We are all being impacted by the reality of the coronavirus (COVID-19) pandemic. Everyone receives minute-by-minute accounts of how quickly the virus is spreading throughout the world. This has made the wearing of facemasks mandatory.
The Presidential Task Force (PTF) on COVID-19, among other guidelines to flatten the COVID-19 curve made the use of facemasks compulsory.
Many other states have followed suit. However, PTF chairman and Secretary to the Government of the Federation (SGF), Boss Mustapha, had to raise an alarm: “The PTF has become aware of the on-going practice of sharing masks and picking of masks for recycling from dumpsites.
“Except for fabric masks, every disposable used mask is a hazardous medical waste and should be disposed of properly, preferably by burning. It is very risky to share masks as the virus is capable of remaining on surfaces for several hours and you could get infected.”
But does facemask really prevent COVID-19 from spreading? What is its effectiveness? What are the challenges associated with the use of facemasks?
Dr Sunday Olalekan, general practitioner, warned that prolonged use of facemasks may cause hypoxia: “Breathing over and over exhaled air turns into carbon dioxide (CO2) which is why we feel dizzy. This intoxicates the user and much more when he must move, carry out displacement actions.
“It causes discomfort, loss of reflexes and conscious thought. It generates great fatigue. In addition, oxygen deficiency causes glucose breakdown an endangered lactic acid rise.
“The CO2 will slowly build up in the mask over time. However, the level of CO2 likely to build up in the mask is mostly tolerable to people exposed to it. You might get a headache but you most likely would not suffer the symptoms observed at much higher levels of CO2. The mask can become uncomfortable for a variety of reasons including sensitivity to CO2 and the person will be motivated to remove the mask.
“Some people with pre-existing respiratory illnesses, like asthma or chronic obstructive pulmonary disease (COPD), may face breathing difficulty with use of certain types of tight fitted masks, called respirators. There is less chance of hypoxia as they may discontinue using masks in that case. Risk is very low with cloth and surgical masks as they are not tight around the face.
“In the case of prolonged usage of facemasks, dizziness is less likely, but fatigue may occur. A mask wearer’s skin condition and microclimate can further exacerbate damage caused by pressure ulcers.
“While skin excessively moisturized by sweat and humidity is susceptible to irritation, so can over-dry skin lead to greater inflammation by crack and fissure. Furthermore, masks may trap heat, causing greater humidity and increasing skin fragility.
“For now, healthcare workers can protect their skin by keeping it clean and moisturized. But it is important to be mindful that bandages on irritated areas of the face would prevent masks from properly keeping out airborne particles.
“Those wearing cloth masks in public can also prevent irritation of their own by moisturizing about a half hour before putting on their face masks. Otherwise, the moisturizer may cause greater friction between mask and skin. In the future, mask designs which take the pressure away from the bridge of the nose could prevent the formation of pressure ulcers.”
Side effects of facemasks
Olalekan identified potential effects of wearing facemasks: “Wearing a facemask may give a false sense of security and make people adopt a reduction in compliance with other infection control measures, including physical distancing and hands washing.
“People must not touch their masks, must change their single-use masks frequently or wash them regularly, dispose them correctly and adopt other management measures, otherwise their risks and those of others may increase.
“The quality and the volume of speech between two people wearing masks is considerably compromised and they may unconsciously come closer. While one may be trained to counteract side effect this side effect may be more difficult to tackle.
“Wearing a facemask makes the exhaled air go into the eyes. This generates an uncomfortable feeling and an impulse to touch your eyes. If your hands are contaminated, you are infecting yourself.
“Facemasks make breathing more difficult. For people with COPD, facemasks are in fact intolerable to wear as they worsen their breathlessness. Moreover, a fraction of carbon dioxide previously exhaled is inhaled at each respiratory cycle. Those two phenomena increase breathing frequency and deepness, and hence they increase the amount of inhaled and exhaled air.
“This may worsen the burden of COVID-19 if infected people wearing masks spread more contaminated air. This may also worsen the clinical condition of infected people if the enhanced breathing pushes the viral load down into their lungs.
“While impeding person-to-person transmission is key to limiting the outbreak, so far little importance has been given to the events taking place after a transmission has happened, when innate immunity plays a crucial role. The main purpose of the innate immune response is to immediately prevent the spread and movement of foreign pathogens throughout the body.
“The innate immunity’s efficacy is highly dependent on the viral load. If facemasks determine a humid habitat where the SARS CoV-2 can remain active due to the water vapour continuously provided by breathing and captured by the mask fabric, they determine an increase in viral load and therefore they can cause a defeat of the innate immunity and an increase in infections. This phenomenon may also interact with and enhance previous points.”
A user’s experience of facemask
A journalist narrated her ordeal: “I find it very difficult to wear the facemask because it makes me uncomfortable. And the day I did, I created a scene by throwing up on the road.
“I was feeling so uncomfortable and sweating profusely. I did not get myself until I threw up on my way from work. Had to call a doctor friend to explain my plight and he asked if I had a face mask on.
“When I said yes, he began to explain that the facemask prevents one from breathing in enough oxygen. When carbon dioxide is breathed into the lungs for too long or when carbon dioxide levels become excessive, a condition known as acidosis occurs, that is a build-up of acid in the bloodstream. Hence, the reason I threw up in public.”
Facemasks can’t stop healthy people getting COVID-19, says WHO
The World Health Organisation (WHO), maintained that while masks could help limit the spread of COVID-19, they are insufficient on their own:
“There was no evidence that wearing a mask in the community prevented healthy people from picking up respiratory infections including COVID-19.”
A professor of the London School of Hygiene and Tropical Medicine, David Heymann, who chaired the WHO’s scientific and technical advisory group for infectious hazards, said unless people were working in health care settings, amasks are “only for the protection of others, not for the protection of oneself.”
He said masks could create a false sense of security that could end up putting people at greater risk. Even with the mouth and nose fully covered, the virus can still enter through the eyes:
“People think they are protected when they are not. Healthcare workers, in addition to the masks, wear visors too, to protect the eyes. Another concern is that people may contaminate themselves when they adjust, remove and dispose of their masks.”
The WHO said people who chose to wear masks in public should follow its advice to ensure they were using them safely. It said countries that recommended masks for the general population should set up studies to monitor their effectiveness.