# 3580
The debate over the effectiveness of simple surgical facemasks for protection against influenza has been a long, drawn out, and contentious one.
The `conventional wisdom’ has been that surgical masks are too porous to stop aerosolized virus particles, and therefore not protective. Only properly fit tested N95 (or better) respirators, they claim, are effective in preventing infection from influenza.
N-95 Respirator Surgical Facemask
And I’ve no doubt that N95 respirators are more protective than surgical facemasks, and certainly more appropriate in a health care setting as protective equipment.
I’ve always felt, however, that if the choice however no mask, or an inexpensive surgical mask, I would personally opt for the facemask.
Admittedly, there hasn’t been a lot of data one way or another on this issue, although over the past few years we’ve seen a number of studies that strongly suggest that facemasks, when used consistently, may be more protective than previously thought.
Some of my previous blogs on this subject include:
Study: Facemasks Reduce Transmission Of Respiratory Viruses
Who Was That Masked Man?
Any Mask In A Viral Storm?
While not advocating the use of facemasks in public, the CDC has released guidelines for caring for flu victims at home that include the use of facemasks in some circumstances.
Interim Guidance for Novel H1N1 Flu (Swine Flu): Taking Care of a Sick Person in Your Home July 8, 2009
And today we learn of a new study which appears in the Annals of Internal Medicine that once again supports the idea that the use of facemasks in the home, when a family member has the flu, can reduce the transmission of the virus.
Facemasks and Hand Hygiene to Prevent Influenza Transmission in Households
A Randomized Trial
Cowling, Chan, Fang, Cheng, Fung, Wai, and others
6 October 2009 | Volume 151 Issue 7
Conclusion:
Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset.
These findings suggest that nonpharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza.
In an article that appears on the CNN website tonight, entitled Study: Face masks seem to protect against flu, the lead author states:
"Many people believe that coughs and colds are so infectious that there is really no stopping them, however hard we try," says Benjamin Cowling, Ph.D., the lead author of the study published this week in Annals of Internal Medicine. "Our results suggest that is not the case, and, in fact, transmission can be effectively stopped with just some simple precautions."
The best results were obtained by those who began interventions early, when someone in their household came down with the flu. Hand washing and the wearing of facemasks, together, produced the best results according to this study.
The CNN report goes on to say:
In tandem with hand-washing, face masks seem to work better than hand-washing alone, but the authors could not conclusively prove which intervention was responsible for the drop in infections of family members
While this study supports (but doesn’t overwhelmingly prove) the idea that facemasks are protective, there’s major hitch to all of this:
We have a limited supply of facemasks, and the demand for them will no doubt soar over the next couple of months.
I seriously doubt that manufacturers will be able to keep up with the demand and shortages this fall are all but guaranteed.
So don’t expect any strong recommendations from health officials to run out and buy masks. There simply aren’t going to be enough to supply the needs of the nation, and the world.
Of course, there’s nothing to stop you from buying a box or two of surgical masks right now, while they are still plentiful and easy to obtain.
Just don’t be surprised if that window of opportunity closes over the next few weeks.
I’ll present a potential alternative to store bought disposable masks in an upcoming blog.
