Every once in a while an idea comes to mind, where I go: “Huh… that’s interesting.” I call those ‘my brain farts’. And I just had one I’d like to share with you.

Face mask debate

In my country, The Netherlands, there is a debate raging about face masks (in Dutch they’re called “mondkapjes”). And unfortunately, the debate is getting quite polarized. President George W. Bush, in an address to a joint session of Congress on 20 September 2001 said, “Every nation, in every region, now has a decision to make. Either you are with us, or you are with the terrorists.” It’s sort of like that. You are either for or against face masks . Nothing in the middle. But oddly enough nobody is really talking about face shields. I’ll get back to this later. The entire country is expecting the government to instill a mandatory face mask directive. See this posting on our government’s website. Public areas, schools, people that work in close proximity, etc… all will need to wear a face mask. Or else…

Recognizing aerosols and humidity

Then there is the ongoing struggle I am having to get people to buy-in to aerosols as the 3rd (and in the fall/winter, the most important) transmission route of SARS-CoV-2 (COVID-19). For some inexplicable reason all scientific facts, studies, papers and aerosol experts are being ignored. Let alone that people buy-in to my claim that humidity is the predominant factor that contributes to aerosol formation. What sometimes annoys me is that many of the renowned experts (looking at you Jacco Wallinga), that I actually admire, have done a complete 180. This, despite their earlier publications.

Recap of current RIVM (Dutch CDC) and Dutch government thinking

Right now, the dominant thinking by our ‘leaders’ is that (i) direct human-to-human- and (ii) respiratory droplet infection are the two main attack vectors. Hence the ‘Social Distancing’ and ‘Hygiene’ recommendations. Which – and I can’t say this enough – I agree with. I just keep saying:

“There is also a third. It’s Airborne transmission and its caused by low humidity”

Face Masks and Face Shields

Face masks (supposedly) protect against (i) direct transmission, (ii) respiratory droplets (ie. droplets that fall on the ground within 2 meters/6 feet) and (iii) airborne transmission.

  • Pro’s (compared to a face shield): Protects against aerosols;
  • Con’s (compared to a face shield): High CO2 concentration, breathability issues (see COPD patients), conversation issues (can’t see mouth), less non-verbal expressions, can cause skin irritation (during prolonged use).

Face shields (supposedly) protect against (i) direct transmission and (ii) respiratory droplets (ie. droplets that fall on the ground within 2 meters/6 feet). But NOT AGAINST (iii) airborne transmission.

  • Pro’s (compared to a face mask): Less CO2 concentration, better breathability (see COPD patients), no conversation issues (can see mouth), better non-verbal expressions, won’t cause skin irritation (during prolonged use)
  • Con’s (compared to a face mask): Won’t protects against aerosols;

The Brain Fart

If our ‘leaders’ truly only believe in transmission through I (direct) and II (droplets), then they should change the upcoming law to direct the use of a face mask or a face shield. Because you either believe in aerosols or you don’t. If you don’t treat a face mask and a face shield as equally protective you are basically admitting that you know full-well about aerosols. And then you should change the guidelines so that locations implement proper measures that deal with the 3rd route. I only wish a journalist would ask this question.

There’s a saying: “You can’t have your cake and eat it too“.

Edsard Ravelli