The other mask fight: are they our best defense against the coronavirus?

As academic fights progress, the dispute over a recent article on facial masks and how they help prevent the spread of the coronavirus is very good.

“It is absolutely riddled with errors,” says Caroline Buckee, an epidemiologist at the Harvard TH Chan School of Public Health, “and it would not have gone through the standard peer review.”

She and more than 40 researchers are calling for the article to be removed, a rare and dramatic move in the world of scientific journals.

But its authors support their finding that in China, Italy, and New York, face liners appeared to be the most effective way to stop the spread of the virus, when added to other measures.

“It’s for the best,” said lead author Mario Molina, a Nobel Prize winner in chemistry, “particularly if the recommendation is also to use social distancing and be especially careful not to go to meetings where there are many people.”

Molina’s work has focused on small particles in air pollution, and emphasizes the importance of masks to block the small particles in the air that people emit while talking. So a mask not only prevents sick people from dropping large drops, he argues; Helps protect the person using it from the incoming airborne virus.

“You use the mask so that you don’t get the infection, “he said.” It’s not just so you don’t spread it to other people. So it is crucial to convince people to use it. “

Molina’s team has presented a defense of the document. Proceedings of the National Academy of Sciences, which says it is currently considering the dispute.

Meanwhile, more new research has found a strong correlation between mask use and local rates of coronavirus infections, including a state-by-state analysis in the journal Health Affairs. More masks appear to mean fewer cases, and the use of relaxed masks appears to lead to higher infection rates.

Across the country, some people resist the advice of public health experts. wearing masks But among researchers in Massachusetts and beyond, there is a different debate going on, about whether masks might be the most effective defense against the virus.

“The strongest evidence is the real-life examples we see in really large population samples,” says Shan Soe-Lin, managing director of Pharos Global Health Advisors, a nonprofit organization that advises governments and philanthropies. “Countries with very strong cultures that wear masks continue to kick our butts.”

Take a look at Hong Kong, for example, says epidemiologist at Harvard’s TH Chan School of Public Health, Michael Mina.

“Hong Kong is remarkably densely populated, but it really had no major outbreaks,” he says. “And I think it’s probably due more to wearing masks than exceptional contact tracking.”

As more data is entered, Mina and others have been modeling the difference that masks and other measurements make in an outbreak.

“If you ask my opinion about which is the simplest and most effective option? Wear a mask,” says Mina. “I think there is no question about it.”

If everyone wore masks, he says, which is unlikely given American culture, but if they did, he would likely keep the outbreaks under control. He estimates that if two people wear masks, the risk of one infecting the other falls in more than 90%.

“So in that sense, I think wearing masks alone can change the game,” he says, “if we as a society collectively decide that we will adhere to those rules.”

Just four months ago, health authorities were broadcasting the opposite message, telling the public no wearing masks But medical historian Dr. Howard Markel of the University of Michigan says the advice came in the context of a mask shortage for healthcare workers.

And, while masks have been recommended to the public since the 1918 flu, scientists have debated heatedly for decades how well they really work against viruses. Markel says the pandemic accelerated that science.

“There were a lot of studies going on at high speed,” he says, “and the studies were actually quite positive that wearing masks could make a difference. It is not the only difference, we have to do many other things, but why? no?”

That change could be compared to condom research that skyrocketed due to AIDS, says Robert Hecht, president of Pharos Global Health Advisors, who has worked on HIV for 30 years. Condom use was long known to offer protection against sexually transmitted diseases, she says, but it wasn’t until HIV came that research on its benefits increased and “we really understood how good a powerful protective measure was.” .

The use of masks, he says, may not offer perfect protection, “but the cost of doing it to people and society is very low, it is a parody, really, not doing it.”

There is still a lot to learn about how well masks protect against coronavirus. Harvard epidemiologist Caroline Buckee, who questions the recently published article, says the impact of wearing masks is difficult to quantify.

“However, we believe, based on logical and plausible arguments, that it could be very effective,” she says, “so it’s definitely worth doing.”

It doesn’t really matter if masks are the best defense, says Dr. Jeremy Faust of Brigham and Women’s Hospital, who edits a daily summary of the COVID-19 investigation called Brief19.

“This is not the Olympics,” he says. “It’s not, ‘If you didn’t win the gold medal, no one will ever remember you.’ It is: ‘You did the podium!'”

Even with many things still unknown, he says, it’s increasingly clear that masks help protect against the virus, so wearing them is a patriotic service.

Markel compares the multiple protective measures that people can take for layers of Swiss cheese that have holes.

“And when you put layers of Swiss cheese on top of each other, you block some of those holes,” he says. “But none of the layers themselves is perfect. We need to accept that.”

So the best bet, he says, is to use as many layers as possible, including the masks.