Why facemasks were not recom­men­ded despite their benefits? Case COVID-19 (2020)

An updated edition, published in January 2021, is available in series Call for Reviews, 4.

Authors:

Ali Harlin, TkT

https://orcid.org/0000-0002-9226-5991 https://isni.org/isni/0000000481145200

Pasi Malmi, HTT, vastaava kirjoittaja https://orcid.org/0000-0002-2303-417X https://isni.org/isni/0000000065081586

Vesa Kirjavainen, FM https://orcid.org/0000-0001-6664-8406

Marja Rissanen, TkT https://orcid.org/0000-0002-5466-7543 https://isni.org/isni/0000000484880219

Thomas Brand, MSocSc, MA https://orcid.org/0000-0002-4559-1153

Published in series Call for Comments, ISSN 2736-9412

This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords General Finnish ontology YSO:

coronaviruses ; civilian crisis management ; COVID-19 ; epidemics ; pandemics ; political decision making ; protecting oneself

Keywords MESH:

Personal Protective Equipment ; Masks

Abstract:

The benefits of facemasks have been verified in dozens of filtration studies, aerosol simulations, population level simulations, country specific mortality statistics, observational studies, and even in a large body of RCT studies.

Already the technical measurements show that the best surgical masks filter 95% of aerosol particles on the range of 0.1–3 microns, while the best woven cloth masks filter about 60–70%. When compared to other non-medical interventions, masks seem to be more effective than cough etiquette or increasing safety distance by 1 meter, and at least equally effective as the frequent washing of hands. The studies with human subjects and populations have shown that countries without diligent mask usage have suffered for twice as big infection rates and mortality rates.

Although the medical pros and cons of facemasks have been studies for decades, very few harms and side effects have been found. These tend to be on the equally low severity level as the harms of washing hands, cough etiquette and social distancing, or are not supported by empirical evidence like the hypothesis about masks causing their users to touch their face more frequently.

This report contains a thorough review of existing medical literature and extends it to technical analysis (filtration, aerosols), social sciences, cultural studies, administrative sciences and economics: For example, by explaining, why Abaluck & al (2020) estimate a $6.000 economic gain per citizen in countries where mask usage is diligent.

At the end, the report analyses the administrative, political and cultural discourses that lead to Finland and Sweden being some of the last countries in the world to recommend facemask usage and to instances in which Finnish schools and enterprises actually forbid mask usage, based on a suspicion that they can be dangerous. The central mask-negative discourses were found to be the political “we do not have enough masks for healthcare professionals” argumentation line, the bureaucratic discourse, occupational health discourse, the exaggerated Cochrane paradigm of EBM, and the culturally conservative (xenophobic) discourse. The analysis of these discourses was made by using memetic discourse analysis as its central method.

This publication has been replaced by a later edition in January 2021: Call for Reviews, 4.  For archieving purposes, also the earlier Call for Comments edition  is maintained available for PDF download.