“Each to their own — I don’t have to wear a mask, keep yourselves safe”

Here are some reasons — with evidence — why you should keep wearing your mask. And how.

Grayscale picture with a dark-haired person with a beard, wearing glasses, who is pulling their mask down, looking surprised with an open mouth.
Photo by Usman Yousaf on Unsplash

Let’s start with respect and common courtesy: If you talk to someone who is wearing a mask, it would be polite to ask them if they felt better if you wore yours. Or even better yet: simply wear yours because them wearing theirs is already a sign that they value protection.

There are, however, way more important reasons why you should wear it in any social encounter. (We’ll come back to the courtesy thing later.) One main concern I hear by people not wanting to wear a mask is:

“But I am not high risk and if you are, you can protect yourself with your mask just fine.”

This attitude is fed by a lot of outdated, inaccurate, or false information. If you do not wear your mask, they still have a high risk of catching Covid from you. But let’s dig things up step by step:

1. Involuntary disclosure: You might not know their status

They might not have disclosed their high-risk status yet to you, and might not appreciate being forced to disclose this if you falsely assume that per default you don’t have to wear your mask around healthy people. Also, you might see them in a situation with others around where this disclosure might not be safe for them, eg. they could suffer a loss in opportunities, peer pressure, and so much more.

2. Vulnerable loved ones

They might be caring for or working with people who are high risk — the latter even without knowing, eg. sharing an office with someone who has not disclosed their status to all of their colleagues. Disclosure of them having vulnerable loved ones they want to protect might also not be ideal, see #1 Involuntary disclosure.

3. They might not be aware of their status

They might simply not know that they have conditions that make them high risk. If them or you had Covid — even just once, even a mild case — you are high risk already. Your immune system has been weakened substantially and every new infection bears worse risks for you.

Same goes for status of infection — new variants like B5 are often not picked up by lateral flow tests, sometimes not even by a PCR. Read: you folks might be thinking you’re doing everything alright by testing yourselves yet still be at risk of transmitting it each other.

4. Every infection is a risk for serious long term conditions

Every infection bears the risk to have them develop serious issues during or post infection, such as ME/CFS. That risk is considerably higher with Covid vs. other viruses. And it is not up to you to evaluate whether they are good to play that lottery.

Every infection with Covid has been shown to impact your immune system by damaging your T cells. This is not reverting post infection and makes you more likely to get reinfected with Covid, plus increases your likelihood for serious issues.

SARS-COV2 COVID at least temporarily causes lymphocytopenia (including T cells) immune suppression. The virus has been found to infect CD8 T cells. HIV AIDS is typically defined by CD4 T cell destruction. This study found COVID infected CD8 T cells.

Amy Mitchell, 30.06.2022

Amy Mitchell is also referring to a paper titled “Postacute COVID-19 is Characterized by Gut Viral Antigen Persistence in Inflammatory Bowel Diseases”.

5. They might simply not want to get sick.

No, not even just “a common cold”. Also, you don’t even know if whatever you might pass on is just a cold. Some viruses, eg pertussis or EBV can be asymptomatic for long but can have dire consequences later, eg Multiple Sclerosis: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(22)00086-2/fulltext

6. You don’t know if they had a sufficient immune response to their vaccine

(They might not know either). While it helps prevent serious cases to a degree — you can still spread or catch it. Esp. with new variants. Only FFP2 / (K)N95 masks help if you wear them correctly.

There is proof that if they are not fitting properly, the leakage is higher and thus is the risk for infection. Dr Satoshi Akima shared a spreadsheet for masks that passed or did not pass fit testing:

Source: https://asapublicaccess.s3-ap-southeast-2.amazonaws.com/AustralianAnaesthetist/Feature_Fittesting.pdf

It is worth checking out Dr Akima’s whole thread, as it explains well why you might still get infected if you wear an N95 on a flight, when others around you are not wearing it, but also details potential solutions to keep you safe.

7. You and them can still transmit Covid to each other when you are outdoors.

Wear that mask. You shouldn’t remove a condom without consent — neither should you do that with your mask when around others.

The claim that you are a thousand times more likely to contract COVID indoors than outdoors is an urban myth that remains abject nonsense, no matter how often the fairy tale has been repeated. A lie repeated often enough remains a lie

Dr Satoshi Akima, 02.07.2022

Dr Akima references a thread by Orla Hegarty about misinformation. Might come in handy if you want to brush up your knowledge about Covid and the pandemic overall.

8. But it must be enough if THEY wear a mask?!

Unfortunately no — it is NOT SUFFICIENT protection if just one of you wears a mask. Even if both of you wear it, the risk is not 0. The picture below is only for FFP2 / KN95. The risk is considerably higher with surgical or cloth masks.

Visualisation of risk of transmission in various settings with an N95 / FFP2 mask: 
 1. Nobody is wearing a mask, one is speaking: high risk for the non-speaking person.
 2. Speaker is not wearing a mask, listener is wearing a mask — still high risk for the listener.
 3. Speaker is wearing a mask, listener is not wearing a mask: medium risk for the listener.
 4. Both people are wearing a mask, low risk for the listener. — And 5. both people wear a mask and are more than 6 ft away: very low risk

Masks have another advantage: if you do catch Covid, it has been shown that your infection can be lighter because you have been exposed to a much smaller viral load while being protected with your mask. Some sources for our claim:

https://www.ucsf.edu/news/2020/07/418181/one-more-reason-wear-mask-youll-get-less-sick-covid-19
https://www.nih.gov/news-events/nih-research-matters/humidity-masks-may-lessen-severity-covid-19

9. But it’s only going to be very short!

Even if the encounter is very short, you risk infecting them without a mask, within just a few minutes. That time frame can be considerably longer if you wear a proper mask (FFP2, KN95). BUT ONLY if that mask is *fresh* and worn properly. In fact, if they wear a mask and you do not, their protection only lasts for roughly 16.4min. That risk increases with viral load, eg. if both of you are at an event where the majority of people do not wear masks.

“In our study we found that the risk of infection without wearing masks is enormously high after only a few minutes, even at a distance of three metres, if the infected persons have the high viral load of the delta variant of the Sars-CoV-2 virus,”

Eberhard Bodenschatz, as reported by Max Planck Gesellschaft, 02.12.2021

A chart showing how much time is required to reach an infectuous dose inhaled by non-infected people, listing various options for different masks or no masks. If nobody is wearing a mask, it’s transmitted within 1.7min, if only one of them is wearing an N95, it can still be transmitted within 16.4mins. Source for this image is https://bettermasks.its-airborne.org/ — I lack the energy to describe the whole table but hopefully this URL is crawlable for screen readers. Sorry!
Original source for this chart and comments on Twitter

10. Kindness and courtesy

Remember how I mentioned courtesy at the beginning?

If a vulnerable person talks to you and you are not wearing a mask, but they need to keep themselves (or loved ones) safe, they will have to interrupt and ask you to wear a mask. This can be exhausting, as they have to do this multiple times per day and are often met with a lack of understanding, acceptance, or people simply being rude. Sometimes, people even cough at them, putting them into additional danger. You see: Asking others can be very exhausting for them. As a result, social interactions can be causing anxiety for them. To avoid being put into danger, they have to use their language very carefully when asking someone else to wear mask. This is called emotional labour.

As a general act of kindness and courtesy, it is safe to assume that if someone wears a mask when talking to you, they will appreciate that you wear one, too — and act on it without having to be asked.

Just imagine you could no longer even do the most simple things by yourself without putting your life at risk — such as getting your prescription from the pharmacy. If you don’t get it, you might suffer dire consequences for your health. If you do get it, you might get infected with Covid through people who are not wearing masks, and die from it. This means vulnerable people have to make very tough decisions multiple times per day and are even more isolated than ever before, which is detrimental to their health — and it would not be necessary if we simply all wore masks per default.

Julia Métraux has detailed this concisely here.

Now that we covered why you need to wear that mask — how do you make sure you wear it properly? We got you covered:

How to test if your mask fits properly with minimal leakage

  1. A simple test at home detailed in a Twitter thread by Richard Corsi. Not 100% accurate but still good — all you need are small mirrors that you place in the fridge to show you any leaks when you exale: https://twitter.com/CorsIAQ/status/1422433693117779977
  2. You can also set up a test system at home. It is a more accurate way but also more costly and complex. Denise Dewald is detailing it in her thread on Twitter: https://twitter.com/denise_dewald/status/1541493238682501120

How to wear your mask correctly and fit it properly at home

Why would you go through the ordeal of fitting your mask correctly? Because using a good mask and fitting it correctly increases the effectiveness of protecting you and others.

Upgrade your mask — Filter + Fit + Function. A visual to show that filter effectiveness increases from cloth masks via surgical masks to N95 to — the best — Elastomeric respirators. Fit effectiveness increases from double-masking (lowest) via hooks or braces to secure your (K)N95 fit via respirator passing fit tests (highest fit effectiveness).
Source: cleanaircrew.org/masks/

Here is a good graphic to show you the best fit and the best mask type. Source: https://cleanaircrew.org/masks/

If you are not lucky enough to get it fitted by a professional at work, there are a number of resources that you can use to fit it all by yourself. This can actually increase your protection to a high degree! I picked some suggestions from a very helpful Twitter thread by David Keating:

Mask fitting advice in a few steps. Unfortunately I lack the energy to describe them all and would suggest that you listen to the video I linked to below. Sorry about that — but I am chronically ill and lack the spoons for long alt text sometimes. I try to be better!
https://www3.uwsp.edu/rmgt/Documents/ehs/Respiratory%20Protection/3m-filtering-facepiece-respirator-fitting-instructions.pdf

If you prefer a video instruction — starting from 00:16:18, there is a short 3 minute instruction for mask fitting:

Lastly — one thing I always see is that masks do not sit well enough on the bridge of the nose. One trick I learned is that when you unpack your mask with clean hands, straighten the nose wire out, then push your thumb into it and shape it around your thumb. You still have to make sure the wire sits well on your nose when you wear it but I found this trick really helps. I also got a big bunch of self-adhesive foam strips that I use with every mask, it helps against fogging your glasses, creates a better seal in FFP2 / N95 masks, and makes wearing the mask overall more comfortable.

Comparison of two ways to wear a mask — if you use it the way it comes out of the package, the nose wire is likely shaped into a triangle form, meaning there will be a gap when you wear it where air can get in and out unfiltered. To make it fit better, you have to reshape the nose wire so it fits your nose better.
Source: David Keating’s thread about mask fitting

Wearing masks is not unhealthy

Wearing a mask is not unhealthy at all (unless you keep reusing it for weeks, letting it wither at the bottom of a backpack and get really dirty). Many people with asthma or COPD can comfortably wear them — and so can you. Heck, I got asthma and am not trained well but went for a run with an FFP2 during a summer heat wave in 2021 and I did actually quite well (for science!). If you need proof how they are effective — find it here.

Why do you care, Gianna?

Oh, there are a few reasons.

  • Half of my loved ones work in healthcare, one of them in the Covid ICU.
  • I went to a conference with 4,000 attendees and did not catch Covid despite almost nobody else wearing a mask and me having contact to at least four people who had symptoms less than 24h after we spoke. I wore a well-fitted FFP2 with foam sealing AND an additional cloth mask to make sure there is no leakage at all times and only had a sip of water when *outside of the venue* alone. It helped but with the new variants I would *not* count on that being sufficient anymore, see the graphics above.
  • I went to a restaurant to have dinner *outside* in the open air once — and caught Covid. At the time of me writing this article, I am on day 12 of infection and still do not feel recovered. It has been bad enough for me to never wanting to catch it again.

You have reached the end of that article, yay!

Now if you found it useful, do us a favour and share it with others. Not everyone has the capacity to do their research, remember or find their bookmarks, and that is what this is here for.

Thank you!

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Gianna Brachetti🐙Truskawa

Gianna Brachetti🐙Truskawa

Interntl. SEO Expert by day. Flatmate of an octopus & amateur poet by night. Non-binary. Tends to prefer music over people at times. ʎ|y