Even with no mandate, masks alongside other factors, helped reduce COVID infection rates and mortality in Japan [1]. Meanwhile, this article is grasping for a m

Even with no mandate, masks alongside other factors, helped reduce COVID infection rates and mortality in Japan [1]. Meanwhile, this article is grasping for a mechanism of toxicity when no epidemiological evidence of toxicity exists, and masks are used occupationally by millions of workers daily. There is evidence from a dedicated infectious disease hospital that elastomeric masks prevent transmission of illness: —In a dedicated TB hospital, they have used elastomeric half-face respirators with N95 filter cartridges since 1995. The filters only need to be changed once per year. —Before implementing these filters, they only used surgical masks that resulted in up to 50% of their staff becoming TST positive and 1-2% with TB disease. —Since they started using the half-face respirators, they have not had a single TST conversion. With a plausible mechanism (filtration), no evidence of harm, and some evidence of benefit with certain forms of masking, maybe what is really needed is a risk:benefit calculation. An essentially no-risk intervention plausibly reduces infection risk and all of a sudden the bar of evidence to practice basic hygiene ratchets up to randomized phase 3 studies. Meanwhile, the same people will cite this preclinical, speculative, provocation of a paper and say masking is murder. Maybe there is something deeper behind this? People don’t like government mandates and don’t want to be told what to do in general. Individualism in contrast with the collectivist self-perception that is more pervasive in Japan may be a more important factor than evidence here. This observation will anger people because they want to believe their decisions are based on evidence, when they are really driven by psychology. [1] https://www.medscape.com/viewarticle/982234 https://www.medscape.com/viewarticle/982234 [2] https://nap.nationalacademies.org/catalog/25275/reusable-elastomeric-respirators-in-health-care-considerations-for-routine-and https://nap.nationalacademies.org/catalog/25275/reusable-ela... (pages 106 to 107)