Updated: Nov 23, 2020
By Amy Hornblas
Contact: Amy Hornblas
Vermont Mask Survey
P.O. Box 55
Marshfield, VT 05658
MORRISVILLE – 10.29.20
The negative health effects of wearing masks by health care workers has been well-documented, yet research on the effects of mandating masks among the general public has only just begun. Mask use in medical settings is very different than is being practiced in the community. For example, medical professionals are trained in proper hygiene and mask use, and work in sterile environments. Even with professionals, in those environments, there are concerns that masks could be causing more harm than good.
While there is a lot of discussion about whether or not mask use by asymptomatic people may be helpful in reducing the spread of SARS-CoV-2, we cannot do a full analysis if we are unable to also measure the health risks associated with their use.
Vermont health officials do not seem to be collecting data to help us assess this side of the equation, and The Vermont Mask Survey hopes it will inspire such research and assessment to begin.
On June 5th, the World Health Organization released a report which stated: “At the present time, the widespread use of masks by healthy people in the community setting is not yet supported by high quality or direct scientific evidence and there are potential benefits and harms to consider.” The report also advised that decision-makers who choose to recommend mask use in the community should continue collecting scientific evidence and “evaluate the impact (positive, neutral or negative) of using masks in the general population (including behavioral and social sciences).”
How could we begin evaluating the negative impacts on Vermonters in the general public?
In my travels this spring gathering essential items and talking with essential workers, I heard that a lot of suffering was going on. Due to wearing masks all day, workers were plagued with headaches, had difficulty breathing, and pre-existing conditions were worsening. A few told me that on their days off, they would no sooner begin to feel better, and then they’d have to return to work to start suffering all over again. Unable to quit their jobs, I heard they felt trapped and, worst of all, were left suffering in silence, as nobody wanted to hear about this side of equation.
As a health educator who has had experience creating surveys and evaluation tools, I decided to help gather data. The result was The Vermont Mask Survey, which began gathering date in July. The stated purpose of the survey “is to begin compiling evidence in order to better evaluate the potential health hazards Vermonters are risking as a result of universal mask recommendations.”
Naming the health difficulties The seven health difficulties asked about in the survey were based on the “likely disadvantages” most commonly cited in the research (WHO, 2020, p. 8):
2. Difficulty Breathing
3. Skin Irritation
4. Difficulty Communicating Clearly
5. Physical Discomfort
6. Mental/Emotional Discomfort
7. Difficulty cleaning your hands every time you touch your mask
Participants were asked to report how often they experienced each of the difficulties when wearing a
mask: every time, half the time, occasionally, or never.
From July through October, about fifty posters advertising the survey were hung on bulletin boards in ten counties across the state. Respondents were referred to a website, where the survey could be found and either emailed or mailed in. In the first three months, 62 individual survey responses were received. Twenty-one reported experiencing difficulties every time they wear a mask, 31 occasionally, and ten never. The initial findings of the survey are available in a newly released report.
By the numbers
Data gathered from this survey demonstrates that a number of Vermonters across the state are suffering multiple health difficulties as a result of wearing masks. For example, the survey discovered that respondents who experience difficulties “every time” are also experiencing three or more of them at a time. Several survey respondents reported they are not accessing essential services in their communities because they cannot wear a mask.
The report cites several studies which demonstrate that people with pre-existing conditions are at a greater risk of complications from wearing masks, and several survey responses confirmed this. Respondents reported a worsening of pre-existing conditions, including: asthma, breathing problems, a heart condition, and post traumatic stress disorder (PTSD).
One respondent commented: “When I have to wear a mask for a longer time (more than 15 minutes), like when grocery shopping, working, hair cut, my heart condition that I had been able to control the past two years with diet and exercise starts to come back. I’m worried this will come back permanently.”
One respondent reported that she is pregnant, and she finds her oxygen levels drop when she wears a mask. This impact has been confirmed by research cited in the report, and is one example given for the need for further study and public awareness.
The health issues related to masking
It is not surprising that difficulty breathing would be a common complaint, and survey respondents who have difficulties every time they wear a mask all had difficulty breathing every time.
The N95 mask, which has been created for optimal airflow, still restricts airflow by about 37%.
How much is breathing restricted by the masks people are wearing in the general public today? How is the restricted airflow impacting brain function and growth, especially for vulnerable people, such as older folks and children?
We know that restricted breathing caused by diseases such as asthma and COPD can also lead to serious, long-term health hazards. Are masks, in essence, forcing healthy people to take on the same risks posed by chronic diseases? For those folks whose breathing is already restricted, what does restricting it another third doing to their underlying conditions?
Difficulty cleaning hands every time you touch your mask was, far and above, the most common complaint among respondents who experience difficulties only occasionally. This finding is in line with the recent findings about mask hygiene published in a study of students in Poland.
Due to the fact that the mask is worn on the face and is collecting viruses and bacteria, the risk of spreading of all types of viral and bacterial communicable diseases actually increases each time a person touches their face. Hygiene is the most important step in mask use in any setting, and the fact that most of our survey respondents have difficulty with it demonstrates that the risk of infection is being increased with universal mask use. In fact, the skin irritation caused by masks (called maskne)actually increases the risk of contamination, because of the increased touching caused by the itching and discomfort.
Research cited in the report also shows that the longer a person wears a mask, the more likely they are to experience complications. This was confirmed by the survey results. Among respondents who experience difficulties “every time” they wear a mask, two-thirds of them are required to wear a mask at work. Over half of those wearing them for work wear a mask five or more days a week, and between five and eight plus hours each day.
Aside from the obvious quality-of-life issues suffered by the survey respondents, there are also serious
long-term health consequences associated with the difficulties they describe. The physiological reasons
for the symptoms, and their long-term consequences, are not yet understood, hence the need for more research.
For example, dizziness was a complaint that was noted in the survey results. While experiencing dizziness can have its own hazards, such as falling down and getting hurt or making mistakes due to disorientation, there can be serious underlying reasons that are causing our bodies to signal us that we are in danger.
As one study of PPE use and its complications among health care workers pointed out:
“Dizziness is an important warning sign, as it can be caused by dehydration, hyperventilation (gasping for breath), elevated carbon dioxide [CO2] levels in the blood, low blood sugar, and anxiety, among other things.”
Evidence of stigma
The survey also uncovered evidence of of a stigma. Threats and abusive responses were received in attempts to discourage the survey altogether. Posters advertising the survey were repeatedly removed from bulletin boards. There appeared to be attempts to skew the data by some of the respondents who reported either “never” or only “occasionally” experiencing difficulties. These issues are more fully explained in the report.
The report’s press release has been sent out to nearly every news outlet in the state, yet only a few have been willing to cover the issue. Front Porch Forum cites their coronavirus policy as the reason for not printing the announcement, but will not clarify which part of the policy they feel the report violates. VT Digger refunded my money and refused to publish the press release, citing it “falls into the category of misinformation about public health issues.”
Unfortunately, the stigma is not only thwarting attempts by professionals who want to address the issue, but is a very real, palpable thing in the community that is further hurting those who are suffering the most. The advice from the CDC, WHO, OSHA, and most other published directions about mask use all warn that some people should not wear masks, and the Governor’s Mask Mandate allows for exemptions for people who cannot wear masks, yet many businesses and schools, as well as essential services such as libraries, public transportation, and medical facilities, are requiring their use by all staff and clients, regardless of the health risks. This is creating confusion and confrontation. How many employers feel compelled to enforce masks on their employees and customers, even when they are aware of the harm they are doing, in order to avoid losing business due to the stigma? How can we reduce the stigma so that people can better understand the risks masks pose to their neighbors?
More questions than answers
The survey raises a number of questions, such as: What percentage of the population is suffering to the same degree as the survey respondents? Are some segments of the population suffering disproportionately, such as children, elderly, or the working-class? How much do these negative impacts undermine the community’s overall resistance to disease?
The purpose of the survey is to encourage more research. For example, useful data could include tracking how many people are being denied medical exemptions by their physicians, and how those patients’ health conditions are progressing since they were denied. Schools already track the health conditions students are reporting to school nurses. Data such as this should be collected and examined on an ongoing basis so that we can understand the health effects and react in time.
The Vermont Mask Survey Fall Report has been sent to all the state departments of health, the health commissioner, and most of the departments in the state. As of this writing, only the department of health in Burlington has responded. The hope is that more public awareness will pressure public officials into taking their responsibility of assessing and addressing the associated health hazards seriously.
Survey responses will continue to be collected through the winter. Copies of the survey and the full report are available on the website: vtmasksurvey.com
For a more in depth discussion about the Vermont Mask Survey, watch Amy Hornblas's interview with Allison Teague at Conversations with Vermonters and Beyond HERE! Or click below:
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