Masks - Covid-19 - HCQ - Let's Debate
- Dr. Stephen Smith
- Sep 3, 2020
- 3 min read
"It would be nice if there was better data regarding masks. Honesty and open discussion is always the best.Masks reduce droplet and aerosol transmission. No discussion or controversy about that. Droplets and aerosols are the principal mode of transmission. Masks also remind people that there is a problem and times are not normal to take precautions."
So, the point is that masks have been studied with influenza and NOT worked.
Surgical masks do not reduce aerosolized particles, even if the exhaled breath goes through them, since the pores are too large.
N95 masks are designed to catch and block aerosolized particles. Surgical masks were not designed for this purpose. They were designed to catch a surgeon's spit or sneeze, hence the name.
Most people don't even breath through a surgical mask.
The vast majority of the exhaled breath goes around a surgical mask and, therefore, re-directs the droplets or fomites, but does not reduce them.
Regardless, clinical data are the most important thing, by far.
And the clinical data that do exist do not support the use of surgical masks to prevent the spread of respiratory viruses.
As mentioned in the post, the fact that putting on surgical mask after your household member developed symptoms didn't protect you means that masks don't work.
That's pretty damning evidence and that is with this virus during this pandemic.
Yes, people can spread before symptoms develop, but they have the highest viral load in the first few days of symptomatic illness and are most contagious during this period.
"Masks are part of the solution not the entire solution. There has been no demonstrated risk to using masks (unlike hydroxychloroquine)."
First, no one has studied the safety of surgical masks in the community.
How many car accidents have occurred because someone was distracted by mask-related activities?
Similarly, how many headaches or other symptoms have developed?
How many people have had anxiety attacks from the claustrophobia caused by wearing a surgical mask?
How many acts of violence have occurred because one stranger told another to put on a mask?
Just because it hasn't been studied, doesn't mean it's a safe practice.
Every intervention causes some issue or problem.
The law of unintended consequences guarantees that.
By the way, the HCQ prophylaxis study from India proves HCQ prevents Covid-19.
The study has controls, was on pre-exposure prophylaxis and tested people in this study. The study by David Boulware in NEJM tested very few subjects and was post-exposure prophylaxis, meaning after a HCW was exposed to someone with possible Covid-19.
In this study on Indian HCWs, the HCQ protection was only seen after 5 doses. This makes a lot sense. The researchers used a very small weekly dose of HCQ, but, since HCQ's 1/2 life is very long, the HCQ level built up with each successive dose. So, these data fit and say you need to take about 2,800 mg of HCQ before you seen an effect.
This isn't a lot of HCQ by the way.
Lupus pts take 400 mg or more per day for life.
HCQ levels increase each day for over 7 months, until steady state is finally reached.
In other words, lupus pts have much higher levels of HCQ than the Indian HCWs in this study.
I don't know how anyone argues with these data.
The US press hasn't argued or criticized them, they have simply ignored them.
"There has been no demonstrated risk to using masks (unlike hydroxychloroquine)."
What risk has HCQ been demonstrated to cause? I have treated over 200 Covid-19 pts with HCQ. I know of no AE's (adverse effects) in these pts. Two pts stayed on HCQ after they recovered from Covid, because it helped their arthritis, an unintended consequence for sure.
The US press, some of it at least, has simply lied about HCQ's safety profile.
If you don't believe me, go to www.ClinicalTrials.Gov and search for all of the FDA approved HCQ trials. The FDA has approved several hundred studies of HCQ over the decades. More recently, they have approved 120 HCQ studies on things other than Covid-19 and 59 Covid-19, HCQ studies. All of the non-Covid-19 HCQ studies use more cumulative HCQ than any Covid-19 pt gets. None of the studies require monitoring of ECGs.
What is the demonstrated risk of HCQ?
Why hasn't the FDA immediately halted the 179 HCQ studies to evaluate safety?
Why hasn't the FDA demanded that each of these 179 studies include ECG monitoring?
So, let's debate, openly and honestly.
Stephen M. Smith, M.D.
I will add this post to the Forum section to encourage debate and responses.
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