5 myths about face masks under the microscope

To cover, or not to cover? That is the question. Not just a question, in fact, but a divisive issue that has led to protests in some parts of the world – most notably in the United States – and explosions of fake news on the internet.

In many Asian countries, mask-wearing has been commonplace during the coronavirus outbreak; far less so in some countries in the West, according to a poll taken in April. But the fault lines don’t end there. In the US, masks have become politically charged.

According to Dr Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases: “We can say very clearly that wearing a mask is definitely helpful in preventing acquisition as well as transmission.”

That message could be getting through to many. In a recent ABC News/Ipsos poll, 89% of Americans said they now wear masks in public. But it also found Democrats were more likely to use them (with 99% choosing to wear a covering in public) than Republicans (79%).

So, with debate on the subject likely to continue, here are some often-cited reasons for not wearing masks, whether medical or fabric, in public – and why they should be challenged.

Myth 1. Oxygen levels will drop and carbon dioxide will be re-inhaled

If you’re not used to it, wearing a mask might feel uncomfortable or unusual. But, wearing a medical face mask will not cause CO2 intoxication or oxygen deficiency.

Consider surgical staff, who have been routinely wearing face masks for decades without passing out due to a lack of air.

“Normal, healthy people can do quite energetic things while wearing the sorts of face coverings that we’ve been talking about in the context of COVID prevention,” Dr William Schaffner, an infectious disease professor at Vanderbilt University in Nashville and medical director of the National Foundation of Infectious Diseases, told NBC’s Today.

One Irish doctor, Maitiu O Tuathail, even took to Twitter to demonstrate how his blood oxygen saturation levels stayed at 99% while wearing not just one mask, but six.

“If you feel uncomfortable in your mask,” says the Mayo Clinic, “Try to limit your talking and breathe through your nose. That will reduce the humidity level in your mask.”

But, the WHO does say you shouldn’t wear a mask when exercising. Sweat can make the mask wet more quickly, reducing the wearer’s ability to breathe comfortably and promoting the growth of microorganisms.

Myth 2. If you’re not unwell, you don’t need a mask

A study carried out in Italy concluded that 40% of people who tested positive for the coronavirus had no symptoms. Other research says this ”silent spreading” might be even more frequent – suggesting more than half of COVID-19 infections result from asymptomatic and presymptomatic cases.

The implication of these findings is that you might not be visibly unwell, but you could still be infected and infectious.

Myth 3. A mask won’t stop the wearer getting ill

The main purpose of wearing a mask is to prevent the spread of COVID-19, especially “in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain,” according to the CDC.

While masks will help keep the wearer safe, they serve a greater good – stopping others from getting infected if you happen to be the spreader. Masks catch droplets of moisture that may be acting as a transition medium for the virus.

Myth 4. If you have a medical condition, you don’t have to wear a mask

This may differ from place to place; some authorities may take the view that some people don’t need to wear a face covering. Anxiety disorders, claustrophobia or some mental health difficulties may lead some people to find mask-wearing distressing, according to San Francisco-based psychotherapist, Susanne Babbel.

Writing in Psychology Today, she said: “Many traumatic memories can be linked to face masks. For example, people are sometimes robbed or assaulted by someone with a mask, or perhaps they endured medical procedures such as cancer treatments or developed a virus that required others to wear face masks around them.

She also advises people to identify the source of any negative associations they may have with masks, and work on “learning how to calm them down can help you to move through these challenging times.”

But anyone with pre-existing respiratory illnesses, including asthma, has more reason than most to wear a mask according to one clinician. Speaking on the US news broadcast Good Morning America, Dr Jennifer Ashton described the benefits of wearing face coverings as “basic science”.

"If someone is well enough to be out in public, they are well enough to put some kind of face covering or mask on," Ashton said. “You are not hermetically sealed by putting a face covering on.”

“Let’s try to keep it to fact not fiction here, because people’s lives are really at stake,” she concluded.

Myth 5. It’s enough to just wear a mask

As the WHO has emphasized, wearing a mask alone isn’t enough. Social distancing and personal hygiene remain important.

Equally, the organization stresses the need to wear fabric masks safely and has a list of dos and don’ts – from how to clean them to wearing them properly.