July 6th, 2020

We should wear masks as the data is good enough to warrant this intervention as the virus rages on.

However, what are the unintended consequences of wearing masks? In a nice piece by Olga Perski in Fast Company, we find four such effects.

1) People are more likely to perceive that they are safe and take on more risky behaviors like an elderly person going to the grocery store and standing within six feet of a person for a prolonged conversation. Assuming that the mask is even donned appropriately the time of exposure to an ill person is a major risk modifier.

2) People may think that they need to wash their hands less often because they are protected with a mask which is a significant negative activity.

3) People are significantly more likely to touch their face to readjust a mask increasing touching of mucous membranes which is a primary route of infection.

4) Billions of masks are going to end up in a landfill somewhere polluting the world. Ugh.

I would add #5) - the mental stress of the discomfort associated with breathing through these devices, especially the N95 masks, for prolonged amounts of time. I have worn them on and off for the better part of three months now and they are not fun.

There is always a positive and a negative to these choices. We will see as the data pours in if mask wearing is a net positive or net negative. It is likely that it will be a net positive for survival if we also choose to continue to practice prudent social distancing and hand washing as many studies are showing. How to account for the pollution is unfortunately impossible and will be a side effect.

Experimenting in real time as a society is what we do. When in doubt, being more aggressive with prevention is usually the right choice as you await more data to define your choices.

Dr. M

Perski Fast Company
Bae Annals of Internal Medicine
Ma J of Medical Virology
CDC Mask Bibliography
Chu Lancet