Please edit the letter below to suit your position and opinion as a patient of a health care provider and partition the regulatory bodies. Important points to note is that mask wearing covers the face and muffles the voice which significantly inhibits optimal communication which is imperative in cultivating and maintaining good Dr.-patient relationship, that this interference reduces the sense of safety and confidence one might have in a health care provider.
Dr. David Williams, Ontario’s Chief Medical Officer of Health - dr.david.williams@ontario.ca
Jeff Burch, MPP Niagara Center - JBurch-CO@ndp.on.ca
College of Chiropractors of Ontario - cco.info@cco.on.ca
Below is the letter (with accompanying research) I have sent to change mandatory to voluntary wearing of masks:
May27th, 2020.
Dr. David Williams, Chief Medical Officer of Health for Ontario
ATTN: Jeff Burch, MPP Niagara Center
ATTN: Vance Badawey, MP Niagara Center
Re: Face masks: In the best interests of the health of our community, physically and relationally
Dear fellow Servants:
Thank you for what I’m sure feels like tireless and maybe even thankless work during such turbulent times as you look to care for the people within your assignment.
I am writing to you about a very hot and likely sensitive topic given the current climate… whether to or not to wear a respiratory mask for protection of others as well as self-protection. As we can all tell, the narrative on this has been very muddied and there seems to be much confusion and debate on what is the right thing to do for public and personal safety.
As health care providers serving the public, we are called to act in their best interest, part of which is avoiding anything that would put them in harm’s way. I believe inherent in that is setting a proper healthy example for the people we serve as we provide health care.
The overwhelming sentiment in the scientific literature is that respiratory masks worn by healthy (asymptomatic) individuals are not effective for personal safety or the safety of others, and what’s worse they have been shown to be quite unhealthy and jeopardize the immediate and long-term health of the wearer.
What is not covered is the affect that masks have on effective communication and relationship, especially between Dr. and patient, that I’m sure is obvious even with basic understanding of communication.
In brief, I’m asking you to make the necessary changes to guidelines relating to the mandated wearing of masks, especially for those of us who are providing health care, and pass these changes onto our regulatory bodies that govern the work we do as health care providers.
Below is a short synopsis of studies that illustrate this.
Dr. Rancourt did perhaps the most recent and exhaustive evaluation of the most relevant studies available on the topics of masks with reference to Covid-19 and his conclusions of the meta-analysis of the available research is summed up in the article abstract below.
“Masks and respirators do not work. There have been extensive randomized controlled trial (RCT) studies, and meta-analysis reviews of RCT studies, which all show that masks and respirators do not work to prevent respiratory influenza-like illnesses, or respiratory illnesses believed to be transmitted by droplets and aerosol particles. Furthermore, the relevant known physics and biology, which I review, are such that masks and respirators should not work. It would be a paradox if masks and respirators worked, given what we know about viral respiratory diseases: The main transmission path is long-residence-time aerosol particles (< 2.5 μm), which are too fine to be blocked, and the minimum-infective-dose is smaller than one aerosol particle. The present paper about masks illustrates the degree to which governments, the mainstream media, and institutional propagandists can decide to operate in a science vacuum, or select only incomplete science that serves their interests. Such recklessness is also certainly the case with the current global lockdown of over 1 billion people, an unprecedented experiment in medical and political history.” Rancourt, D.. (2020). Masks Don't Work: A review of science relevant to COVID-19 social policy. 10.13140/RG.2.2.14320.40967/1.
A bullet point summary of a handful of the relevant studies cited is referenced below, and citation hyperlinks included for ease of verification or more in-depth study…
“None of the studies reviewed showed a benefit from wearing a mask, in either HCW or community members in households.”
“We identified 6 clinical studies ... In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection, (b) influenza-like illness, or (c) reported work-place absenteeism.”
https://www.cmaj.ca/content/188/8/567
“Among 2862 randomized participants, 2371 completed the study and accounted for 5180 HCW-seasons. … Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.”
https://jamanetwork.com/journals/jama/fullarticle/2749214
“A total of six RCTs involving 9 171 participants were included. There were no statistically significant differences in preventing laboratory-confirmed influenza, laboratory-confirmed respiratory viral infections, laboratory-confirmed respiratory infection and influenza-like illness using N95 respirators and surgical masks. Meta-analysis indicated a protective effect of N95 respirators against laboratory-confirmed bacterial colonization (RR = 0.58, 95% CI 0.43-0.78). The use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory-confirmed influenza.”
https://onlinelibrary.wiley.com/doi/epdf/10.1111/jebm.12381
“There were 17 eligible studies. … None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”
https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1750-2659.2011.00307.x
Many of the articles cited reference influenza virus protection for the Covid-19 specific studies due to its recency are as of yet unavailable, but Rancourt confirms the results would be relevant and applicable. Dr. Rancourt concludes, “No RCT study with verified outcome shows a benefit for HCW or community members in households to wearing a mask or respirator. There is no such study. There are no exceptions. Likewise, no study exists that shows a benefit from a broad policy to wear masks in public.”
Another literature synopsis I encourage you to review is from Dr. Russel Blaylock entitled: Face Masks Pose Serious Risks To The Healthy. This well referenced discussion on the efficacy and safety of face masks can be found at the following web citation:
Some of the key points are highlighted below…
“Dr. Russell Blaylock warns that not only do face masks fail to protect the healthy from getting sick, but they also create serious health risks to the wearer. The bottom line is that if you are not sick, you should not wear a face mask.”
“17 of the best studies were analyzed, concluded that, “ None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection.”1 Keep in mind, no studies have been done to demonstrate that either a cloth mask or the N95 mask has any effect on transmission of the COVID-19 virus. 81% developed headaches from wearing a face mask.”
“The researchers found that the mask reduced the blood oxygen levels (pa02) significantly… The importance of these findings is that a drop in oxygen levels (hypoxia) is associated with an impairment in immunity. Studies have shown that hypoxia can inhibit the type of main immune cells used to fight viral infections called the CD4+ T-lymphocyte. This occurs because the hypoxia increases the level of a compound called hypoxia inducible factor-1 (HIF-1), which inhibits T-lymphocytes and stimulates a powerful immune inhibitor cell called the Tregs. . This sets the stage for contracting any infection, including COVID-19 and making the consequences of that infection much graver. In essence, your mask may very well put you at an increased risk of infections and if so, having a much worse outcome.”
“Repeated episodes of hypoxia has been proposed as a significant factor in atherosclerosis and hence increases all cardiovascular (heart attacks) and cerebrovascular (strokes) diseases.”
The final study I’d like to bring to your attention from BMJ entitled - A cluster randomised trial of cloth masks compared with medical masks in healthcare workers by MacIntyre, Seale et al.
https://bmjopen.bmj.com/content/5/4/e006577 Dr. Colin Furness, an Infection Control epidemiologist at U of T when discussing mask use and Covid-19 referenced the findings of this BMJ study article stating:
“wearing a mask can be dangerous. That is if the wrong mask is worn, it's worn incorrectly or people have incorrect expectations when wearing it. "The worst one is wearing one for too long," he said, noting masks can collect bacteria and other viruses. He said a study in a U.K. medical journal showed health-care workers who wore cloth masks all day while working were 13 times more likely to get a respiratory illness when compared to the standard practice of only wearing a mask when necessary. Those who wore a paper or procedure mask were twice as likely to get some type of respiratory infection if they wore it all day. …”A mask, you're breathing on it all day long creating all this wonderful space for bacteria to multiply, and once they get to a certain quantity you start inhaling them.”
I would urge you Dr. David Williams, as Ontario’s Chief Medical Officer, to be a stand for health and what’s best for the people of Ontario whom you are mandated to protect and change operational requirements especially for health care providers. Given the available scientific literature clearly demonstrates the benefits of wearing face masks do not outweigh the risks, AND, we are actively pre-screening ourselves, our staff and our patients in advance of any contact made with them, I ask you to make the necessary change from mandatory to voluntary wearing of masks.
If we collectively are to be acting in the public’s best interest, we should not encourage or model behaviors that put ourselves, our employees or our patients at risk.
Thank you for your time in reviewing these papers, the plethora of scientific studies referenced and of course in considering any current or future health sector recommendations in light of them. And my continuing recognition and thanks for all you do for this great province.
Sincerely,
Dr. Thomas Egan.
