Face Masks and COVID-19: What are the scientific facts?
From the start of the COVID pandemic, authorities throughout the world have recommended wearing a face mask, practicing frequent and thorough hand hygiene, and social distancing as the most effective precautions to both protect ourselves and help slow the spread of this deadly disease. Yet the issue of wearing a face mask is- if anything- becoming more controversial among the population and a recent report states that 80% of respondents who wear face masks still have questions about it. So what are the facts? Here is scientifically resourced information from a number of clinical trials, in the United States as well as throughout the world.
First let’s talk about the different kinds of face masks.
The “gold standard” in face masks are N95 masks. N95 masks are actually a type of respirator that filters out both large and small inhaled particles. The name derives from these masks block 95% of very small airborne particles. Healthcare workers are trained specifically in the fit and use of these masks in the workplace. Because of a general shortage of these masks, the recommendation for the general population is to instead rely on disposable masks or cloth face masks.
The disposable, usually blue face masks are called surgical masks. These loose fitting masks when worn correctly protect the wearer’s nose and mouth from contact with any droplets/particles or sprays that contain germs, including the virus. Surgical masks also protect others by reducing exposure through air or saliva coming from the wearer.
Although these masks are not specifically approved for healthcare workers, they provide some protection in these settings when N95 masks are not available.
Cloth face masks are designed to trap droplets that are released when the wearer talks, coughs, or sneezes. If everyone wears a cloth face mask, it will reduce the spread of the virus from individuals who are infectious but don’t know it. Cloth face masks are most likely to reduce the spread when worn in any public setting and that protection is enhanced by social distancing and hand hygiene. Cloth face masks can be made of a wide variety of materials, with varying numbers of layers.
Unacceptable face masks: Some N95 respirators, as well as some cloth face masks, have one-way valves that can make them easier to breathe through. Although these masks can protect the wearer from coming into contact with the virus, they DO NOT protect others if the wearer is infectious since unfiltered air is expelled. That is why these masks are actually banned in many places for community use.
What do the scientific studies tell us about the efficacy of face masks in absorbing- and not transmitting- the coronavirus and other respiratory particles? In the past 6 months there have been thousands of studies asking this question with a wide variation in the scientific value of the studies. The best way to assess what information is reliable is something called a meta-analysis. Meta-analyses are statistical studies the include a large number of studies asking the same question. The value of meta-analyses are the strict objective inclusion/exclusion criteria to eliminate out the unreliable studies. A review of two such analyses provides very clear evidence of when the use of facemasks are effective in community settings – what applies to all of us. The conclusions of both of these analyses are that proper wearing and use of face masks in the community setting are effective at slowing the spread of this virus, especially as infected persons in the community do not show symptoms. The type of cloth in the face mask does make a difference in how well it absorbs virus particles. Single layer cloth face masks, including scarves, are somewhat protective but less than double layered masks especially with an additional filter. Surgical masks – the disposable blue ones – are 3 times as protective as a single layer cloth mask but are comparable to layered cloth masks with filters. Additionally, it was reported that face mask usage was even more effective with hand washing and careful hygiene. Some studies compared partial coverage vs high coverage. We all have seen individuals wearing masks – sort of – but usually below the nose. Most studies report that partial coverage is more effective than no mask but only roughly 25% as effective as a full coverage – covering nose and mouth- mask.
The bottom line – supported by numerous studies of community spread in a number of countries including the US- is that wearing a mask in public is effective at slowing/reducing the spread of COVID. It is important to wear the mask correctly – make sure the mask covers your nose and mouth; don’t touch your mask with your hands; when you remove the mask- wash your hands – carefully remove the mask by the ear loops and put it in the wash. Wash your hands again.
In these times of the Quarantini and Zoom happy hours, I thought it would be worthwhile to look into potential effects of alcohol consumption on well-being in these COVID-19 times. I asked this question of Google – and got over 600,000 hits! Clearly this is on a lot of people’s minds!! In fact, early on there was a surge of posts claiming that drinking alcohol was actually protective against the virus. After all – the key ingredient in hand sanitizer is alcohol – so by extension….this might make sense?? Definitely not!!! And thankfully, there have been numerous articles – including from the World Health Organization (WHO) completely debunking this myth. However, liquor stores/distributors were declared essential businesses in the first days of our national shutdown and in March liquor sales increased by more than 55%, while online liquor sales were up by 250%. Restaurants – not yet open for dining – are offering home delivery and carryout cocktails. Clearly, alcohol consumption is up now- as has occurred during previous stressful times such as post 9/11 or after Katrina or Hurricane Sandy. It is not uncommon to turn to drinking for stress relief and our now virtual social interaction. Last Saturday SNL even did a skit entitled Let Kids Drink as a way of relieving some of the stresses of families being isolated together. But what are the dangers here? Long term follow-up studies 3 years after 9/11 and the other stressful events have shown significant increases in alcohol and substance dependence in the general population – and we are likely to be suffering the stress of the current situation far longer than these previous events. And rather than being in any way “protective” heavy alcohol use impairs the immune system and especially lung function, causing acute respiratory distress syndrome (ARDS) which is a major component of COVID-19. Alcohol consumption also negatively impacts sleep duration and quality. So at a time when it seems tempting to have that evening cocktail or wine to induce sleep, the net effect is interrupted and less restorative sleep.
So what are we to do? For most of us – total abstinence is unrealistic – especially now. The question is how to incorporate some alcohol into a healthy lifestyle – and especially now! The guidelines for healthy alcohol consumption continue to stress 1 drink/day for women and 2 for men and not to exceed twice that amount in any given setting. One way of doing that is to either dilute the alcohol in each drink by making spritzers. This works for wine (inexpensive!!) as well as either sweet or dry vermouth. Or alternate a full glass of water with your drink. Add the water/seltzer to your glass rather than refilling! Try to schedule a couple of alcohol-free days/week. And consider non-alcoholic options. Here are links to a couple of my favorites:
Or check out any number of “mocktails”! One problem I have always had with these drinks is the high level of what is called simple syrup – basically liquid sugar and makes the drinks has high in sugar and calories as the regular cocktails. If you are ok with the taste of Stevia (or Stevia and Monkfruit) as non-caloric sweeteners try making your own 0 calorie syrup:
Bring 1 cup of water to a boil and add 2 Tbs of stevia, simmer until completely dissolved. Let it cool and then refrigerate.
This is a follow up on the below post from more than a year ago!! This is a great recipe to make now and works with whatever types of mushrooms you can get. The broth alone is wonderful to keep in the fridge for up to a week - or freeze! Enjoy!!
Spicy Noodle Soup With Mushrooms and Herbs Recipe - NYT Cooking 5/11/20, 4:44 PM
https://cooking.nytimes.com/recipes/1020122-spicy-noodle-soup-with-mushrooms-and-herbs?smid=ck-recipe-iOS-share Page 1 of 2
3 tablespoons canola or olive oil
4 garlic cloves, thinly sliced
2 large shallots, thinly sliced
Kosher salt and ground black pepper
1.5 .pounds mixed mushrooms, suchas maitake, oyster, cremini or shiitake, torn into bite-size pieces1 to 2 fresh red or green chiles, such as Fresno, thinly sliced (or 3/4 teaspoon red-pepper flakes)
1/2 cup low-sodium soy sauce, plus more to taste
1/4 cup unseasoned rice wine vinegar, plus more to taste
8 to 10 ounces noodles, such as udon,soba, rice or spaghetti
2 cups herbs (tender leaves and stems), such as cilantro, mint, chives, parsley or a mix, for serving
Sesame seeds, sesame oil or both, for serving (optional)
Ingredient Substitution Guide
YIELD 4 servings
TIME 45 minutes
Spicy Noodle Soup With Mushrooms and Herbs
By Alison Roman
Heat oil in a large, heavy-bottomed pot or Dutch oven over medium heat.
Add garlic and shallots, and season with salt and pepper. Cook, stirring occasionally, until shallots start to turn a nice golden brown, 3 to 4 minutes. Add mushrooms and half the chile, and season with salt and pepper.
Cook, stirring occasionally, until the mushrooms have softened, released much of their water and turned a deep golden brown, 10 to 15 minutes. (A browned mushroom will have infinitely more flavor than an unbrowned mushroom, because the water inside it evaporates and the flavorconcentrates. So do not skip this step.)
Add 1/2 cup soy sauce, 1/4 cup vinegar and 8 cups of water. Bring to a gentle simmer and season with salt and pepper. Continue to simmer until the flavors have melded and the broth tastes good enough to drink (you will be drinking it), 15 to 20 minutes. Season with more soy sauce and vinegar as you like.
Meanwhile, cook the noodles in a large pot of salted boiling water until just al dente. (The timing will depend on the type and brand of noodles, so consult the package.) Add the noodles to the pot with the broth, and let them hang out in there for a minute or two to finish cooking and soak up all that flavor.
To serve, use tongs to divide the noodles and mushrooms among bowls, then ladle the hot broth over the top. Serve with the remaining chile, the herbs and the sesame seeds and oil (if using) for people to dress their own bowls to their liking.
We are now 2 months into this pandemic and I am sure - like me- you feel like it is much longer, and worse yet- unending. There is a lot of information- and misinformation- in the media making its way into our daily lives. I've been working hard to keep up on what information makes sense and is worthwhile and what is not valid- especially when it comes to personal health and wellness. Over these next days to weeks I will be posting regular comments and updates on steps we can all take to promote our health and well being - mental as well as physical.
The best way to stay healthy and strong in this time is to make every effort to eat well and stay active - even while social distancing! The first step we can all take is to be mindful of what we are eating. By now we are hopefully getting past the "stress eating" and ready to move on from that. Think about getting rid of any unhealthy, sugary/fatty/salty comfort foods you might have turned to - and replace them with healthier options of whole fruit, nuts, whole grains, and lots of water. Eat slowly- and not too much.
Next essential step is to start- or continue- to exercise. The weather is improving so walk and walk often. Even with the sedentary lifestyle of working from home or self isolating it is so helpful to get up and walk around!
Upcoming articles will deal with more specific topics including how body fat affects vulnerability to COVID, exercise at home options, recipes, and yes- the safest way to deal with groceries and take out food. Meanwhile - leave a comment and certainly if you have a specific question let me know!
https://www.brodo.com/Here is a super easy - and delicious - dinner for one on this cold night! I started making bone broth from the brodo cookbook (marco canora) - and it great- but lots of bones to lug home, VERY greasy - lots of work- and not all of us want meat! Enter mushroom broth- this is fabulous...and so easy - once all the veggies are in the pot it cooks itself and NO GREASE! Sip it,freeze it, use it for other recipes.
So- tonight - reconstitute some rice noodles and drain, saute sliced shitakes and scallions till soft, add 1-2 cups mushroom broth and a coupe of handfuls of baby spinach. If you likehot- drizzle with chili oil! So good! And easy cleanup- what else do you need for dinner for one?
Here is a great recipe- from the Blue Zones Solution book! It is a great recipe that serves a crowd - great with a healthyish pizza - but also keeps so can serve as a base for a great lunch - by itself or add some tuna, beans, or grilled chicken!
Here is a great- and easy - way to cook skinless, boneless chicken breasts (or thighs) - cook once and then you will have them ready for the week! Use 4-6 oz pieces for single servings. Preheat the oven to 350. Clean and rinse chicken and then rub all over with seasoning of choice - try sea salt, black pepper, lemon pepper, oregano, thyme - or whatever appeals to you! Heat an oven-proof fry pan and add a Tbs of olive oil. When hot place chicken in pan just long enough to turn the edges a golden brown, flip over, and place in oven to finish the cooking. 8-12 minutes for breasts, 15-20 for thighs. If your pan is not oven-proof- switch to a baking sheet. Chicken is done when firm to the touch, and when cut juice is clear! If not eating right away, let cool, wrap in store in fridge up to 5 days.