To Mask, or Not to Mask, That Is Indeed the Question….Time to Look at This Again

To paraphrase Hamlet’s soliloquy, that is indeed the question we now face during this phase of the coronavirus pandemic. There are those amongst us that would have us all believe that the universal wearing of a face mask will save thousands of lives. However, instead of looking at this as the political statement it seems to have become, let’s take a look at the reasoning beyond this to see if a universal mask mandate really makes sense. Let’s look at some of the facts and not the political fodder that mask wearing has become for some in the media and politics.

First, let’s take a look at viral particle size and mask filtration characteristics. The SARS-CoV-2 viral particle known as a “virion” is about 120 microns in diameter although it probably varies from 60 to 140 microns. Cloth facial masks which most people are wearing are too porous to either catch the virus on exhalation if you have the virus or prevent you from inhaling it if you don’t.

Second, only a mask that has filtration characteristics of an N-95 mask or better has a chance of stopping such small particles. The “N” in N-95 stands for “Not Oil Resistant” and the “95” means that it will filter out 95% of particles 0.3 microns or greater in size. Without getting into the murky details of particle filtration science, suffice it to say that the SARS-CoV-2 virus itself may be smaller than the actual N-95 particle filter size, but the virus usually travels attached to larger particles or conglomerates of viral particles that are consistently snared by the filter. In addition, though the actual individual viral particle size may be smaller than the filtration or pore size of the N-95 material, there are other mechanisms that promote capture of the viral particle by an N-95 mask. For example, electrostatic attraction may promote attachment of the virus to the fibers of the mask and the erratic movement of the viral particles may also help to ensnare these viral particles in the filter material. In any event, the N-95 mask is pretty good in filtering out the virus if the filtration material is intact and if worn properly.

Third, a cloth mask may retain droplets of expiratory secretions, but these droplets are not going to be airborne for prolonged periods like an aerosol would be likely to do. So if a person is infected, a cloth mask may be of some benefit in limiting spread of the virus due to droplet transmission in a close environment. For example, if a carrier of the virus happens to sneeze or cough up droplets, then these infected droplets may be retained in the cloth fibers of the mask thereby limiting the spread of the virus to others. However, a cloth mask will not stop the transmission of aerosolized viral particles that may also be launched by a cough or a sneeze. Likewise, on the receiving end, a non-infected person wearing a cloth mask might be somewhat protected from the large droplets launched by a infected person with a cough or a sneeze, but a cloth mask will not protect him from aerosolized viral particles which will pass through a cloth mask. Bear in mind that when an infected person coughs or sneezes there is both droplet and aerosolized transmission of the virus.

Fourth, many people now seem to feel it is necessary to wear a mask, cloth or otherwise, when they are in the wide open spaces walking, running, or riding a bike with no one within yards or miles of themselves. This may make them feel more comfortable and protected, or it may make them feel that they are better neighbors because they are protecting others even if they themselves are asymptomatic. However, the reality of such protection is very questionable because the need for a mask of any kind under these circumstances is questionable. My personal feeling is that using a mask of any kind in this setting, and I emphasize “in this setting” is unnecessary and tends to foster paranoia, or at least unnecessary worry, at a time when we should be trying to bring things back to normal.

So my suggestions regarding mask wearing are:

  • Wear an N-95 type mask if you are in an enclosed area where you cannot maintain a good degree of social distancing. This affords the best degree of protection both for yourself and others.
  • If you don’t have an N-95 mask and can’t maintain social distancing, than by all means use a cloth mask at the very least. It will provide some limited degree of protection.
  • If you are in the wide open spaces for a walk, jog or a bike ride, then wearing a mask of any kind seems unnecessary. It’s time to start bringing things back to normal.

National Psychosis—A New Epidemic

I’m not a psychiatrist, but it strikes me as a physician that we may be dealing with a somewhat unique type of psychosis in the U.S. characterized by widespread delusion shared among large numbers of people. There are precedents of shared delusion disorder (SDD, ICD 10 code f24), but when it occurs it is usually in a small number of people such as between two people who are in a close relationship. The French term for this is “folie a deux” which translated loosely means “madness for two.” Occasionally it can include larger groups such as a family in which case the term “folie a famille” has been used, “family madness.”

However, now we appear to be witnessing the evolution of a new delusional or psychotic disorder involving huge numbers of people who in their delusional state believe that their home country, the United States of America, is a monstrous place rife with hatred, bigotry, injustice, and evil. All of which characteristics they paradoxically have assumed onto themselves. One might believe that this mass delusional state is an extension of the previously described “Trump Derangement Syndrome,” but it is far more serious than that disorder often manifesting itself in violent and destructive ways including the burning of buildings, destruction of businesses, savage beatings, and even murder. These activities are often portrayed by their perpetrators and by those who propagate their delusions as justifiable and righteous acts which should be condoned and praised by all in the U.S. even those who do not agree with them and those who have been tormented by them. Destruction of society as we know it seems to be the goal.

To make matters worse from a sociological and psychiatric point of view, this delusional disorder seems to have spread to many of our political leaders in an epidemic fashion the consequences of which in the long run may be far worse than that of the Covid-19 epidemic. Yet the origins of this epidemic may not have stemmed directly from the general population of our citizens and spread upward to the leadership. Rather it seems more likely that the origins of this disorder can be traced to many of our politicians who have completely lost the ability to discern truth from falsehood. These political “leaders” have become very adept at developing their own alternate reality which they then feed to their followers as truth that cannot be denied or refuted. The term “liberalism” has now developed a new meaning much more akin to that of “fascism” since alternative thought and speech is prohibited by the new liberals who are replacing the old guard of the Democratic Party. Groupthink takes over in this new environment, and the mob absorbs a unifying mentality seeing only the “reality” that they are being fed by leadership who have usurped individual freedom of thought. Think differently from the new fascists and run the risk of being assaulted verbally if not physically. That’s why we see many of our so called “leaders” on the left ignoring the violence and mayhem that they intentionally or unintentionally provoked all over the country. They have lost control of the situation, and they don’t know what to do about it. They can’t put out the fire.

Their position in the new social framework they were trying to create has been usurped by anarchists like ANTIFA and the fringe elements of Black Lives Matter. The old guard of socialist ideology is befuddled now and does not know how to gain back control of the social monster they have created. So they try to convince the rest of us that the protests are peaceful when we see rioting, looting, mayhem and worse. We are told not to believe our eyes. They have no way of dealing with the monster they created except to say that it doesn’t exist. We see this in the media all the time now as a blatant display of denial, deflection, downright lying and perversion of the truth. For example, we are told that saying “all lives matter” is wrong and somehow a demonstration of racial prejudice and bigotry when in fact it is just the opposite. It is a statement of equality. What could be a greater statement about equality than valuing all life equally? It is madness not to realize this.

Cities On Life Support

Can They Be Resuscitated? Should They Be Resuscitated Or Made DNR ?

Needless to say the events of the past year have had a devastating effect on New York City as well as on other major cities across the country. Many of these great cities like Chicago, Los Angeles and Seattle are virtually on life support at this time. First, having been decimated by Covid-19, otherwise known as the “plague” or “China Virus,” these cities were next set upon by gangs of marauding vandals whose clear intent was to pillage and destroy the very cities that contributed so much to making this country great. Legitimate issues that initially provoked rightful protests and demonstrations were usurped by anarchists whose sole aim was not justice but rioting and destruction of the country. These anarchists used whatever tools they could to wreak havoc on everyone who failed to join them in their quest of destruction. They were organized and appeared to be well funded by sources who yet remain in the shadows. What they managed to accomplish in large part was the ruination of the businesses and residential areas upon which these cities depended for survival both economic and social. So our great cities sustained a “one-two” punch. The first being the Covid-19 itself and the second being the riots. Now those people who can are leaving the big cities in droves. Thanks to technology “telecommuting” has become a real thing. Many of us no longer have to go to a conventional office to work. We can work in a virtual office anywhere so why risk living and working in a city that is falling apart and dangerous? The leaders of these cities have really done nothing to help their fellow citizens who want to stay and work. These citizens are not protected, and they are not supported so they feel it is time to leave. Who can blame them? In actuality, it is time to leave if your leaders cannot or will not protect you because their priorities lie elsewhere. In this case these priorities seem to lie with the rioters and anarchists. So can our cities be resuscitated? Should we even try?

The situation with our cities really is like a critical illness. They were first attacked by a terrible virus. Many of our elected state and city leaders made bad treatment decisions which resulted in loss of life. These mistakes were unintentional, but they happened just like in real medicine. Weakened by a terrible virus our cities were next attacked by another necrotizing infection; namely, anarchy and rioting. Call it whatever you like, but this second wave of destruction caused by criminals was analogous to what is seen in medicine when a patient weakened by an infection is hit with a second infection causing even more severe damage. The third and final assault on theses patients, our cities, who were in the care of our political leaders is the exodus of the heart and soul of the city. The middle class upon whom these cities depended can no longer can afford to live in the city. Nor do they want to, and they certainly don’t have to. The wealthy are now joining the exodus. They can easily afford to live elsewhere. The only ones left, unless things drastically change, will be those who cannot afford to leave.