nlm.nih.gov/18500410/
Mask use for one university class is less than ideal, but extrapolate to small children for much longer time periods:
https://pubmed.ncbi.nlm.nih.gov/33516744/
Lip reading, language acquisition, social cues, and communication are all impacted by mask wearing: Yale Child Studies
https://globalnews.ca/video/7706730/can-masks-impact-a-childs-speech-and-language-development
We need to make sure it is actually worth all of the potential downsides—even those not studied (no longer seeing people smile at you) before recommending or requiring masks. Dr. Prasad argues that has yet to be proven.
Prozac! 😹😹😹Bring on those randomized control trials for the hyper paranoid 🙏🏼