Hopefully, you're still wearing face mask protection whenever you're out in public. Because a new commentary from one of the leading medical journals in the world suggests that face masks may not only be reducing the severity of COVID-19 cases — they could also give you immunity from the illness. But this would mean that a greater proportion of new infections are asymptomatic.
Is Illness Severity Related to Infectious Dose?
A piece published in the New England Journal of Medicine bolsters the promising yet unproven theory that universal face mask-wearing decreases COVID-19 severity in infected populations. If validated, then mass face mask-wearing could actually be a form of inoculation that generates immunity.
This information could be imperative in slowing down the spread of the deadly pandemic. Currently, the coronavirus has infected more than 3 million people in the United States alone.
Evidence has been mounting that the amount of coronavirus that someone is exposed to at the beginning of their infection — known as the infectious dose — may be the main determinant of illness severity. The Lancet has published a large study that supports this concept; it found that "viral load at diagnosis" was an "independent mortality predictor" in coronavirus patients in hospitals.
Since face masks filter out virus-containing aerosols that people come in contact with, they also reduce the infectious doses that wearers are exposed to. Consequently, this could nullify the disease's impact.
The More Face Masks Worn, the More Lives Saved
If the theory pans out, population-wide face mask-wearing could ensure more people infected with the coronavirus stay asymptomatic. Recent data supports this by suggesting that even a mild or asymptomatic coronavirus infection could be enough to yield a strong immune response.
With all this taken into account, researchers emphasize that public health strategies and coronavirus protection measures that reduce illness severity, such as mask-wearing, should also increase population-wide immunity.
You may be wondering, why is this? Because a low viral load basically acts like a vaccine; it's not enough to hurt you, but it is enough to induce an immune response in your body.
More clinical studies are needed to confirm this theory. Though, an experiment with hamsters has hinted at a connection between dose amount and disease severity. Earlier in 2020, Chinese researchers placed hamsters behind a barrier of masks. They found that COVID-19 was less likely to infect these protected critters. But the ones who did contract the virus became noticeably less sick than their counterparts without any mask protection.
Human observations also support this study's findings. For instance, a coronavirus outbreak occurred on an Argentinian cruise ship. Passengers wore surgical masks, while the staff donned N95 masks. In this case, the rate of asymptomatic infection was 81 percent. To put this in perspective, prior cruise ship coronavirus outbreaks in which widespread mask-wearing was not done only had a 20 percent asymptomatic infection rate.
More Testing Is Needed to Confirm This Theory
Dr. Monica Gandhi, an infectious disease doctor at the University of California, is one of the New England Journal of Medicine paper's authors. She emphasizes that the commentary should only be seen as a theory at the moment.
Gandhi explains to The Telegraph, "To test the variolation hypothesis, we will need more studies comparing the strength and durability of SARS-CoV-2–specific T-cell immunity between people with asymptomatic infection and those with symptomatic infection, as well as a demonstration of the natural slowing of SARS-CoV-2 spread in areas with a high proportion of asymptomatic infections."
However, Gandhi does say that, if masking does increase the proportion of asymptomatic infection, it probably also increases the population proportion who has a short-term immunity to COVID-19. If confirmed, such an insight would be priceless as the world awaits a vaccine for this sickness.
Dr. Julian Tang, a University of Leicester Honorary Respiratory Sciences Associate Professor, shares Gandhi's caution and optimism: "This idea of 'variolation' - a term originally derived from the smallpox pre-vaccine era - is quite feasible and may add to the protective physical effects of universal masking - by low-level stimulation of the wearer's immune system as it is exposed to low levels of airborne SARS-CoV-2, which can induce an immune response but without any overt infection and disease."
Wear a Face Mask!
Tang does note that the data they have seen does mirror the response normally seen from a typical vaccine. Still, both doctors emphasize that more formal studies are certainly needed to confirm whether this is true or not. And around the world, a plethora of natural experiments are occurring as we write this.
In this matter, it's always better to be prudent and conservative. So wear a face mask!
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