On October 28, 1918, a San Francisco horseshoer named James Wisser urged a street corner crowd to throw away their masks in defiance of a local mask mandate issued a few days before. He was shot twice after resisting a local health inspector’s attempt to force compliance. At that time, most of the medical community believed that cotton gauze masks were useful in slowing infection rates, but dissenting voices felt that the masks had no effect. And others, like a prominent Santa Barbara, California physician named James Bainbridge, who stated that “the common use of the mask tends to propagate rather than check influenza.” The thing that is most clear in retrospect is that infection and mortality rates continued to spike and subside until the microbe itself mutated into a milder form.
Our understanding of respiratory diseases is vastly improved since the days of the Spanish flu. At that time, we did not know whether the pathogen was a bacterium or a virus, or about the genetic role of DNA and RNA. Antibiotics and antiviral drugs were a long way away. Today our risk when we get sick is lower than a century ago, but it is still severe, so we continue to look for better ways to protect ourselves from getting infected.
Unfortunately, it isn’t easy to stop the movement of things as small and airborne as viruses. They can pass through all but the smallest gaps, leaving the barriers we set up only partially effective. The uncountable viruses that are stopped collect, and the barriers become unsafe, and the viruses that get through continue in their mission to spread.
A recent South Korean mask study has gained attention by showing that KN94 masks can expose users to dangerous levels of harmful compounds. This news is concerning for people who wish to wear a mask and leads to a difficult risk/benefit choice. But in a close read of the study, beyond the headlines, it is noteworthy that only 14 masks were reviewed and that waiting 30 minutes between opening the package and wearing the mask dissipates most of the harmful chemicals. Choosing to wear a mask is and should remain a choice of informed individuals.
But some public health officials are considering declaring new mandates. They are seeing a dual threat to the public. The Australian flu season, which is consistently a preview of our flu season, has been harsh this year, and the vast majority of cases are in children. Concurrently a new strain of COVID-19 is causing cases and hospitalizations to spike again. From July to October, hospitalizations rose 65 percent. And public health officials cannot ignore the facts or simply trust that current treatments like anti-virus drugs like Tamiflu and Paxlovid will be sufficient for many of people who will get sick.
We can still do a better job at reducing infections through barriers. Using a production process for materials comprised of very small fibers, called electrospinning, a 2021 study found that masks and filters made with electrospun material captures virtually all coronavirus-sized particles. Even the best respirator masks and high-efficiency filters fall far short of that efficacy.
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 have been studied since the 1960s for anti-microbial properties, and in addition to capturing viruses, is fully effective at deactivating them.
As the fall respiratory disease season builds, it would be a mistake for officials to re-impose 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 in making rational choices and helping to improve access to the new technologies that work well and can be chosen through reason rather than fear.
Ken Blaker is a Los Angeles-based health care and technology consultant focused on medical devices and FDA compliance. As an author, Ken has written on a variety of topics, including treatments for neurodegenerative diseases, cancer research, and the opioid epidemic.