World Monitor Magazine, №1/2020 WM_March 2020_FOR WEB (12.03.) | Page 48

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FIGURE 7. Major route of viral entry is likely via large droplets that land in the nose — where expression of the viral entry
receptor, ACE2 is highest. This is the transmission route that could be effectively blocked already by simple masks that pro-
vide a physical barrier.
The viral replication in the nasopharygeal mucosa may also
explain positive tests in the prodromal stage and transmis-
sion by healthy carriers, and perhaps the anosmia seen in
early stages of COVID19. But this biology also means: avoid-
ing large droplets, which cannot enter the lung anyway but
land in the upper respiratory tracts, could be the most effec-
tive means to prevent infection. Therefore, surgical masks,
perhaps even your ski-mask, bandanas or scarf, may afford
more protection than portrayed by governmental official in
their initial (understandable but unfortunate) recommenda-
tion against wearing of masks by the public in general. N95
respirator masks may offer relatively little additional protec-
tion than thought. (To be fair, the CDC suggests use of scarf
by health care providers as last resort when no face masks
are available).
From a practical and societal point of view, surgical or self-
made masks, if handled properly, will at worst not hurt and
may at best, help. (Make sure to discard or launder after use
without touching the outward surface). These simpler, inex-
pensive masks may suffice to help to flatten the curve, per-
haps a bit, perhaps substantially. Importantly: using them will
not take away valuable N95 respirator masks from health
care workers.
THE IMPLICATIONS
It would be tragic if the wrong logics and mechanics and biol-
ogy, which has led Western governments to not encourage, if
not stigmatize the wearing of masks, may have contributed
to the steep rise of COVID-19. Given that the upper respi-
ratory tract is the major site for SARS-Cov-2 entry into hu-
man tissues, wearing simple face masks which exert a barrier
function that blocks those big projectile droplets that land in
the nose or throat may substantially reduce the production
rate R, to an extent that may be comparable to social distanc-
ing and washing hands. This would then double the effect of
mitigation in “flattening the curve”!
Looking forward: if we are soon loosening the lockdown due
to the political pressure to sustain the economy, perhaps en-
couraging face masks to be worn in the public would be a
good compromise between total lockdown and total freedom
that risks resurgence of the invisible enemy. There is now a
robust scientific basis for putting an end to the officials’ anti-
surgical mask hysteria and to recommend or even mandate
a broad use of masks as in Asian countries that have bent
the curve.
Written by Sui Huang, Institute for Systems Biology