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Amy Hall

Professor Rebecca Morean

English 1201.505

30 July 2020

Wear a Mask, Save a Life!

Videos of the inside of Chinese hospitals started to emerge in January 2020, showing the

desperation of the patients infected, the pleas of help from the hospital employees, and the

overloaded corridors filled with beds because there were no rooms available (“Leaked Videos

from China”). News and internet stories had pictures of everyone in public wearing a mask in

Wuhan, China, while the streets were being sprayed with disinfectant. Then less than two months

later, the Coronavirus (COVID-19) hit the US, even harder and spreading faster than it did in

China. Some hospitals in the United States were facing the same dilemmas that China faced,

overcrowding in hospitals and not enough Personal Protective Equipment (PPE). Now, face

masks have become part of the “new norm” but is that beneficial? How does people reduce the

possibility of transmission to another person? Could it cause more harm than good if someone

removes their mask improperly or does not wash their hands after touching their mask? Are the

chances of infecting someone else reduced significantly enough to require everyone to wear a

mask? The answer is that face masks should be required in public places as a preventive measure

against COVID-19 by slowing down the spread of respiratory droplets.

In January 2020, the first US case of COVID-19 was confirmed in the state of

Washington. Americans started hearing new words for the first time, “social distancing,”

“unprecedented,” and “Universal Masking.” By mid-March, businesses were forced to close,

essential workers were the only employees to report to work, restaurants could only offer
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delivery or drive thru service. The public was encouraged to stay home. Surgeries were

cancelled. Schools and churches were shut down. Nursing homes enforced a “no visitor” policy

to protect their residents. Recommendations were made to the public to not wear a mask. The

threat of a shortage of PPE was initially the reason. People started making cloth masks but those

were also not recommended to protect against COVID-19. Then any mask, cloth or disposable,

was recommended to wear in public. Now, masks are required by almost all of Ohio. As new

studies are happening and new information is interpreted, recommendations have also changed,

leaving America to question any policies or guidelines enforced by the Government.

The severity of COVID-19 varies from person to person. Some may be asymptomatic,

while others never recover. According to the Centers for Disease Control (CDC), an Agency that

monitors threats again Americans, both in the US and elsewhere, symptoms range from fever to

loss of taste or smell. Elderly people seemed to be the hardest hit at the beginning of the

pandemic but now nobody is safe. A stay-at-home order was issued to help alleviate the medical

system and preserve much needed PPE for healthcare workers. Another problem is that COVID

is so easily spread that patients are unable to have family members at their bedside when they are

hospitalized, which is both scary for the patient and taxing on the health care workers.

To understand if masks are beneficial, we must first understand how a virus spreads. In a

peer-reviewed article by Alex Rodriguez-Palacios, an Assistant Professor at Case Western

Reserve University’s School of Medicine, COVID-19 is mainly transmitted from person to

person via respiratory droplets that are produced when someone talks, sneezes, or coughs that

can land in the mouth or nose. These particles could also be inhaled into the lungs or introduced

into the body from touching something that has infected droplets on it.
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A writer at Massachusetts Institute of Technology (MIT), Peter Dizikes, reports on a

study done by the MIT researchers about the “gas cloud” that is emitted when a person coughs or

sneezes. When a person sneezes, the smaller droplets travel further and remain airborne much

longer, possibly long enough to reach a ceiling ventilation unit, thereby dispersing the droplets

even further (Dizikes). Luckily, the smaller the droplet, the less likely a person will get infected

from it. The average sneeze reaches about seventy-one inches (Rodriguez-Palacios), which is

five feet eleven inches. This is why the six-foot social distancing rule is so important. However,

it is possible that the droplets can linger in the air for a period of time, allowing an unsuspecting

person to walk right through the droplets moments later. Wearing a mask may provide some

protection from droplets entering the body.

The worst part is that “transmission from people with asymptomatic infection has been

well documented,” states Dr. Michael Klompas, a Professor at Harvard Medical School. And

since it is possible to become infected without knowingly coming into direct contact with an

infected person, it is also possible to spread the infection before one knows they have been

compromised. Therefore, wearing a face covering significantly reduces the number of respiratory

particles released into the air by the user. However, the user must keep in mind that they are still

susceptible to catching the virus as it could enter through their mask or into the openings around

their mask. There is also a possibility that the virus is on the outside of the mask and could be

touched and then introduced into the body. It is especially important to continue to use other

preventative measures, such as hand washing, and avoid touching the face, to combat the spread

of Coronavirus.

Which type of mask is appropriate? There are N95 masks, surgical masks, disposable

cloth masks, and reusable cloth masks. In April, Professor Raina MacIntyre, who is head of the
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Kirby Institute Biosecurity Program, published an article in the Journal of Travel Medicine

where the World Health Organization (WHO) suggested that using masks in the community has

no benefit. Part of the reasoning for that statement was to protect the limited stock of masks that

health care workers desperately need. Since then, reusable cloth masks have been made readily

available for purchase or one could simply make their own with easy-to-follow instructions.

N95 masks are at least 95% effective at blocking particles from entering the mask. The

user must be “fit tested” in order to properly wear this mask. It is designed to fit snuggly around

the mouth and nose to prevent droplets from entering around the seal. The N95 masks are

reserved specifically for health care workers. Another type, the medical mask, is normally used

in the surgical field to protect the patient from being infected by the wearer. It does offer some

protection to the wearer as well because it is fluid-resistant to avoid potential sprays or splatter

from penetrating the mask. o Then there is the common 3-ply disposable mask, generally blue in

color. These are rated for non-medical use but are acceptable for the general public. They also

have ear loops for easier use, whereas the surgical masks tie behind the head.
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The increasingly popular choice is the reusable cloth masks. These masks are made of all

types of material, come in different shapes and sizes, and provide more protection to others than

the wearer. These masks can be made to support a filter, which would be placed in between two

pieces of cloth material; those provide the greatest protection for the wearer. The type of

material, such as cotton or polyester used for the mask will determine how much protection it

will offer. When the mask is held up to the light, the more light that passes through it, the more

chances of respiratory particles passing through it as well (see figure 1). In the following figure,

all materials provide some protection. Two layers are better than a single layer. A double layer

polyester pillowcase provides the best protection as a homemade mask

Figure 1. Images taken in high resolution to see which textiles light passes through easily. The

top row is a single layer and the bottom row is a double layer. (Rodriguez-Palacios, et al).

One may argue that wearing a mask increases the chances of touching the face or goes

against one’s constitutional rights. Wearing a face mask that is uncomfortable or the wrong size
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has potential for the user to continually readjust it. However, the truth is, even without a face

mask, people touch their face on average twenty-three times an hour, according to a study

published by Yen Lee Angela Kwok, School of Public Health and Community Medicine. The

study was done in 2015 with medical students. The results found that of all face touching done,

44% involved mucous membranes and of that, 36% involved touching the mouth (Kwok).

Wearing a mask limits the user from touching the mouth and nose, if worn properly.

For the people that believe their rights are infringed upon, the use of a mask in the

community is not about protecting the wearer, it is about protecting the people around them.

Polly Price, Asa Griggs Candler Professor of Law, contributed to the Expert Forum for

ACSLaw.org (American Constitution Society), comparing the use of masks to the smoking ban

where the law was put into place to protect the employees and patrons of a business. In her

Forum, Price also states that, “Masks reduce the chance of infected people transmitting the…

virus. State or local face-covering requirements rely on the current medical consensus that not

wearing a face covering or mask may endanger others.” In a situation like this, the court

normally sides with legislation (Price) and rightfully so.

Wearing a mask should not be a choice but a requirement simply because it is possible

that it will save lives. There are two reasons to wear a mask, to protect oneself and to protect

others. It does have the potential to prevent a healthy person from touching their mouth, thereby

stopping the virus from entering through mucous membranes. It also stops an infected person

from contaminating others, especially when the person unknowingly has COVID-19

(MacInytre). With so many people who are asymptomatic, this provides a great benefit to

everyone. This virus targets every human being.

For the community, reusable cloth masks are now recommended. To prevent self-

contamination, the masks should be washed daily (Macintyre). It may also be wise to have

multiple masks that can be changed in between errands. Keep in mind that handwashing or

sanitizing is strongly suggested after removing a face mask to prevent any germs that may have

been on the outside of the mask from getting into the body. Reusable cloth masks should go into

a paper bag to transport and may be washed with other clothes.

As the United States is trying to open back up and return to some sort of “normal,” it is

imperative to continue to take precautions. There is such a shortage of much needed medical

supplies, even to care for the everyday Emergency Room visits and other routine medical

procedures, that it is senseless to risk putting oneself or someone else in danger of contracting

such a deadly virus. For the people who think their immune system is healthy enough to endure

it, they might be right, but that person can still pass it on to someone who may not be able to

survive it. And as the hospitals become overwhelmed and run short on supplies, it will not just be

COVID patients that will be affected. Car accidents, sports injuries, heart attacks, and

appendicitis patients will also face the same medical supply shortages and overwhelmed staff.

Think back to all the elective cases that had to be cancelled or postponed. While elective

cases are not a life-or-death surgery, for many it is to relieve common ailments. Douglas Wood,

the chair of University of Washington’s Department of Surgery, commented in an article written

by Bobbi Nodell saying that, “Surgery alleviates disability and pain, and it improves quality of

life… Thousands of people have been asked to live with pain or delay their cancer surgery.” Just

in the initial twelve weeks when COVID had peaked, it is estimated that four million surgeries in

the United States were cancelled (Nodell). Since that time, elective surgery has begun to start
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again. There are still obstacles though, such as anxiety for patients to return to the hospital and

the shortages of PPE.

Figure 2. New Cases by Day in the United States (Centers for Disease Control and Prevention)

The number of total cases confirmed is rising daily in the United States. As Figure 2

shows, when the economy started to open back up, there was a steep incline in reported cases.

Prior to that, the curve had started to flatten. The total number of new cases for one day is over

70,000; and that is just for America (Centers for Disease Control and Prevention). According to

Ohio’s Department of Health webpage, there have been almost three-thousand deaths and 2,305

patients admitted into the Intensive Care Unit, as of 17 July 2020.

Implementation of face covers, masks, or scarfs will reduce the risk of transmitting and

acquiring COVID-19 (Rodriguez-Palacios). Along with proper handwashing, the United States

can fight this pandemic and overcome this disease. It will take more than just masks and

handwashing, but at least that is a start. It is something that can be done today. Is that not enough

to convince even the most stubborn person to wear a mask? China is still seeing new cases each

day, and although the numbers are not as big now, it has been over seven months since the first

case was confirmed. The health of the public is greater than the health of the individual, and that
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is exactly what the Government is trying to protect, the entire public. Nobody wants another

wave of infection, despair, and desperation like China and parts of the United States has

witnessed.

Works Cited

Alex Rodriguez-Palacios, et al. “Textile Masks and Surface Covers—A Spray Simulation

Method and a ‘Universal Droplet Reduction Model’ Against Respiratory Pandemics.”

Frontiers in Medicine, vol. 7, May 2020. EBSCOhost, doi:10.3389/fmed.2020.00260.

Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Updated

16 June 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-

covid-spreads.html. Accessed 10 July 2020.

Dizikes, Peter. “In the Cloud: How Coughs and Sneezes Float Farther than You Think.” MIT

News, 8 Apr. 2014, news.mit.edu/2014/coughs-and-sneezes-float-farther-you-think.

Klompas, Michael, et al. “Universal Masking in Hospitals in the Covid-19 Era: NEJM.” New

England Journal of Medicine, 1 Apr. 2020,

www.nejm.org/doi/full/10.1056/NEJMp2006372?

query=recirc_mostViewed_railB_article#article_citing_articles.

Kwok, Yen Lee Angela, et al. “Face Touching: A Frequent Habit That Has Implications for

Hand Hygiene.” American Journal of Infection Control, U.S. National Library of

Medicine, Feb. 2015, pubmed.ncbi.nlm.nih.gov/25637115/.

“Leaked Videos from China reveal what’s really happening in Hospitals.” YouTube, uploaded by

Epoch Times, 10 February 2020, https://www.youtube.com/watch?v=QcE4JZg2GqM

MacIntyre, C Raina, et al. “Community Universal Face Mask Use during the COVID 19

Pandemic - from Households to Travellers and Public Spaces.” Oxford Academic, Journal
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of Travel Medicine, 18 Apr. 2020, academic-oup-

com.sinclair.ohionet.org/jtm/article/27/3/taaa056/5822103.

Nodell, Bobbi. “Study: Pandemic Halts, Delays 28 Million Elective Surgeries.” UW Medicine

Newsroom, 19 May 2020, newsroom.uw.edu/postscript/study-pandemic-halts-delays-28-

million-elective-surgeries.

Price, Polly, and Patrick Diaz. “Face-Covering Requirements and the Constitution: ACS.”

American Constitution Society, 5 June 2020, www.acslaw.org/expertforum/face-covering-

requirements-and-the-constitution/.