Why do some people still think they shouldn’t wear a mask to help control the COVID-19 pandemic?

The usual suspects…
Confusion About Face Masks and COVID-19
Much of the confusion about face masks stems from the fact the initial guidance from the WHO and CDC said that wearing a mask wasn’t necessary for everyone.
“Wearing medical masks when not indicated may cause unnecessary cost, procurement burden and create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices. Furthermore, using a mask incorrectly may hamper its effectiveness to reduce the risk of transmission.”
Advice on the use of masks in the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak – WHO Interim guidance January 2020
Using a mask incorrectly?
If you are going to wear your mask under your chin or with your nose or mouth exposed and think you are protected and not social distance, then wearing a mask might actually get more people sick. With little information that masks were helpful, this fear that they would create a false sense of security likely influenced initial guidance.
Experts were likely also concerned about a limited supply of medical masks at the time.
Of course, as we have gotten more information about the SARS-CoV-2 virus and how it spreads, that guidance about face masks changed.
“CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.”
Use of Cloth Face Coverings to Help Slow the Spread of COVID-19 (April 2020)
We know that the best way to avoid getting COVID-19, at least until we get a vaccine, is going to be trying make sure you are never exposed to the SARS-CoV-2 virus. In addition to social distancing and washing your hands, wearing a face mask correctly will help to decrease your risk of exposing others. And if those around you are wearing a face mask, then they won’t expose you!
What to Know About Face Masks and COVID-19
But what about the idea that the pore size of the masks are too big to stop the small size of the SARS-CoV-2 virus?

The thing is, the SARS-CoV-2 virus, while it is very small, isn’t just floating around in the air by itself! It gets carried in and on larger respiratory droplets.
And if the mask blocks those respiratory droplets, then it should keep you from exposing others to the SARS-CoV-2 virus.
What about the claim that face masks cause folks to breath their own carbon dioxide, even leading to breathing problems?

Most folks realize this isn’t a real problem, after all, health professionals wear face masks all of the time without any problems, right?
But just think about these arguments…
On the one hand, they are worried that the pore size of face masks won’t block out the SARS-CoV-2 virus, which is about 0.1 μm in diameter.
But then they think these very same face masks will block carbon dioxide? How big are carbon dioxide molecules???
They are about 1000 times smaller than the SARS-CoV-2 virus…
So a face mask is not going to affect your ability to breath well.
Who Should Not Wear a Face Mask
Not surprisingly, a face mask is even recommended for folks with asthma, as long as their asthma is well controlled.
“There is no evidence that wearing a face mask makes asthma worse.”
AAAI Recommendations on the use of face masks to reduce COVID-19 transmission
Infants and toddlers under age two years can skip wearing a face mask because of the risk of suffocation, as can “anyone who has trouble breathing, is unconscious, incapacitated or otherwise unable to remove the mask without assistance.”
If you have “trouble breathing” though, you likely have a severe respiratory condition and you aren’t simply someone who doesn’t want to wear a mask.

And there are no face mask exemptions under the Americans with Disabilities Act (ADA).

Are you ready to put on a mask now?
Since we are seeing higher rates of COVID-19 in states that don’t have mask mandates, the only confusion should be over why anyone still won’t wear a mask when they are around other people.
More on Controlling COVID-19
- Who Are the Real COVID-19 Experts?
- Why There is Still So Much COVID-19 Confusion
- What to Do if You Have Been Exposed to COVID-19
- What to Do if You Have Been Diagnosed with COVID-19
- COVID-19 and mask confusion: Separating myths from realities
- Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus
- AAAI Recommendations on the use of face masks to reduce COVID-19 transmission
- FACT: The prolonged use of medical masks* when properly worn, DOES NOT cause CO2 intoxication nor oxygen deficiency
- CDC – How to Safely Wear and Take Off a Cloth Face Covering
- ADA – COVID-19 ALERT: Fraudulent Face Mask Flyers
- MMWR – Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After Exposure at a Hair Salon with a Universal Face Covering Policy — Springfield, Missouri, May 2020
- Study – Community Use Of Face Masks And COVID-19: Evidence From A Natural Experiment Of State Mandates In The US
- Study – Association of country-wide coronavirus mortality with demographics, testing, lockdowns, and public wearing of masks
- WHO – Advice on the use of masks in the community, during home care and in health care settings in the context of the novel coronavirus (2019-nCoV) outbreak: interim guidance, 29 January 2020
- WHO – Advice on the use of masks in the context of COVID-19: interim guidance, 6 April 2020
- WHO – Coronavirus disease (COVID-19) advice for the public: When and how to use masks
- WHO – Q&A: How is COVID-19 transmitted?
- CDC – Use of Cloth Face Coverings to Help Slow the Spread of COVID-19
- CDC – CDC calls on Americans to wear masks to prevent COVID-19 spread
- CDC – COVID-19 Frequently Asked Questions
- Claim that N95 masks can’t stop COVID-19 particles due to size is nonsense
- Universal Masking in the Covid-19 Era
- Study – Quantitative Method for Comparative Assessment of Particle Filtration Efficiency of Fabric Masks as Alternatives to Standard Surgical Masks for PPE
- Visualizing Speech-Generated Oral Fluid Droplets with Laser Light Scattering
- No, the Americans With Disabilities Act doesn’t say shop owners have to let maskless people into their stores
- Dr. Cammy Benton: An antivaxxer plays the “both sides” card on masks for COVID-19
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