Should you elect to wear masks when restrictions are lifted ?

U.K. is on course to lift almost all COVID restrictions in mid July 2021.

A U.K. minister has said that “wearing masks” would become a personal choice.

Just because there is a choice, it does not mean it is always good for you.

Government decisions are often made not only with scientific facts but also with economic and political considerations. Compulsory masks may not be liked by a section of society and Government has to take that into account in a democratic society.

Personally electing to wear masks in crowded public places could be sensible for the following reasons.

– There is some debate about the extent of protection a person gets wearing masks following the Danish mask study. But no robust scientific study has shown significant harm from wearing masks. So it is better to be safe and wear masks even if the extent of protection is debatable.

Infections are rising now and luckily, vaccines seem to have protected most people from getting severe COVID. But Vaccines are not 100% effective. Moreover, when infection rates go up further and society opens up more, there is a risk of variants emerging that may be partially vaccine resistant. So wearing masks may provide some protection.

– Not all people get poorly when they get COVID. But these people with COVID can still pass infection to other vulnerable family members and people who don’t have the protection from vaccines. So wearing a mask can stop people with mild COVID from spreading the infection to others.

– Some people do not want to wear masks because they think they are not at risk of death or hospitalisation. Remember, COVID related problems affect different people in different ways. Lot of people do recover from COVID without major problems. But some people do develop long-term symptoms from COVID. So it is better to wear masks for COVID protection.

References

1. BBC news. Covid-19: Masks will become personal choice, says Robert Jenrick
By Emma Harrison & Kathryn Snowdon
BBC News

2. Bloomberg. Face Masks in England to Become ‘Matter of Personal Choice’
By Andrew Atkinson
4 July 2021, 09:47 BST
Updated on 4 July 2021, 11:14 BST

3. Daily Mail. SAJID JAVID: The economic arguments for opening up Britain are well known. But, for me, the health case is equally compelling. By Sajid Javid For The Mail On Sunday 22:02, 03 Jul 2021 , updated 23:13, 03 Jul 2021

4. BBC news. Covid-19 in the UK: How many coronavirus cases are there in my area?
By The Visual and Data Journalism Team
BBC News

5. Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

6. BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

7. NICE. COVID-19 rapid guideline: managing the long-term effects of COVID-19
NICE guideline [NG188] Published: 18 December 2020

8. Coronavirus: When can we stop wearing face masks or coverings?
By Michelle Roberts
Health editor, BBC News online

9. Science. Implications of defective immune responses in SARS-CoV-2 vaccinated organ transplant recipients. Peter S. Heeger, Christian P. Larsen, Dorry L. Segev

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Do face masks prevent COVID illness ?

Yes, good masks may help to reduce infections that are spread by airborne particles.

But not all masks are the same.

Cloth masks were promoted during 2020 when the proper surgical masks were in short supply . The effectiveness of cloth masks are not well studied and they are of varying quality depending who made them and how well they were made.

Properly manufactured surgical masks are better than home made cloth masks. But how much protection they can offer is a matter of scientific debate. Surgical masks have been found to give some protection against other respiratory viruses in past. But a recent Danish study found no significant benefit against COVID among the general public.

The high quality FFP3 masks which filter most of the inhaled air is superior to normal surgical masks. A recent study from Cambridge found that Heath care workers who used FFP3 masks had better protection from COVID compared to normal surgical masks in the Hospital.

Overall, clean, well manufactured masks are likely to of some benefit to the public rather than wearing no masks at all. In the hospital setting, FFP3 masks seem to provide superior protection to Health care staff working with COVID patients.

And most importantly people have to understand that masks are not to be used alone. Masks got to be used along with protective measures such as social distancing and Hand-washing.

References

CLOTH MASKS

BMJ. Covid-19: What is the evidence for cloth masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1422 (Published 07 April 2020)
Cite this as: BMJ 2020;369:m1422

DANISH STUDY- SURGICAL MASKS

Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial
Henning Bundgaard et al. Ann Intern Med. 2021 Mar.

BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

BMJ. The curious case of the Danish mask study
BMJ 2020; 371
doi: https://doi.org/10.1136/bmj.m4586 (Published 26 November 2020)
Cite this as: BMJ 2020;371:m4586

Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

Spectator (magazine) https://www.spectator.co.uk/article/do-masks-stop-the-spread-of-covid-19-

Full fact.org. Danish study on mask efficacy only tells us half the story. 24 NOVEMBER 2020

Forbes. Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask
Leah Rosenbaum. Forbes Staff 18 Nov 2020. Critics of mask-wearing policies used a Danishstudy on mask-wearing to bolster their claims such policies are ineffective, but scientists, including those involved with the study, disagree.

JAMA Insights
February 10, 2021
Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
John T. Brooks, MD1; Jay C. Butler, MD1
Author Affiliations
JAMA. 2021;325(10):998-999. doi:10.1001/jama.2021.1505

CAMBRIDGE REPORT ON HIGH QUALITY MASKS

BMJ. Covid-19: Upgrading to FFP3 respirators cuts infection risk, research finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1663 (Published 29 June 2021)
Cite this as: BMJ 2021;373:n1663. https://www.bmj.com/content/373/bmj.n1663

BBC news. Covid: Masks upgrade cuts infection risk, research finds
By David Shukman
Science editor

Guardian. Cambridge hospital’s mask upgrade appears to eliminate Covid risk to staff
Hospital infection study shows use of FFP3 respirators at Addenbrooke’s ‘may have cut ward-based infection to zero’
Nicola Davis and Denis Campbell
Tue 29 Jun 2021 10.49 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Is this the beginning of the end for COVID-19 ?

The superstitious might say “don’t jinx it by calling the end early”……..

So the answer is “may be”.

The good news from two Vaccine trials indicates that this might be “beginning of the end” for COVID-19.

Two recent press reports give rise to lot of optimism to the population that is getting weary with the lockdown. It is good to have a ray of hope among all the doom and gloom.

The covid-19 vaccine (mRNA-1273) from US biotech company Moderna was found to be 94.5% effective.

Another mRNA vaccine developed by Pfizer and BioNTech was reported to be 90% effective.

Now the caveats…. these are interim trial results and the trial results have not been subject to scrutiny by the wider scientific community as the full results are yet to be published.

Clinical Trials usually recruit motivated people without too many other medical problems. So one has to hope that these interim trial results can be replicated in the wider elderly population with lot of medical problems.

Update: Now a third Vaccine, the “Oxford Vaccine” has been found to be 90% effective when given as “a half and then full” schedule.

Update: summary so far at BMJ website.

Let’s hope that all the vaccines are very safe and highly effective when used in the real world population.

References: (1). Covid-19: Vaccine candidate may be more than 90% effective, interim results indicate. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4347 (Published 09 November 2020). Cite this as: BMJ 2020;371:m4347.

(2). Covid-19: Moderna vaccine is nearly 95% effective, trial involving high risk and elderly people shows. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4471 (Published 17 November 2020). Cite this as: BMJ 2020;371:m4471

(3). Covid-19: Oxford vaccine is up to 90% effective, interim analysis indicates
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4564 (Published 23 November 2020)
Cite this as: BMJ 2020;371:m4564

Covid-19: What do we know about the late stage vaccine candidates?. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4576 (Published 24 November 2020)
Cite this as: BMJ 2020;371:m4576

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Some good news amid the doom and gloom: People have Longer immunity to Coronavirus infection after recovering from it.

After someone has recovered from a Coronavirus infection, the body remembers how to fight the virus in future. This is called immunity and it is not known how long this immunity will last.

If the immunity is not long lasting, people can get coronavirus infection again during the second and even third wave.

The body’s immunity is made up of two types of cells: B cells and T cells. T cells and B cells are central to the human immune system.

B cells produce antibodies and previously in various studies , they were found to decline rapidly give rise to fear that people would get Coronavirus infection again and again.

Now a study has reported that T cell immunity can last more than 6 months in patients who have recovered from an infection.

This news is also good from a vaccine point of view. It gives us hope that sooner or later an effective vaccine would become available.

BMJ News.
Covid-19: T cell response lasts for at least six months after infection, study shows
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4257 (Published 02 November 2020)
Cite this as: BMJ 2020;371:m4257

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Are families of Healthcare workers at increased risk of hospital admission due to COVID-19 ?

Yes !

“Patient Facing” healthcare workers do admirably put them at harms way during this Coronavirus pandemic .

So health workers are at increased risk of getting admitted to hospital due to COVID-19.

But a recent Paper in BMJ says that families of healthcare workers are also at increased risk of hospital admission. In very few other lines of work, does the occupational hazard affect the families of workers as well.

The authors report “ …. patient facing healthcare workers and members of their households were, respectively, threefold and twofold more likely to be admitted to hospital. Healthcare workers and their households accounted for one in six of all admissions with covid-19 in the working age population (18-65 years).”

The paper says “Among admitted healthcare workers, one in eight were admitted into critical care and six (2.5%) died; in admitted household members, one in five were admitted to critical care and 18 (12.9%) died.”

Routine testing of healthcare workers and early testing of families as well as better access to effective PPE is urgently needed.

References : 1. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3582 (Published 28 October 2020)Cite this as: BMJ 2020;371:m3582

2. Covid-19: risks to healthcare workers and their families. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3944 (Published 28 October 2020)Cite this as: BMJ 2020;371:m3944

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

How long can Coronavirus Virus Survive on doors, handles, furniture and fittings?

Coronavirus was previously known to survive for about 3 days at room temperatures. (On certain surfaces made of plastic and stainless steel).

Now an Australian team has found that Coronavirus can survive upto 28 days in Cold conditions. The results need to be interpreted with great caution as it tested virus under unusual artificial conditions and hence might not be relevant for real life situations

On the other hand , if the study is right, then it might indicate that the Pandemic can get worse during cold Winter before it gets better in Spring and Summer.

What can we do? In addition to Social distancing measures and Mask wearing, Frequent hand washing would stop the Virus from Spreading.

Every Week , we are learning more about the Virus. Let’s hope it comes to an end soon.

1. BBC news: Covid-19 virus ‘survives on some surfaces for 28 days’. https://www.bbc.co.uk/news/health-54500673

2. Daily Mail. https://www.dailymail.co.uk/news/article-8828459/Coronavirus-survive-MONTH-surfaces-including-banknotes-mobile-phone-screens.html

3. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1
April 16, 2020
N Engl J Med 2020; 382:1564-1567
DOI: 10.1056/NEJMc2004973

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

COVID-19 risk assessment of NHS members : is it an opportunity missed?

The National Health Service had recently embarked on a Risk assessment exercise of its staff to assess the Vulnerability of individual members to Coronavirus infection ( COVID-19).

The exercise is being done with good intentions. Given the unprecedented situation of the pandemic and lack of concrete data , the exercise seemed to have steered away from firm “one size fits all” type of recommendations.

Given the uncertainties with the currently available data on various forms of protection ( from simple surgical masks to shielding) , the exercise could have been a starting point for an nationwide intervention study .

An opportunity seems to have been missed and if there is a second wave, NHS might regret not learning from the first wave.

Please do add your opinion at the rapid response section of the BMJ.

References

1. Covid-19 risk assessment in BAME staff

Covid-19 risk assessment: a futile metaphorical strip search

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3251 (Published 26 August 2020)

Cite this as: BMJ 2020;370:m3251

2. Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2743 (Published 15 July 2020)

Cite this as: BMJ 2020;370:m2743

3. Complete protection from covid-19 is possible for health workers

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2641 (Published 07 July 2020)

Cite this as: BMJ 2020;370:m2641

4. Two metres or one: what is the evidence for physical distancing in covid-19?

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3223 (Published 25 August 2020)

Cite this as: BMJ 2020;370:m3223