To Mask or Not to Mask – That is the Question

Martha M Grout MD, MD(H)

A study published October 29,2020 in the Annals of Internal Medicine reports that asymptomatic infections with SARS-CoV-2 are high. It is therefore not possible to determine which people are infected and potentially spreading the virus, and which people are not infected and therefore not spreading the virus.

The Proportion of SARS-CoV-2 Infections That Are Asymptomatic -

“Available data suggest that at least one third of SARS-CoV-2 infections are asymptomatic. Longitudinal studies suggest that nearly three quarters of persons who receive a positive PCR test result but have no symptoms at the time of testing will remain asymptomatic.”

What conclusions may we draw from this study?

• Do not judge a book by its cover. You cannot tell if someone is infectious if they have no symptoms.

• Wearing some form of facial mask might help to slow the transmission of the virus.

• Slower transmission means not as many numbers of people getting infected at the same time.

• “With viral infections in which host immune responses play a predominant role in viral pathogenesis, such as SARS-CoV-2, high doses of viral inoculum [number of viral particles inhaled] can overwhelm and dysregulate innate immune defenses, increasing the severity of disease.”

• Lower doses of inoculum can improve a person’s chances of survival.

This one is really interesting: “asymptomatic infection rates are reported to be higher than 80% in settings with universal facial masking”.

The conclusion of the authors: “Ultimately, combating the pandemic will involve driving down both transmission rates and severity of disease. Increasing evidence suggests that population-wide facial masking might benefit both components of the response.”

Each of us has control only over our own behavior. We can choose to contribute the to problem, or we can choose to contribute to the solution. My personal opinion is that wearing a mask may contribute to the solution, by decreasing the total viral load I might transmit, should I become infected with the SARS-CV-2 virus. My choice is clear.