On October 28, 1918, a San Francisco farrier named James Wisser called on a crowd on a street corner to throw away their masks in violation of a local mask mandate issued a few days earlier. He was shot twice after resisting an attempt by a local health inspector to force compliance. At the time, most of the medical community believed that cotton gauze masks were helpful in slowing infections, but dissenting voices believed that the masks had no effect. And others, such as a prominent doctor in Santa Barbara, California, named James Bainbridge, who stated that “the simple use of a mask tends to spread rather than stop the flu.” What is clearest in retrospect is that infection and death rates continued to wax and wane until the microbe itself mutated into a milder form.
Our understanding of respiratory diseases has greatly improved since the days of the Spanish flu. At that time, we did not know whether the pathogen was a bacterium or a virus, nor about the genetic role of DNA and RNA. Antibiotics and antiviral drugs were far away. Today, the risk of getting sick is lower than it was a century ago, but it’s still serious, so we continue to look for better ways to protect ourselves from infection.
Unfortunately, it is not easy to stop the movement of things as small and airborne as viruses. They can slip through all but the tiniest gaps, leaving the barriers we’ve put up only partially effective. The countless viruses that are stopped gather and the barriers become dangerous, and the viruses that get through continue on their mission to spread.
A recent mask study in South Korea has drawn attention by showing that KN94 masks can expose users to dangerous levels of harmful compounds. This news is worrying for people who wish to wear a mask and leads to a difficult risk/benefit choice. But a careful reading of the study, beyond the headlines, shows that only 14 masks were examined and that waiting 30 minutes between opening the package and wearing the mask dissipates most of the harmful chemicals. The choice to wear a mask is and should remain the choice of informed people.
But some public health officials are considering announcing new mandates. They see a double threat to society. Australia’s flu season, which is consistently a preview of our flu season, has been severe this year and the majority of cases are in children. At the same time, a new strain of COVID-19 is causing cases and hospitalizations to spike again. From July to October, hospitalizations rose by 65 percent. And public health officials can’t ignore the facts or simply believe that current treatments like antiviral drugs like Tamiflu and Paxlovid will be enough for many of the people who will get sick.
We can still do a better job of reducing infections through barriers. Using a manufacturing process for materials made up of very small fibers called electrospinning, a 2021 study found that masks and filters made from electrospun material trap virtually all coronavirus-sized particles. Even the best respirators and high efficiency filters fall short of this efficiency.
And in a study in Nature, similar efficacy was documented with HEPA filters to which a recently developed and highly charged non-toxic polymer called C-POLAR was added. C-POLAR is a non-toxic compound from a class of polymers (cationic) that has been studied since the 1960s for antimicrobial properties, and in addition to capturing viruses, is completely effective in inactivating them.
As fall respiratory disease season approaches, it would be a mistake for officials to reimpose the kind of mandates that didn’t work in the recent pandemic any better than a century ago. But they would do well to educate the public to make rational choices and help improve access to new technologies that work well and can be chosen through reason rather than fear.
Ken Blaker is a Los Angeles-based healthcare technology consultant focused on medical devices and FDA compliance. As an author, Ken has written on a variety of topics including the treatment of neurodegenerative diseases, cancer research, and the opioid epidemic.