No Free Pass For Masks

Not All Masks Are Alike

During the pandemic, face masks minimize transmission of corona­virus contagions. If you are asympto­matic, they reduce the spread COVID-19 to others. If you are virus-free, they block much of the aero­soliza­tion of droplets that can make you sick. There are all types of face coverings that range from 1- to 7-ply. Local restric­tions generally recommend at least 2-ply. But no one is going to cut open your fabric and count layers.

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As long as the legal system exists, there will be people who either look for a loophole or challenge guidelines. Current CDC guidance allows for a limited number of health exemp­tions. If a physi­cian authorizes such, you can receive a card or badge to wear in public. But these cards are far and few between.

Physicians Resist Patient Exemptions

Doctors see firsthand the ravages of the coronavirus. They endure the discomfort of wearing face masks and full-body PPE for many hours each day. When a patent asks for an exemption from wearing a scarf or mask, doctors have little tolerance for excuses. In fact, they gain the support of colleagues who applaud them for holding the line by rejecting requests. Some physicians believe legitimate reasons for not wearing masks do not exist.

Are you are too sick to breathe through cloth? The general thinking is that if a patient cannot wear a mask, (s)he probably should not be out in public. For example, a patient on a ventilator or one who totes a portable oxygen tank is likely exempt. But then we ask, why is this person foraging for food among potentially asymptomatic shoppers when food delivery services are available?

Legitimate Exemptions?

People without chronic pulmonary problems often complain that wearing masks hinders breathing. This is true with strenuous physical exertion. A silicone breather insert helps. Even with a cloth mask, some of your breath escapes though the edges of the mask. This is most apparent near the bridge of your nose.

People who wear eyeglasses endure frequent fogging. This happens when there is a sudden temperature difference. Entering from the warm outdoors into a building with air conditioning can lower the temperature of eyeglass lenses.

There is virtually no circumstance that warrants an exemption from wearing a mask.

Pulmonologist Raed Dweik, MD, Chairman of Cleveland Clinic’s Respiratory Institute says, “We’ve taken the position that there is virtually no circumstance that warrants an exemption from wearing a mask based on lung disease. Exceptions come along with the risk of individuals endangering themselves and everyone around them.”

In the interest of public safety, experts say there are very few medical reasons preventing people from wearing masks. “If you look at the research, patients with COPD, those with restrictive airway, even those can breathe through a mask,” Constantine George, MD says. Requests for exemptions due to medical reasons are usually without basis, he says. “Obviously, if someone is incapacitated, for example, with mental health issues, that’s case by case.”

See: Behind The Mask

“Probably the most common reasons [for exemptions] are mental health issues, such as anxiety, panic and PTSD, and children with sensory processing disorders (making them oversensitive to their environment). I think there are very few pulmonary reasons,” says Mical Raz, MD, a professor in public policy and health at the University of Rochester, and a hospitalist at the university medical center. #MaskUp

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To support the writing of useful articles about this topic, ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may sponsor specific articles or remit a small donation.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online to offset expense of the writing useful articles about this topic. Slide extra posters into DeuPair Frames without removing from the wall.

ClinicalPosters sells human anatomy charts, scientific posters, and other products online. You may remit a small donation.

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